Clydesdales/Athenas (200+ lb / 91+ kg) - Need "Water on the Knee" advice.

I was really having a pretty good mileage year up till 5 weeks ago. I was back up to 25 - 30 mile rides and starting to feel better on the climbs then on the flats. Then, I was derailed with pneumonia and have not been able to walk 25 ft the last 4 weeks without gasping for air and scheduling breathing treatments.

Well, night before last I crawled back on the bike and did a little over 4 miles and was pretty happy with my lungs, but noticed that my right knee was hurting the entire ride. When I got home I noticed that the muscle on each side of my knee cap was swollen. Since then it has remained swollen. I did nothing to aggravate it. My ride was very mild. I never cranked or stood. I am 50yr and 255#. I know that weight can be a factor, but I have weighed this much and more for ever. Maybe the combo of age and weight is catching up :(

From what I can tell this is "Water on the Knee". So we don't have to belabor it, I will see a Dr., but I want to know if others have had this and if there is any relief or therapy beyond draining?

Thanks all.

Jay

HI,
Ask local LBS to look at your set up, my local shops will do almost anything for a bike owner hoping for future sales.
You may have a bad knee cap, many times you can have a bad knee cap and over flexure can drag it across the cartlidge leading to a sore knee.
Thats why its important to not have that happen seat height and seat/leg alignment to crank..
I used to lift weights and would have sore knees if i popped my knee cap while extending my quads with weights.
Doug

Had Pneumoinia Twice. takes months to gain full recovery.
Never had the knee problem.


http://www.200.com/kneefluid.htm

RICE: Rest, Ice, Compress, and Elevate

There's not much you can do for it once it's there, other than draining, and rest.

Getting your bike fit checked is not a bad idea. If you LBS has the equipment, there is also a way to precisely fit your cleat position to your shoes and pedals if you are using clipless.

I'm going in Saturday to have my bike fitted. Any suggestions on a price range for this?

Around here, taking a bike in that wasn't purchased at the shop will run around $50. Most any shop in my area will provide a fit if you bought the bike there.

jboyd: What Tom said (RICE)!
One other thing to consider. There actually aren't any muscles on either side of your knee cap; ligaments and tendon's, sure, but the muscles are both above and below. There are several bursa in your knee (fluid filled sacks that provide a whole host of functions in a joint), and the area you describe as being swollen includes several of them. That being said, I'm not real good on the disease physiology of pneumonia, but here's what I would do if I was in your shoes. Start with the RICE thing that Tom talked about. On top of that, I would start taking one of the drugs in the NSAID group (Aspirin, Aleve, Motrin, Ibuprophrin, etc., not Tylenol, its in a different class and doesn't do anything for swelling). I would expect to see significant progress in about 2-3 days with the above.
Keep us posted.
D

Thanks to all.

I really do wonder if there is a pneumonia connection. I was on a high dose of Levaquin, 4x/day of albuterhol & Isaproprium Bromide breathing treatments and Hydra Codone. The last week I have been just trying to get away from the meds and adding anything was not in my mindset, but I appreciate the Motrin suggestion for its anti-inflammatory action.

The RICE advice: Rest is pretty easy. I work from home and have that luxury. ICE is easy. Wife has migraines, so we have like 10 Ice-Paks in the freezer. Compress, now this one I am a little fuzzy on. Do I need to go the pharmacy and get an elastic knee brace??? Elevate, no problem, I can run my business reclined with the laptop on a pillow on my belly (who is jealous of that:D)

I really want to get past this and if I have to will go get it drained but I am kind of a wiener and will try not to if I can:cry:

Thanks again and I will keep you posted.

Jay

An Ace Wrap, or a knee compression wrap, either one. They make some new fangled wraps for the knee that have pockets for the ice packs. Personally, I just stuck a Blue Ice pack in a pillowcase, placed it where I wanted the cold, used the excess to start the wrap, and then an ace over the top of that.

I think of "compression" less as squeezing, more as support. Unfortunately, it's hard to do a good job on your own knee with an elastic bandage. I'd say compression is in order if you find that your daily activities seem to aggravate the condition. For example, when I had a mostly-healed wrist sprain that just wouldn't heal that last 10%, I noticed it was most sore after I'd been typing all day -- so I just taped it every morning, religiously, whether it felt painful at the time or not. After a couple of weeks it was good to go -- the support of the taping was just what it needed.

Yeah, agreed, that's part of the reason I suggested the more new fangled compression wraps specific for the knee that can hold an ice pack. 10 wheels also had a great suggestion above, or a moderate compression/support knee brace will help as well.

Yeah, also agreed, an Ace can be difficult to get proper compression with, it's usually either too much (most likely!), or not enough. A foundation wrap underneath can help a lot though. This is a nonelastic padding wrapped, and then the Ace over the top of that. It can help prevent pinch spots from bunching or overcompressing the joint.

I'll second the ace wrap. Stockenett, compression bandages, or tubular gauze (all basically the same thing), do a great job with the compression part of RICE. If you are still swollen, I would steer clear of the neoprene knee sleeves. They would definitely provide compression (and a lot of support), but would probably be very painful to get on, and they might restrict the swelling below the knee, causing your foot to swell. If you have got an ace wrap, start about mid calf and wrap up to mid thigh. Then, lay down on the couch, throw the bad leg up on the back of the couch, and watch the olympics for a while.

D

The articular cartilage in my left knee is all but gone (since '99, had to stop playing ball in '05), well, there is a very small amount left. Anyways, from time to time I will twist the knee wrong and get bone on bone contact and the joint would swell with 180 to 221ml of fluid. Now, soon as I feel it starting I pop 400mg of Celebrex, put a brace on at night to prevent me from twisting it while I sleep and it prevents the inflammation. There is a surgical procedure I could have done but I prefer 800mg of Celebrex over the course of a year or two.

Granted the symptoms can be the same but be caused by different injuries so the above may not work for ya.

Along with asking on this forum (I mean who better to know about knee problems, then a bunch of overweight cyclists), I also asked my son and his wife. She is a first year resident pediatrician and he is a first year resident neurologist, and my daughter who is an ER nurse.

From the Clyde forum, I got great answers from people in the know. Folks who have been there and got the t-shirt. From my medical kids I got "Go to the DR.":roflmao2:

My son did indicate that if my knee is red and hot (and it is), it probably is a side bar to my pneumonia and not funny.

So, I have gone to WalMart and got the stretchy sock thing and am doing the full RICE therapy as recommended by my clyde buddies and tomorrow I am calling the DR.

Thanks folks,

Jay