Training & Nutrition - Can't ride b/c knee problem

Well, I just made an appt w/ one of the better knee docs in our area (a surgeon/soccer-playing friend recommended the guy) for the last wk in June. So I have to sit tight & wait for answers, but maybe someone else has had a similar injury.

Often, my left knee can get a 'building pressure' sensation around the kneecap when I sit & spin a high cadence. But it always goes away as soon as I stand up. My seat is raised high enough so (I believed) that shouldn't be the cause of the trouble. I ride in toe-clips too.

So last weekend I did my first +40mi ride, (2 days, hilly, 115 miles). A couple of miles into the 2nd day & I felt a sensation like someone stuck their thumb under the my left kneecap. Then the pressure started in & standing didn't relieve it. This sensation was just uncomfortable, not painful but I felt like I might have to quit. Instead, I started pedaling heels-down & this seemed to relieve it. Since that ride, I am getting pressure & (it seems like) 'impingement' sensations on inner/outer sides of the patella.
I wonder, since I avoid court sports, it shouldn't be a torn meniscus/cartilage. Or can that kind of tear occur from bad pedaling form?
Bursitis? The cap's not tracking right?

The sensations range from feeling like a small balloon was being inflated (when I was riding) to these new weird impingement-like sensations (when I walk or sit or ride) on either side of the patella.
My question: Does this sound familiar to anyone?

<PS I posted last week re: a bike accident, if the handle looks familiar, but the knees were not affected, luckily. Thanks again for the advice from other forum members, I def got an education!>

Try a homeopathic clinic, and see what they say.

similar problem...pain medial side right knee, from about 2" above to 3" below kneecap. diagnosed with tendonitis/bursitis (pes anserine bursitis). i currently don't have any pain, per say, but when i have been able to ride i do have that pressure feeling which you are describing.

mine occured 5/11,12 and i was off the bike for 14days, then rode on the 26-28 for 30min at a time and the 29th for 1.5hr; 1.75hr 6/2, 2hr 6/6 and 2hr 6/9. went back to dr for followup on 6/13 and he told me to stop riding for another 4wk and if not better, then consider getting cortisone shot.

i would say limit your riding and start doing some stretches for your hamstrings, quads, hip flexors. also strengthening exercises for quads that hit your VMO muscle, which is what i've been doing for a month now.

i'm back to 30min rides, flat terrain, spinning, no big ring 3-5x week till the first of July when i finally get to do a ride on the 4th. if i have pain after that ride, shot it will be.

good luck.

Yeah Wolfpack, I am staying off the big ring for the most part (occasionally on downhills) & doing no riding besides my 3mile commute to work.

I just talked w/ a Cycling Performance doctor who was supposed to eval me in early June. We'd cancelled the appt due to the accident. He advised me to come in Monday for a Perfomance Evaluation ($75)before the knee doctor appt so we can see if it is a set-up issue & not my body per se ("physiologic testing services; treatment, and management of cycling-related injuries; technical consultation; and injury prevention").
I wonder if he'll advise I switch to clipless...

similar problem...pain medial side right knee, from about 2" above to 3" below kneecap. diagnosed with tendonitis/bursitis (pes anserine bursitis). i currently don't have any pain, per say, but when i have been able to ride i do have that pressure feeling which you are describing.

mine occured 5/11,12 and i was off the bike for 14days, then rode on the 26-28 for 30min at a time and the 29th for 1.5hr; 1.75hr 6/2, 2hr 6/6 and 2hr 6/9. went back to dr for followup on 6/13 and he told me to stop riding for another 4wk and if not better, then consider getting cortisone shot.

i would say limit your riding and start doing some stretches for your hamstrings, quads, hip flexors. also strengthening exercises for quads that hit your VMO muscle, which is what i've been doing for a month now.

i'm back to 30min rides, flat terrain, spinning, no big ring 3-5x week till the first of July when i finally get to do a ride on the 4th. if i have pain after that ride, shot it will be.

good luck.

Hello Wolfpack. Could you explain a bit more about the cortisone shot? I have been having some pesky knee pain (not a severe pain but more of an annoying and frustrating pain) in my knees that I can't seem to shake. What would the shot do to help? Thanks.

Hello Wolfpack. Could you explain a bit more about the cortisone shot? I have been having some pesky knee pain (not a severe pain but more of an annoying and frustrating pain) in my knees that I can't seem to shake. What would the shot do to help? Thanks.

can't really tell you much...haven't had it yet, but will most likely get it in the next week to week & a half. i did have a few in my shoulder back in the early 90's. for the most part they helped. the last one i got, tho, only lasted about 4wks and it was my 3rd for the year. the ortho dr wouldn't give me anymore and suggested therapy. i was a poor, single mom at the time and couldn't afford that, so it was motrin popping time. that (shoulder problem) eventually went away when i stopped doing the repetitive motion that was causing the pain - chopping line for roadway new location surveys.

anyways, you can search internet or the forums and get a ton of info that says it is bad for you and info that says good for you. it's really up to the individual to determine whether the benefits of a one-time (or two) injection is in their best interest. for me, i just want the inflammation gone in the bursa and to be able to ride again. hopefully, i won't have to get more than one.

i'll let you know my results later.....

...
Often, my left knee can get a 'building pressure' sensation around the kneecap when I sit & spin a high cadence. But it always goes away as soon as I stand up. My seat is raised high enough so (I believed) that shouldn't be the cause of the trouble. I ride in toe-clips too.

So last weekend I did my first +40mi ride, (2 days, hilly, 115 miles). A couple of miles into the 2nd day & I felt a sensation like someone stuck their thumb under the my left kneecap. Then the pressure started in & standing didn't relieve it. This sensation was just uncomfortable, not painful but I felt like I might have to quit. Instead, I started pedaling heels-down & this seemed to relieve it. Since that ride, I am getting pressure & (it seems like) 'impingement' sensations on inner/outer sides of the patella.
...

if it was me
I'd certainly keep the MD appt.
but also would check the fore-aft position and try to get to KOPS as a good neutral place. Leg extension - with the heel on the pedal, set height to where you can just stretch and pedal without hips rocking to reach pedal. Toe-clips - keep the straps real loose so your shoes can rotate easily to allow the feet/knees to track as they might. Dont' exaggerate any particular pedal stroke, let it happen as 'naturally' as it does for you. Take 'notes' so you can get back to where it was set previously, should any change prove nonproductive.
If you jumped from doing under 40 mile rides to back-to-back higher mileage days; that could easily cause the issues. A change in pedal stroke from your normal stroke, while fatigued and carried over some distance, can easily cause the knee problems. I did a similar thing back in Mid-March and its taken until just a week or 2 back to really start feeling much better. Regardless of what you find it will take some considerable time to really 'recover' to 100%, so patience really helps here.

Start an easy stretching program, especially dealing with the hips and associated muscles. Focus on the Tensor Fascia (sp?) which anchors the IT Band. This will help relieve any patella tracking issues. Don't forget the inner thigh, especially the sartorius, and of course the back of leg, the hamstring group and GM.

Let yourself recover/heal and then build your mileage back up more gradually and give yourself a decent break between hard days, unless you've already worked up to that level. When fatigue really sets in you're better off 'slowing' the pace and keeping 'form' rather than pushing through, unless of course your livelihood depends on it...

I've also had a weird pain above my right knee, and I've been laying off for a few days.

Not sure if it's the saddle position or a lack of stretching, but I'm going to look into both...