sharp pain under kneecap

ddraver

Hi Guys

I ve been Training for a 300km ride and have done 2 long weekends now (220 last, 160 this). This weekend my kneecap started to feel like someone was gently working a knife into the underside of my kneecap from pretty much km 0. The sensible thing to have done would have been to stop obviously but of course I didnt and by the end of the ride it was really very uncomfortable and is still not very nice today. Ive never really suffered with knees before now so I'm not really sure what i could have done.

Any ideas? Ma and Pa raver are visiting next weekend and are Docs so I can get them to have a poke around and it will be a weekend off the bike but does anyone have an ideas in the mean time? I guess I need to stretch it a bit better or something.

diy

Sounds like tendonitis - google patellar-tendonitis or Anterior Cruciate Ligament. if its this, I'm afraid you wont like the treatment.

I don't know how old you are, but as we get older it always seems to be the tendons and ligaments that can't keep up with the muscles.

Stretching probably wont fix it, but it may respond to taping. Tendons take a few months to heal and need to be rested. Of course nobody listens to that (including me) which is why I have extremely painful elbows today after doing back & biceps day in the gym yesterday.

ugo.santalucia

I suffer from that fairly regularly... what I have found useful:

1) Stretch your quads at every opportunity before, during and after the ride

2) Don't wear tights, or if you do cut a hole around the knee cap... the pressure makes it worse

3) change your gearing... you need to use much lower gears... forget about those 11-25 cassettes and get an 11-32 instead... and use it!

ddraver

hmmm, doesnt sound good

Hopefully this was just a one off and I need to rest up for a bit and be a bit more careful

ugo.santalucia

ddraver wrote:

hmmm, doesnt sound good

Hopefully this was just a one off and I need to rest up for a bit and be a bit more careful

It will happen again, no point in hiding the head in the sand.

Out of 16 people who did the raid Pyrenees with me, 4 had the same problem to various degrees. It's down to riding "too hard" for too long. Typically climbs are the killer, hence my advice to gear more conservatively. My left knee has improved substantially since I fitted a 36 x 30 and then 36 x 34... I did a 100 miler with 2400 mt of climbing last week with no pain, which is encouraging.

ai_1

A possible alternative cause is an issue with patella tracking which I suffered with for a while. It caused pain behind and below the kneecap. Although it may have been a different issue to what Ugo's talking about I had a similar experience with tights making it worse.
As I understand it patella tracking related problems are usually due to stabilising muscles around the kneecap being unbalanced and causing slightly irregular movement of the kneecap which with constant repetition causes inflamation and pain. Strengthening of the knee and a switch to speedplay pedals to allow more free movement of the knee helped me.

diy

I agree - Unchecked it just slowly gets more painful. Anti-inflammatory pain killers can help

ddraver

Yes I don't mean it will never ever happen again, just that it may need to recover now and then I can start more realistic training. ie it's a warning that I need to be careful rather than a permanent injury from 1 ride

edit - and another K up the A that I need to stretch!

diy

You don't stretch after a ride? :shock: :shock:

ai_1

diy wrote:

You don't stretch after a ride? :shock: :shock:

Sometimes! :oops:

Even worse I often don't stretch properly after running which is much more prone to cause problems.
Must do better!

ddraver

I ve never really had to diy - As I'm 31 next Sunday I may have to finally admit that my 20s are over and I need to be more careful about these things

ugo.santalucia

ddraver wrote:

I ve never really had to diy - As I'm 31 next Sunday I may have to finally admit that my 20s are over and I need to be more careful about these things

Not sure why I built this image of you being an old fart... must be because you talk like one... 8)

On a more serious note... best to stay off the bike for a full week and reassess after that. It normally takes me 3 days of rest to get rid of the inflammation

ddraver

How very dare you! Did you not see my sexy Genesis?!!!

diy

It takes 3 to 4 mins. to do a quick cool down stretch. and 15-30 mins for a body stretch. It helps to stop your muscles getting progressively tighter, tugging on the tendons more and more.

My mate threw some together with me on utube:
https://www.youtube.com/watch?v=QgEbH31FbWs - post cycle 3-5 min
https://www.youtube.com/watch?v=WElIDKxmyQo - 1 or 2 times a week - body stretch.

She's also about your age. though she'll kill me for posting that on the internet.

Most of my suffering now is down to abuse I did to my body in my 20s and late teans doing martial arts and body building. and a few motorcycle crashes :oops:

ddraver

I ve already got all of that through rugby - luckily not much of it on my legs...

ugo.santalucia

diy wrote:

She's also about your age. though she'll kill me for posting that on the internet.:

She looks much younger than Ddraver...

964cup

I get this too. From what you describe, I think it's patellar tracking irritating the patellar tendon, rather than a cruciate problem*. Things that have worked for me:

Stretching
Squats to build strength
Patellar support band (now wear one for all rides anywhere near threshold)
Raising my saddle height (by a few mm).

Last one seems counter-intuitive, but seems to be the internet consensus, and has worked for me.

Treatment once the problem has been aggravated involved rest, topical NSAID (ibuleve gel) and aspirin.

Don't try to ride through it. I did that on a 100-miler and ended up getting tibiliar anterior tendon inflammation (the tendon that moves your foot up and down, front of the shin above the ankle). That put me off the bike for two weeks and needed steroid cream to bring the inflammation down before it would settle.

* I am neither a doctor, nor a physio, just getting older and frequently injured. YMMV.

ddraver

ugo.santalucia wrote:

diy wrote:

She's also about your age. though she'll kill me for posting that on the internet.:

She looks much younger than Ddraver...

How d'ýou know? #BabyFace

(gosh, she's rather lovely...ahem... :oops: )

diy

When I first met her I thought she was about 18. Its what happens when you get old everyone looks like a child

ddraver wrote:

(gosh, she's rather lovely...ahem... :oops: )

hyper mobile (bendy) too and single, last I heard :shock: :shock:

but back on track - I'd hold off doing any strength training or development stretches until its rested as it will make it worse, if its a tendon.