79pmooney

I'm skeptical of pool anything based on my knees. Most pool water is WAY TOO COOL for my knees! (When I took swimming lessons, freestyle was OK because the kick means so little. But they did not like the breaststroke kick at all. And I had to make it a point to not put any load on my knees after I'd been in a pool. (My knees hurt just thinking about the exercises you mentioned above.) The temperature they like the best is body temperature. They do not like doing anything in air less than about 80F. I wear super kneewarmers to that temperature or higher. And air pulls far less heat away from knees than water does.

Ben

Jinkster

79pmooney....thank you so much for taking the time and effort to post and share that...I guess winning the Tour De France is officially off my wish list.

And?....this really sucks eggs...here it is Sunday morning and my left knee still has a little burning in it from a ride I took Thursday night.

So?...I guess it's time for me to start learning and taking measures to stop the burning and I can already feel where leg lifts and stretching exercises are going to help as I did actually feel some relief the moment I began doing them...an hour ago. LOL!

It's kind of strange that when I place my knees under the tension of a full hamstring stretch or?....compress them with a really tight/acute bend that I actually feel relief....and how it's that 50% of motion in the middle that seems to aggravate it.

Anyways...again?...thanks for sharing that and I'll be headed out for some glucosamine sulfate shortly.

Coal Buster

Ibuprofen and naproxen are nephrotoxins as are all NSAIDs. Not usually a problem but athletes tend to take higher doses for longer periods of time. An aspirin is usually the best choice if needed. I exercise regularly and have the typical aches and pain. I'll use 500mg of acetaminophen but in general have learned to deal with pain.

JohnDThompson 

And acetaminophen is hepatotoxic. You just can't win...

Worknomore

I have been dealing with Chrondomalacia for 16 years. What I have learned; Chrondomalacia hates change so stick to one bike or if you must ride a different bike back way off when you change. Use a light quick spin (80-90 rpm) and stand if you run out of gears. Take it easy! Ice and Ibuprofen to manage the inflammation. I had a complete physical/ bike fit/ motion analysis from Andy Pruitt who was the US cycling team dr. back in the 90's. This advise comes from him and has been spot on for me.

Jinkster

Wow...don't get me wrong here because you all are pouring out a wealth of helpful information and it's not your fault but D@mn man...now my head is hurting because first I had to look up WTH is "nephrotoxins"?

and when I did?..I saw all this crap about "renal" failure...so then?...I had to look up "Renal"...so please...someone tell me...


WHY DON'T THEY JUST SAY FREAKING...

"KIDNEY"

Do they do that crap just to aggravate and confuse ignorant people like me?...is this how the gene pool gets cleansed?

sorry...I'm trying to laugh away my pain...of not riding.

Jinkster

Hey!...I just did!...cause when I looked that one up?...

"hepatotoxic"

they actually referred to the liver as a freaking liver.

And just to clear things up, step back, and take a look at the big picture here?...now that I have kicked drugs and alcohol remaining clean and sober for 4+ years only to discover I have TypeII Diabetes and have quit smoking for nearly 3 months and got back into cycling to save my legs?...

Now I have knee pain that the over-the-counter meds for destroy my kidneys and liver?

I gotta cure...I'm going to pray and turn it all over too God...then I'm going to do some stretching exercises...then I'm going to take a nice warm shower...and then I'm going to grab my lightest and easiest pedaling bike (my Giant OCR3 RB)...and then I'm going to go for a nice long, slow ride in low gear.....

before I die.

Carbonfiberboy 

Both aspriin and ibuprofen are just fine unless you take them in very, very high doses for a long time. Some have better success with one, some with the other. I do better with ibuprofen. If you doubt this, ask your doctor. Lots of "fear this" stuff on the interwebs.

Coal Buster

My nephrologist won't allow me to take any NSAIDs except baby aspirin for my heart (and he always calls it 'kidney' failure).

As far as Tylenol being hepatotoxic, it is, but the failure mode is different than the way NSAIDs attack the kidneys. Take enough acetaminophen and you will have a catastrophic failure of the liver. The amount needed is much less when mixed with alcohol. If it happens, you're a dead man. Evidence shows, however, that normal doses don't do any damage whatsoever. There is no cumulative effect. NSAIDs, on the other hand, always cause some damage in any amount used but the mechanism to cause a catastrophic failure of the kidneys doesn't exist. In fact, you're more likely to burn a hole in your stomach with any single overdose. The upshot is that acetaminophen is perfectly safe for long term use but one time abuse can lead to death. Long term use of NSAIDs will damage your kidneys but most people have plenty of kidney to spare. People with diabetes and/or high blood pressure are more likely to already have or will have reduced kidney function and should never take NSAIDs.

ModeratedUser150120149

Congratulations on taking charge of your health. From all your posts it seems you are taking this fitness thing seriously.

So, get used to the idea there is no specific thing that will cure your problems. Relatively speaking there aren't many people who are starting athletic lives at your age. So, you need to get used to the idea that you are your own best manager of your body. You are very much an experimenter conducting the experiment on your body. I think you are right on in viewing all the practitioners with a jaundiced eye.

Many are either in it for the money or are otherwise not very patient centered. Others like many of the chiropractic references I see are just not as broadly qualified as they advertise. If you find a good, patent centered practitioner grab on to that person like a bar of gold.

Also, get used to having "odd" symptoms and sweating. Also, for my knee pain after awhile I just slacked off on intensity and speed. Under less pedal pressure and shorter distances the pain seemed to go away.

jmiked

Glucosamine/chondroitin is completely worthless, IMHO. Every single reputable independent test I looked at over the years has come to the conclusion that it is ineffective. There are plenty of people around who will say that it worked for them, but that's anecdotal, not proof. They may have gotten better while taking nothing. That's the problem with anecdotes.

I took Glucosamine for quite a while, noticed no significant difference, then stopped. My condition didn't get worse. Then I did the research. My conclusion: it's a ineffective. Even the explanations of why it is supposed to work don't make any sense to me under closer examination.

Eat healthy, exercise in moderation, and see a good doctor. A real doctor, not one of these pseudo-science quacks that abound these days. If you don't what's wrong, you don't know what you have to do to fix it.

79pmooney

Jinkster, keep up the stretches and strengthening. Get to know your knees. In a few months, they will be more robust than they are now and you will start knowing when they are OK and when you need to take action. I keep regular 325 mg aspirins around and take one to two as needed, usually before bed after a ride my knees did not like. Sometimes I take one or two more the next morning, But I often go long stretches riding with no aspirin at all except the baby my doc has me on for my heart.

Since I was diagnosed, I raced a final season, have ridden ~130,000 miles, last year did two 130+ mile days and have ridden four Cycle Oregons, two of which were hilly and I rode fixed (stopping to flip the wheel or unscrew the cog; ie the old way! One day had 10,000' of climbing.). CMP isn't a death sentence. But it does teach us patience. We HAVE to listen to our knees. For me to ride CO fixed in September, I have to ride through the winter and start preparing in April.

Edit: And start planning on keeping your knees far warmer than you ever thought necessary or even reasonable. My knees are at their best at body temperature. 90sF. Seriously warm. After 20 years of overdressing my legs or paying for not doing so, I designed and had made some custom kneewarmers that look like basketball style kneepads and hang from loops I sew in all my shorts and cycling brief. (I keep the straps around my knees loose because tightness there is exactly what ymy knees do not like.) I wear just those (somewhat dorky looking) kneewarmers up to the low 80s or higher. Below about 75 I wear standard cycling kneewarmers over the customs. Then the usual tights, thermals etc and the temps drop.

I can send you the pattern I made and you can have someone sew them up. The fabric I used was windblock 300 weight fleece. You need enough to go two layers plus some 3/4-1" elastic strapping. 1/2-3/4" Velcro strapping and a little webbing to match the Velcro. You can E-mail me jeffries at spiretech dot com if you are interested.

Those warmers get worn almost every ride I do. About 3 days/year it is warm enough to go without (and I may well put them in my pocket just n case). I had two pairs made, one with edges hemmed and looking neat, one unhemmed and more comfortable under clothes.

Ben

Carbonfiberboy 

This does not seem true of glucosamine sulphate. One confounding factor is that some trials use glucoasamine hydrochloride and label it simply as "glucosamine" and it does appear that glucosamine hydrochloride is ineffective. I have not seen a trial that found chondroitin alone an effective treatment.

Here are two positive findings for glucosamine suphate:
Long-term effects of glucosamine sulphate on osteoarthritis progres... - PubMed - NCBI
A Clinical Study on Glucosamine Sulfate versus Combination of Glucosamine Sulfate and NSAIDs in Mild to Moderate Knee Osteoarthritis

Some studies do show no effect. A good discussion of why study design and participation might create a variation in effect can be found in the discussion in this study:
A randomized, double?blind, placebo?controlled trial of glucosamine sulphate as an analgesic in osteoarthritis of the knee

IMO these studies show a positive protective effect in the prevention of osteoarthritis (OA) and a positive analgesic effect in early cases, though no analgesic effect in advanced cases. I think that the reason we do see anecdotal evidence of effect is that, as these studies show, it helps some people and not others. We find the same evidence from anecdotal stories, including yours.

My advice to olders and those who experience minor knee discomfort along with no diagnosis of advanced OA has been to try 1500 mg/day of glucosamine sulphate, 1000 mg of MSM, and to take ~100 mcg of selenium (often found in multiples). For those seeking analgesic relief, if no relief is obtained in 2 months there is no reason to continue. For those seeking to prevent OA, well, there are a lot worse things to spend your money on. Says the guy who started taking this stuff 35 years ago to get rid of knee pain and still has "perfect" knee cartilage, according to the doc who snipped my meniscus a few years ago.

Support for taking MSM:
Efficacy of methylsulfonylmethane (MSM) in osteoarthritis pain of the knee: a pilot clinical trial
Randomised, Double-Blind, Parallel, Placebo-Controlled Study of Oral Glucosamine, Methylsulfonylmethane and their Combination in Osteoarthritis - Springer

Jinkster

Thanks everybody!

I really appreciate all the help, guidance, suggestions and shared experience here.

I haven't had a chance to pick up the gluco sulfate yet...that store just hasn't been in my travels the past couple days but I will!

Update: Today is the first day (day 4) since my last big ride last Thursday evening...the first one to set my knees on fire....that my knees are somewhat back to normal.

In Hindsight: That ride was my first big ride on the new-to-me hybrid....the same one I stretched out on with a longer, lower stem to accommodate a more aggressive riding position to facilitate use of what was my only decent saddle...my Romin Evo off my Giant OCR3 RB...so I'm left wondering if maybe that had something to do with it because since then?....

Changes Made: included going back too the shorter, higher 50deg stem and buying a Specialized Toupe Comp Gel saddle which I bought and installed today to get the bike back to the more upright riding position of this hybrid...(putting the romin evo back on my RB where it belongs)....



Tuning Changes: For the time being?...I'm no longer going to lock my seat height into "By-The-Book" numbers....it's a great starting place but from there?...I'm going to let my knees do the tuning and whatever position relieves the most knee pain?...is where the saddle height is getting set...and so far?...that looks like 1/4-1/2" lower than by-the-book.

Again, Thanks for all the help and info...looks like I'm going to get to relearn many things the hard way again but with you folks around?...it may be a lot less drawn out and painful. Thanks, Bill.

VNA

I hope you had a cast over that beautiful art work--you must have been between casts to take that picture? (speaking from experience)

79pmooney

Another fit piece to look at: your cleats and foot position. For me, that is critical. To keep my knees happy, I have to force my feet to a more pigeon-toed position than they would take naturally. Very little toe-in on the left foot, but quite a lot on the right foot.

Not saying that will work for you, just that is that one more thing to be aware of. Look to see what works on any of your bikes and copy it. I ride no-float cleats and pedals on all my bikes and I am very picky about getting the cleat positon right with new pairs. When I replace cleats, I place tape along the edges o the cleat coming off s guides t get the new ones in exactly the same.

Again, number one is building awareness of what works for your knees.

Ben

qcpmsame 

One tip,if you aren't already doing the changes this way, change just one thing at a time, try this out to see what effect it has on the questionable aspect of pain free riding. If you are changing multiple things all at once you won't know which change had a positive, or even a negative effect. Learned this while tuning carburetors and suspension for motocross racing.

Bill

Jinkster

And in that spirit?...this evening?...I left the cleats home and doned the nikes on the platform side of my duel-interface pedals and you are correct...and I've felt this before where if I turn my toes inward?...the knees feel relief...and that amkes perfect sense to my minds eye because it seems to me that doing so tensions that cartilage and?...takes "the slack" out.

I'm sitting here chuckling thinking..."Truer words never spoken"....because I just got back from my first serious trial run of the new Toupe Comp Gel on the hybrid and now I'm thinking that maybe the lower, longer stem needs to go back on....I felt a wee bit cramped upstairs at times...like when I wanted to bow down to the 10-15mph headwinds.

That said?...my emphasis this evening was to get back to pedaling but not re-aggravate my inflamed knees and take things easy by keeping the resistance low and revs high....at one point (pedaling into the wind) I'm pretty sure I was counting a cadence of two full revs per second...the Toupe Comp Gel?...felt great for the first 5 miles but did get just a slight amount of pressure discomfort on the sit-bones the last couple miles...but it didn't feel like anything some fine tuning of the saddle position couldn't cure...big difference of how much weight the sit-bones carry on a hybrid as opposed too my RB but other than that?...I think the Toupe Comp Gel is going to make a fine butt pedestal for this crosstrail.

Here's the ride stats...

https://www.mapmyrun.com/workout/8041...ref_map=[]

Thanks again folks and L8R, Bill.

Phildog

Jinkster, I think you're just "waking up" some muscles that you haven't been exercising in a long time. As we all do, you may just need to ease back and progress a little slower than you would have 10 years ago. Hopefully, you're just feeling "lactic acid"in those sleepy muscles. I think you'll be fine once your legs develop "memory" for cycling. But in the meantime, SEE YOUR DOC! Prevention is the best medicine buddy! Keep your body hydrated and don't worry about cadence just yet. Let your legs catch up and get stronger for cycling. Take it easy and STAY WELL!

jsjcat

what did you have done here?

Jinkster

And I think there's a lot of truth too that...also?...It may have been a bad idea to "clip in" on that first big ride before knowing if the initial setup was even close....think I'm going to stay on the platform side of my pedals (where I have some foot position latitude)...until I get is as comfy and knee friendly as possible.

Wanderer

The best advice I can give you, Jinx, is to take it easy at first. Build up to it gradually.

I know this sounds stupid, but limit yourself to a mile a day for the first week, then add a half mile every week until you get where you want to be, or where you can get to.

It may seem slow, but even turtles are still on this earth! And a lot of the rabbits are fox food, because they thought they could out run or out maneuver him.

Your body will thank you in the long run.

locolobo13 

This has been my experience with Drs as well. While I haven't tried it some insurances will let you go to a physical therapist or other specialist before seeing your MD. Sometimes they will help you deal with your MD so you get the proper diagnoses. There's a lot of good info in this thread.

Nowadays I start by googling my problem and trying out some of the exercises I find. Maybe not ideal but.. A few years ago I did something to my shoulder. My self diagnosis was tendonitus. I found a web page with some exercises and started them. Dissatisfied with my progress after a month I saw my Dr. His diagnosis was separated shoulder. He used some Drs website and brought up the identical list of exercises. LOL.

I have been dealing with a problem knee the last couple of months. Here is a link to the exercises I am trying currently. Although I can't do them all at the sets and reps recommended yet.

https://orthoinfo.aaos.org/PDFs/Rehab_Knee_6.pdf

Good luck.

Jinkster

My knees actually felt great during last night's ride and are just fine this morning....looking forward to pedaling more tonight but I guess the important thing is to not push myself in any way just yet...whether it be distance or speed...last night's ride was a couple less MPH..and a few less Miles than usual and that seemed to do the trick...and from here?..Consistency will be key...I'm thinking.

Wanderer

Yep, get used to that, and then expand slowly..................