Pes Anserine Knee Bursitis- More Pain Now
 

Last August on a ride a week and a half prior to the MS150, about mile 52 into a 62 mile ride upon standing going up a hill the left inner side of my right knee gave me severe pain which then prevented me from any further standing up on hills and made it a LONG 10 mile ride back. I went to the doctor, they felt I had bursitis: http://www.med.umich.edu/1libr/sma/sma_pesanser_sma.htm and sent me to rehab. I wanted a cortisone shot to get through the MS ride but they wouldn't do it. Instead they made me go to rehab. (I went ahead and did the MS ride but sat for every hill and it was pretty sore by the end of the second day.)

The following week after the MS ride the PT thought that the cause might have been the fact that I had taken my bike in for service a month or so before that and unknowingly they had my adjusted my seat lower and after riding like that for several weeks and having knee pain (behind the knee cap) I called the LBS where the fitting and service was done and they suggested that might be the cause and that I bring it in and they adjust it back. Turns out it was an inch lower than the fitting set it. I rode again in the higher position for several weeks when the above mentioned happened. The PT gave me little cortizone patches with an electrode to use on the spot and had me keep my riding under 25 miles a ride. As the year tapered off I was not riding a lot so the pain ended up going away.

Now I'm hot and heavy into training to race beginning in April and my same knee is bothering me, but not on the left as before, more behind the knee cap again. I feel it during and just after running, spinning, elliptical, pretty much everything EXCEPT when I ride my bike on the trainer. Generally it gets worse as time passes. If I go more than an hour it gets worse. It goes away after I stop exercising. Any thoughts? I don't want to get right into the race season and have to go the weeks of PT visits before cortisone shot route, rather address now. I've also been wearing an ace bandage just for support as I had done per the PT's suggestions end of last year. Thanks for your thoughts in advance!

You may just have arthritis. That's life. A good MRI and a good doctor could tell.

I had a bout of pes anserinus tendinitis. I resolved it by doing my therapy sessions, doing a specific stretch and purchasing specialized shoes with 3 degree of varus. I ave flat feet which made caused the to pronate when standing. Apparently these pronation cause over stressing of the pez tendon. Once I went through the therapy and used the cycling shoes I haven't suffer the tendinitis. I rode quite a lot last year without aggravation,but my mileage did not increase although my riding intensity did. To stretch the pez spread youfeet apart as wide as you canpossibly can (like a side split) rotate your feet outward (toes pointing out as far as you can). Then bend down fm the waist. You'll feel the stretch at the pez. DO this after riding ofcourse never cold. That's my 2 cents.