Training & Nutrition - Another knee pain thread
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03-06-07, 10:05 AM
Over a year ago, I tore the miniscus (sp?) ligament under my right kneecap and had surgery.---right knee is ok for now. About 4 mo. ago I started experiencing pain behind my left knee----its that ligament or tendon of whatever right behind your kneecap----I can definately notice it is swollen and bigger than the one behind my rt. knee. I have done all sorts of stretchign exercises for my leg and have been doing leg curls, but the pain behind my left knee wont go away----it doesn't necessarily restrict my movement---nor is it "stinging" or "burning pain"----it is just a weakness--a dull ache---and hurts the most when i bend my left leg. I don't want to have to go under the knife again---but I can't really afford to pay for an MRI right now.
Anyone else ever have this type of pain in the muscle/tendon/ligament/whatever behind their kneecap? If so, what can be done to alleviate it? I have tried ice, icy hot, stretching--nothing seems to work except not using my leg. I took 2 mo. off of exercising due to work issues, and last night when riding the bike at the gym (only 20 min) it started hurting again.
Please help--i dont want to miss another cycling season.
03-07-07, 02:19 AM
Does the pain happen only when/after you move, or is it constant? One possibility that came to mind as I read your post was patellar tilt (one of the issues I have). Forgive me for not remembering the names of the muscles, but essentially the outer muscle attached to the kneecap is stronger than the inner one. As you bend your knee, the outer muscle tends to pull the kneecap toward the outside of the groove it's in, causing pain and inflammation. It's more common in women than men but can happen to anyone.
Some of the things that may help are stretching the outer muscle so it's not as tight, and strengthening the inner muscle so they both pull evenly. You can do that through leg lifts with your toes turned to the outside, or by using the machine at the gym that makes you squeeze your upper legs together against resistance. Good old ibuprofen (Advil, Motrin) can be helpful for reducing inflammation and therefore pain. Ice is generally helpful at least for bringing the swelling down- maybe ice it regularly after a workout?
I hope some of this is helpful- I understand how knee issues affect a person's life and for someone active, it's a huge bummer. Good luck!
03-07-07, 08:55 AM
So this is pain right behind the kneecap? If so, it might be chrondomalacia. I'd stop the leg curls for sure. I'd quit all lifting unless I had a qualified physical therapist show me particular exercises that she thought would help. Pain behind the kneecap usually means "raise your saddle." You can raise it as high as having about a 4mm gap below your heel with the leg completely straight. Try that and just do easy spins on the rollers or trainer for a couple of weeks.
There's a starter article on bike fit and knee pain here:
03-07-07, 09:13 AM
Thanks---when i saw pain behind the kneecap--i mean that muscle behind your kneww that connects your calf to your hammy
The last few days i stopped the weights and started doing 30 reps of wall squats with one of those big yoga ball things----that seemed to help---as well as lots of icyhot
The leg extension thing has always confused me----my doc told me to do them for my knee but I've been reading (here and other places) that leg extensions are really bad for your knees
03-07-07, 02:36 PM
OK. You said "leg curls," so that is a little confusing, too. There are two single joint knee exercises, leg extensions and knee curls. Knee curls are the ones where you lie on your stomach with the padded bar on your calf or achilles, which you curl toward your butt. Knee extensions are the ones where you sit with the padded bar on your shin and straighten your leg. I wouldn't do either one.
Most docs don't know squat about it. I had knee pain one time - went to an orthopedist who told me: sorry, you just have malformed knee caps and legs, better never exercise and just get used to a life with pain. That was uh, 10 hard cycling years ago. Another doc told me that with the tendinitis in my forearms - just sign here; I can get you on disability and you'll never have to work again. (:-)>
I'm no doctor, so I don't know much physiology, but there are three things going on behind the knee. There are the two major tendons, one each on the inside and outside of the joint. When you flex your ham with the knee bent 90° they really stick out. Then there is a large muscular pad between them that sort of joins the ham to the calf muscle. Is it one of those and if so which is it?
Sounds to me like you might just have a little tendinitis. Easy spinning and Ibuprofen. Let it rest.
03-07-07, 04:28 PM
It seems to be the muscle connecting the hams to the calf but the surrounding tendons also hurt.
I was talking about what you call as "knee curls" (my weight coach in HS called them leg curls---but 6 1/2 one half dozen another) I will definately lay off the leg curls/extensions. I have talked to some friends who also thought that doing a lot of low weight reps w/ a yoga ball or running the stairs is much better than doing high weight low reps. This whole high rep/low weight thing is new for me---in HS I used to powerlift for swimming/track/football, so I don't really know how to work out any other way.
It is just so frustrating what with the knee surgery last year and now this. That, and the fact that I am pigeon-toed (if my knees are centered on my legs my feet point in/if my feet point straight up, my knees are out to the side) seems to mean I am in for a life of cycling pain.
03-07-07, 07:51 PM
Why fixate on the weights? Drop them for a while. Don't run stairs, either. Give your knee a break! Just spin on your bike. You might also think about dropping by a bike shop that does bike fitting and having your cleats adjusted. There's a gizmo called a Rotational Alignment Device (RAD) they put on your foot while you pedal. It shows how your cleats should be affixed to give your foot a natural alignment to your knee. I personally prefer a pedal/cleat system with a few degrees of float. I'm not a bike fit guy, but my guess would be that your knee should be vertically above your pedal and your toe be allowed to point in if that's what it wants to do.
And don't tell yourself about the life of cycling pain. Get your denial in gear. It's not just a river in Africa. Just keep moving forward. Tell yourself about how strong you'll be this year because you're going to figure out how to train smarter.
I had knee surgery, same thing as you, in April of last year. I was back on the bike, spinning, in a week and by fall was having my best season ever.
Yes, cycling is very different from powerlifting. You'll have to rebuild your leg muscles almost completely. Get Joe Friel's book Cyclist's Training Bible. That'll give you something to start with. But ignore the stuff he says about doing max weight lifts for now. Just do the Anatomical Adaptation phase this year. It takes years (really!) to adapt the body to best cycling performance.
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