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Old 10-21-10, 10:56 AM
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Knee Pain

A week and a half ago, my right knee started to hurt. Within 24 hours, I could barely walk. Rested it, elevated it and iced it but the pain continued. Went in for an x-ray and the diagnosis is calcification of the knee cartilage. Doctor was surprised, given the extent of damage, that this was my first serious bout with pain.

I've had minor knee pain over the years but it had all but disappeared since I started cycling a little over three years ago. This really caught me off guard. I'm being referred to an orthopedic surgeon and will see what my options are. I'll ask to have the other knee looked at as I assume it is in the same condition.

The good news is that, while painful, using the knee isn't causing further damage. And, now that the swelling has gone down, taking Alleve has eliminated most of the pain so I can get on with life while determining next steps.

And the better news is that I'm getting back in the saddle tomorrow. Coincedentally, I'd won a bid on eBay for a Shimano 105 compact crankset a few days prior to my knee flaring up (I finally admited to myself that it makes more sense for me than a standard crankset) and had time to install it on my road bike while I was laid up. Should be a bit easier on the knees and give me lower gearing when I'm ready to hit the hills again.

Anyone else here been down this road? I'd appreciate any insight or suggestions from someone with experience.
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Old 10-21-10, 03:23 PM
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Originally Posted by CACycling
I'm being referred to an orthopedic surgeon and will see what my options are.

Anyone else here been down this road? I'd appreciate any insight or suggestions from someone with experience.
I had similar knee problems a few years ago. Went to an ortho doc. He said after surgery I'd be on crutches for 2-3 weeks and would start physical therapy a month after surgery.
Went to a sports med doc (who is also a triathlete) and he said there would be no crutches. I decided to go the sports med route.
He had me on the trainer 7 hours after surgery for 5 minutes. It was the toughest 5 minutes of my life. My physical therapy was to ride the trainer each day. He had me work up to 30 minutes, 3 times a day over the next 3 weeks. After that he told me I could get out on the road but to be careful.
That was 2-1/2 years ago. Since then I've had no pain and no limitations on my riding or walking.
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Old 10-21-10, 03:34 PM
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I have a knee problem rear its head occasionally and this does stop all exercise. Cycling is not too bad but it has to be gentle. So while laid up- I try to do some leg exercises without putting any pressure on the knees. Even walking is out due to pain so I have to be carefull. I go back to the quad exercise that I have done for years. Lie on my back and raise the leg without bending the knee. Once I can raise the leg 10 times- I put a weight on the foot. just a pair of boots initially but gradually raise it to a 2 lb weight (The weight of a bag of sugar in old money over here)

So while I am laid up- I can still put some exercise into the legs- and build up the quads at the same time.
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Old 10-21-10, 04:50 PM
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RonH - Did the sports med guy do a different surgery/no surgery or was it just a different approach to recovery?

stapfam - With the pain I had, leg lifts were out.

I guess I'll see what riding is like tomorrow and take it from there. Thanks guys.
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Old 10-22-10, 09:15 AM
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Check out the following link https://bicycling.com/training-nutrit...-out-knee-pain
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Old 10-22-10, 09:51 AM
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Originally Posted by CACycling
A week and a half ago, my right knee started to hurt. Within 24 hours, I could barely walk. Rested it, elevated it and iced it but the pain continued. Went in for an x-ray and the diagnosis is calcification of the knee cartilage. Doctor was surprised, given the extent of damage, that this was my first serious bout with pain.

I've had minor knee pain over the years but it had all but disappeared since I started cycling a little over three years ago. This really caught me off guard. I'm being referred to an orthopedic surgeon and will see what my options are. I'll ask to have the other knee looked at as I assume it is in the same condition.

The good news is that, while painful, using the knee isn't causing further damage. And, now that the swelling has gone down, taking Alleve has eliminated most of the pain so I can get on with life while determining next steps.

And the better news is that I'm getting back in the saddle tomorrow. Coincedentally, I'd won a bid on eBay for a Shimano 105 compact crankset a few days prior to my knee flaring up (I finally admited to myself that it makes more sense for me than a standard crankset) and had time to install it on my road bike while I was laid up. Should be a bit easier on the knees and give me lower gearing when I'm ready to hit the hills again.

Anyone else here been down this road? I'd appreciate any insight or suggestions from someone with experience.
About 4.5 years ago, I was still jogging as well as bicycling and my left knee started to hurt. This led to arthroscopic surgery on the knee which cleaned up a torn meniscus (cartilage). Recovery was reasonably fast (I had been able to keep riding right up to the surgery) and I was able to do the 500 mile across NY state FANY ride that summer (surgery was in the spring).

I was just starting to get back into jogging when my right knee started to hurt. I think mostly from cycling. This started in fall, 2008. By laying off the bike for a while and then using a crank shortener on the right crank, I was able to keep riding up to surgery in December, 2008. The verdict here was I had no cartilage left in the outer half of the right knee - bone on bone. I was able to resume riding reasonably quickly, but attempts to play softball with the grad students or just a short run down the driveway led to pain, and I felt twinges in the knee. But I was able to ride and did the FANY ride in 2009, although I walked more hills than usual (I think because my training had been somewhat delayed by the surgery and also since I wasn't running any more, it's harder to stay in good shape over the winter).

This summer, I started having right knee pain in late June. I tried raising the seat, crank shorteners, etc., but couldn't make it go away and had to cancel my participation in the FANY ride. The orthopedist gave me an anti-inflamatory and sent me for physical therapy. He also told me to try riding the bike less and try swimming or an elliptical trainer. I took that under advisement and the next time I saw him told him no - my goal was to get back to riding the bike as much as before! Eventually he gave me a shot of synvisc (artificial synovial fluid - a lube job for the knee) and I have been building up the mileage and climbing since. Still feel twinges, but it seems they are getting less frequent. Last weekend, I did a 61 mile ride (flat) and on other weekends I've done shorter rides with some hills.

Apparently, one can get a new shot of synvisc every 6 months or so, but if that stops working, the next step would be a knee replacement. I think I'm actually looking forward to the knee replacement, but also think the longer I can postpone it, the better will be the artificial knee!

Sounds like your problem may be similar to mine. I'm surprised the docs didn't want to clean it out with arthroscopy. I suppose eventually, the ultimate solution is a knee replacement.

- Ed
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Old 10-22-10, 10:47 AM
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I heard on the TV the other day about a knee replacement supposed to last 30 years. Also, they now do partial knee replacements, which would be the choice for my wife for her right knee, if it got worse. She had a total on the left a few years back.,
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Old 10-22-10, 10:58 AM
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I have deteriorated cartilage in my right knee that requires care on my part to avoid a painful flareup. I have to avoid vigorous exercise early in the day and can't carry heavy items. It's annoying, but livable, as it's fine when fully warmed up. Every few weeks I forget and do something stupid, though, and have a painful knee for a few days. Had arthroscopic surgery done on it in 2000 which helped, but will probably need the knee replaced eventually.
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Old 10-22-10, 12:06 PM
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Philipaparker - Thanks for the link. Looks like I'm doing things right according to those tips.

Groth - Haven't seen the orthopedic surgeon yet to see what he recommends so surgery may be suggested. It's good to hear you were able to get back in riding shape quickly. The synvisc sounds interesting, I'll have to look into that further.

I did go for a short ride this morning. 10 miles without much pain as long as I didn't push too hard and I was glad I'd switched to a compact crank. Worst part was that I couldn't get out of the saddle when going over bumps. Tried it on the first pothole and my knee made a strong suggestion that I not do it again. Just glad to be able to ride and it was awesome along the beach this morning.
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Old 10-22-10, 04:31 PM
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I have been very fortunate not to have knee injuries now. I did several years ago, but went to a really good sports medicine doc at UC Davis to check the fit of my bike. he spent about 3 hours playing with cleat position, seat position, stem height, length, cants, etc. The outcome is changed position, cant and shim in one shoe, and no knee pain. While I know this is not the "be all, end all" solution for you, you might want to check for fit, after surgery to make sure something in your position on the bike is not contributing to your pain.
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Old 10-22-10, 06:33 PM
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Originally Posted by CACycling
RonH - Did the sports med guy do a different surgery/no surgery or was it just a different approach to recovery?
He did arthroscopic surgery. I had two large tears in the meniscus. He removed that section of the meniscus rather than trying to repair it.
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Old 10-22-10, 06:48 PM
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I'm still dealing with a bout of "Patellofemoral Syndrome" that had me good and worried. The pain lasted about 3 weeks, mostly going down stairs or walking uneven ground. The ortho doc took pics and to my surprise said they looked fine
and that I should ride but cut my mileage in half? So I went from 20 miles 3 times a week to 15 3 x a week. ( I'm not so good at math ). Anyway, it still hurts a bit but can ride. Good luck to you, I have read a bit and it seems that surgery pts can many times resume riding, in case you have to go that route.
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Old 10-22-10, 08:28 PM
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I've been suffering from knee pain for years. I've had orthoscopic surgery on both knees, and my left one is shot. You can not only feel, but actually hear the grinding of bone against bone, as the cartilege is gone. An MRI this past spring verifies I need a new knee. But the orthopedic surgeon told me to keep up the bicycle riding (either bike or swimming, as both keep body weight off the knees) and come back when the prescription strength Tylenol no longer knocks down the pain and swelling.

Yesterday on a trail ride, I noticed a new vibration and grinding coming from the left front side of my left knee. This is something new, and so far only happened while cranking along on my bike.

Question I have is, if I go ahead with a knee replacement, will I have to be off my bike so long that I lose all my conditioning, and have to start over from scratch - riding to the corner and back and working up from there?
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Old 10-23-10, 05:36 PM
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Originally Posted by xizangstan
I've been suffering from knee pain for years. I've had orthoscopic surgery on both knees, and my left one is shot. You can not only feel, but actually hear the grinding of bone against bone, as the cartilege is gone. An MRI this past spring verifies I need a new knee. But the orthopedic surgeon told me to keep up the bicycle riding (either bike or swimming, as both keep body weight off the knees) and come back when the prescription strength Tylenol no longer knocks down the pain and swelling.

Yesterday on a trail ride, I noticed a new vibration and grinding coming from the left front side of my left knee. This is something new, and so far only happened while cranking along on my bike.

Question I have is, if I go ahead with a knee replacement, will I have to be off my bike so long that I lose all my conditioning, and have to start over from scratch - riding to the corner and back and working up from there?
Well, it seems that they are very anxious to start PT right away. About the first thing they seem to do in PT (I've been there 3 times) is put you on a stationary bike for 10 or 15 minutes. I confess, I cheat, and once the stationary bike feels OK, I get on my regular bike. Couple of weeks (this from arthroscopy, not knee replacement - yet).

- Ed
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