Sore knee... ride or call my Doc?
 

Hi,
did a 2 week cycling vacation, it was great but came back with
a sore left knee. Doc said to give it a week. Tuesday I hit the gym
hoping for some instant rehab. My muscles were great, but my knee
is still sore. When I stand up it feels like the femur is not being held firmly and sags just a bit. While it is getting better, it is happening slowly.

I had wanted to do a ride manana, nothing dramatic, just 30 miles near the coast.
But I wonder if that is foolish, I also wonder if I should be going to the gym right now. Btw, what I am doing there is just leg extensions and hamstring curls for the legs.

So... can I ride if I take it easy? Should I try to get in to see my Doc today (I go
to a clinic that is great that way, I can usually see someone the day I call if I want to). Or maybe just hit the gym again on Sunday?

I'd stay away from the gym. The gym is where all my injuries happen.

I would take it easy. Knees don't heal very well or sometimes at all. I need to be reaaaallly carefull with my right knee, otherwise I'll be in big trouble.

I injured my knee last year while jogging too many miles. The pain was mostly prevalent going up and down stairs and anytime I put a large resistance on my right knee. I put off having this looked at for over six months thinking it would get better on its own. I finally went and had an MRI done and now am going through six to eight weeks of physical therapy. I was diagnosed with common "runner's knee" which also can effect cyclists as well, but not as often as in runners. The Doc said that it was from weak quadraceps. Typically the hamstring and the quadracep are not always equal in strength and as we age they become even weaker. In my case he said that my hamstrings were actually much stronger than my Quad, and needed to balance out the strength in my legs. Just looking at a muscular quadracep is no way of determining true strength. This needs to be determined by the doctor. My quads are huge and feel strong to me, but not strong enough for the stresses that I have been putting them under. The Quad is the muscle that supports the knee. Weak quads can mean poor knee support. I was told that just cycling will not alway build the quads sufficiently to support the knee properly and that some extra weight training is required. Also Core body strengthening will help immensely. I have been going to physical therapy for three weeks now and can feel a significant improvement. I have been doing the following excersises:

• 20 mins of standard leg stretches
• Individual leg presses (low weight) 3 sets X 15 reps
• Hamstring curls 3X15
• Standing on one leg (eyes closed - no peeking) 10 x 10 seconds each
• Standing on one leg and tossing a heavy fitness ball into a trampoline for three minutes
• Lying on a flat table or bench do leg lifts with 3 pound weights on the ankle. Do 3 sets of 20 holding the leg in the air for five to ten seconds each raise. Do this on your back, on both sides and lying on your belly.

I swear all of this seems silly but it really works great. I have also been doing a spinning class two to three times a week 45 to 60 min each time depending on who teaches it that day. I wouldn't say I'm pain free at this point but I'm felling a lot better than before. I also started taking some basic tennis lessons and cardio tennis to get even more time on my feet and lungs.

Now I have no time to ride my bike!! :D

I slipped on rocks and stretched the linings of my knee. I had to use a crutch for a while. Here is what I did:
Went to MD for x-ray and MRI. MD said there was nothing to be done and prescribed Vioxx.
I went on trainer with light spinning and no load. Two months of that and I switched to Advil.
A few months later and I got off the Advil. A year later and I was back to full strength.

I would not take advice from a bunch of nuts on the internet. Having said that, I think people overuse the docs. Docs can do all kinds of amazing things, but I think it's best if people take as much responsibility for their own well being as possible.

If it was me, I'd take it easy. Pay close attention to how it feels, but don't be a hypochondriac. A certain level of pain should be acceptable, but whatever you're doing shouldn't leave you feeling worse. If you find your knee swelling or getting noticeably worse on the ride, clip out and use the other foot. Or be ready to call for a ride. You might go for a couple miles practice ride just to assess things before going out.

You should not go to the gym. Leg extensions and curls put a lot of stress on the knees.

I would recommend that you keep riding, but keep it light. I find that my knees need the movement to stop being sore.

The leg extensions and curls my PT is working me with are very low resitance and higher reps. Until you actually do this kind of activity for a consistent period of time and see the actual results it would be unfair for you to say that these excersises put undo stress on the knee if done properly. They are intended to strengthen the muscles that support the knee. I feel confident in the diagnosis I have recieved and the therapy being applied. I know a lot of people like to self diagnose and often get themselves into trouble, so I would sugest either go to a good sports medicine guy or just do what you want to do. It's your knee not mine. I was just giving one situation for an example. What works for one will not work for everyone.

Cheers

What kind of pain is it? Is on the outside (lateral)? Over the patella? Rear? These typically mean different kinds of injuries.

Sounds like you are saying that your knee feels "unstable". If you can do leg extensions without pain, that can help tighten up the joint so that your muscles take more of the brunt than your joint, but I wouldn't go this route if it's painful. Rest, Ice, elevation, yadda-yadda otherwise.

I'm having a touch of ITB on the outside of one of my knees right now, so just doing very easy rides just cause I don't want to miss what's left of the warm weather...