Long Distance Competition/Ultracycling, Randonneuring and Endurance Cycling - Patellar Tendonitis after 600km Brevet
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on 10th Sep we had our very first 600km Brevet here in India-Pune, while I've done a few brevets of 200 & 300km this was my first brevet on the New custom Surly Cross Check. I don't wanna boast but I'm one of the stronger Randonneur here as I usually one of the first finishers, But this on I just scraped through due to severe knee pain after about 360kms or so, till then I was the first one at all the controls, but after the night's sleep the knees were jammed like hell. Yet I persisted & kept at it & managed another 240kms somehow. I knew I was playing with fire and I somehow feel dreadful I've rested myself post that, it did help & I thought I was healed completely; but yesterday's 70km ride on my Roadbike again made this problem crop up.
I'd really like some advice as to how can I go about treating this, since the PBP qualifiers will begin from Nov'10 onwards, how can I get back to complete fitness & how can I avoid this in the future. I had never faced this problem before this is my first time.
10-03-10, 07:21 AM
You should go to the doctor, no matter what. Follow their advice (not ours). Also, ask him/her for a referral to a physical therapist, no matter what,. The PT might be more useful than the doctor. They can show you workout routines to help prevent injuries like this, depending on the cause of the injury. Nothing ever helped me along as much as the PT. I became a stronger rider, and got rid off the tracking problem that was causing me knee pain when I tried to log a lot of miles.
Also, get a bike fitting. You said you were riding a new bike, which is a big tell that something might be wrong with the fit, which would add up to a big problem over so many miles. Good luck, and don't get discouraged. If you do the right things, you can probably beat it and come out stronger.
10-03-10, 09:52 AM
I also have a knee tracking problem. I use a Cho-Pat strap to keep it under control. The thing that really helps it is swimming, and I have started doing that again. I had a big problem with knee pain on the 400k I did this year, I rode the last 20 miles only pushing with my left leg. I tried taking Ibuprofen, but it didn't seem to help much. Fish oil does help. Look for ITB stretches and using a foam roller to stretch your ITB.
About 10 years ago, my knee hurt any time I went up stairs. My son was a baby, and I was in severe pain just to carry him up the stairs. So I went to the doctor, who sent me to physical therapy under the supervision of a surgeon. They gave me a batch of ineffective exercises to do. Swimming got me to the point where I could ride a bike without pain.
10-04-10, 09:19 AM
Yep, see a doctor, preferably one who specializes in sports injuries. You are not going to get good medical advice from a web forum.
That said, in addition to "go to a doctor now:" Chances are you have a bad bike fit and/or are mashing too much. Different types of knee pain, by the way, are associated with different fit and technique issues. And if you didn't do this from the start, set up lower gears on the bike.
You also probably aren't recovering properly from the injury. Follow the doc's advice on this one.
On my first 600k I also had a Patella Tendinitis on my left knee, I barely finished the ride and I could not ride over 30-40 miles since with the same set up. In my case it was the SPD pedals that were causing to problem(not enough float). I had to switch to the pedal with more float to keep riding 600 k and above.
It also could be overuse if your knees are not used to the distance, providing your fit on the bike is perfect.
I also try to have a good base during winter, before I start pushing big gears in spring. Riding hard or climbing after a long winter break will cause the inflammation of the knees also, especially on long rides. I try not to climb hard unless I have at least a 1000k millage and my knees are still weak. Also building up your knees at the gym during winter months helps to not have any pain when cycling.
Once you have a PT pain I would take a break from riding and not stress it any more till it heals.
I would've seen a Doc but finding sport specific docs is a challenge here; I had ridden the new bike for about 500kms with a few centuries before & didn't have this issue. I don't know if a regular Orthopedic can help but I'll go to one anyway. I had thought it had healed but I think I over did it with a 70km ride I should've taken it slow.
Andrey you're right, it was a cleat problem since I took the pedals & shoes of my road bike to this one. My Road bike has a very aggressive geometry & it has a standard double crank. The LD bike has a triple & feels more wide; also I use shimano red cleats with very little float, so I'll need to get myself cleats with float or I'll need another set of shoe & cleats.
anterior knee pain (including either above and or below knee cap)- try having a competent bike fitter raise your bike seat. If it's above the knee cap (associated w/ quad insertion) it might simply be an overuse injury- too rapid of an increase in mileage in too little time. Are you sliding on your seat a lot? If so have your competent bike fitter adjust the fore/aft of your saddle. Good luck and happy healing
Have a read through this page:
10-05-10, 06:32 PM
First congrats on finishing the 600K! I have had patellar tendon issues on both knees at different times with different solutions.
My left knee has been problematic since having the rear half of my meniscus take out in '96 (I would only 19). On a 144 mile ride one day it really flared up. I found that some new shoes (Specialized Pro Road) and some Specialized varus wedges helped solve that problem. The wedges cant your feet to the outside and according to Specialized put the leg in a more natural position throughout the pedal stroke. No petellar problems with left knee since.
My right leg has been my strong leg since my knee surgery. This August I did a 9 day, 500 mile loaded tour from the CA/OR boarder to San Francisco. Around day on day 4 or 5 we put in an 82 mile day with fully loaded bikes (mine about 50 pounds) over two passes. The rest of the trip my right knee was in very bad shape. Pain was excruciating each morning and after long breaks. Unfortunately the pain continued for nearly 6 weeks after returning home until I started playing with my cleat position. After a few modifications the pain has all but disappears in the last two weeks and my power has returned.
There is no silver bullet to solving your problems. There have been several sound pieces of advice so far, petellar tendon strap, bike fit, cleat adjustment, varus wedges, strength training, not ramping up distance or climbing too quickly, and ITB stretches. Some combination of these will likely solve your issues. I would start with a bike and cleat fit - either with an experienced fitter or following some basic information found on the web. Do not try to do all of them at the same time. Approach it a little bit more scientifically by changing one or two things at a time so you know what worked for you. Good luck!!!
There aren't any professional bike fitters around here too :( Anyway post my Docs visit i'll also try out these options & tweak with cleat positions & seat height a bit. As of now I'm simply off the bike :(
One thing I'd like to kow is, Do you guys use the same Road/Mnt - "cleat & shoes" for your LD bikes or have entirely different setup i.e. different Pedals, shoes or simply another shoe with a different cleat just for LD bike?? I'm asking because I used the same Road Shoe+Pedals for this bike too; I think since this bike is exactly opposite in geometry & fit, it'll need a different cleat position. The reason I used the same one was because that's what I was riding from the last 3yrs & I find them extremely comfortable.
I see that most of these Mount bike SPD Pedals offer more float but how do these perform over Long distances?? Any of you use Mt SPD setups for brevets??
10-06-10, 08:20 AM
kk27, I suspected there might be a lack of professional fitters in India, but there might be if you ask around. That said, there is a good bit of information online for fitting a bike. If you spend some time with the bike on a trainer (if you or a friend has one) you should be able to transfer the bike fitting information on the web into results on the bike. The help of an assistance could be useful.
As for shoes and cleats I have two sets of shoes, one for all my road biking and one for all my mountain biking. Road shore are three screw Look style cleats and MTB are SPD cleats. The common wisdom is that SPD cleats do not distribute pressure as well as Look style cleats thus creating hot spots on long rides. Does this mean that no one uses SPD for long distance riding? I am sure there are plenty that do.
Here is some online resources of bike fitting.
I actually switched from Shimano SPD pedals(3-4 deg. of float) to Crank Brothers Eggbeater SPD compatible pedals for more float (6 deg.) I do like the fact that one can walk in SPD cleats, easy to click in/out. I just have to have over 5 deg.of float to avoid issues with knee pain.
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