artimus

Hi there. As the season here in South Western Ontario has gotten off to a roaring start, I find myself shelved for a week or so.

Over the past week I've had a pain develop in the back of my knee (left leg only). No swelling as such, but more of a lingering ache in the relaxed leg. When I try to do a hamstring curl (bend knee), I get a more pronounced pain primarily between to tendons in the back of the knee.

I plan on seeing my GP, but an not holding my breath on a diagnoses, "Yes there is something wrong here. Stay off of the bike til you feel better". The guy is a pure rocket scientist. Waiting for a appointment with a knee doc could take awhile (read MONTHS/SEASON).

Does this sound like a 'fit' issue? I've already have started to drop my saddle, do I look at KOP as well, or is this more for front knee pain? This was a fit set up that did me well for the little that I've ridden. The cleat position is fine.

The real question that I'm looking for (from experience), is this a muscle, tendon, or ligament injury?

ryanwood

I pulled a right hamstring during last fall and the pain and soreness were definitely not originating me knee. The pain and stiffness was in the muscle tissue, almost no joint pain at all. The effects lasted a while though because I never really allowed for proper time to recover, so I recommend making sure it gets taken checked out rather than potentially having a recurring injury that nags for a long time into the future.

Brando_T.

have you been icing it?

CPFITNESS

there really isn't such thing as ligament pain, no nerve endings there. if they tear, they tear and after the initial swelling and trauma from the acute event is gone, there shouldn't feel any pain (trust me, I blew 2 ligaments in january, putting of surgery until the fall but bought a bike so i could still get cardio and I have Zero pain.

At this stage of the game it's a bit too early to tell what it is. Can you tell us some more info on how much riding you did the past week when you started feel it? You did mention the season just getting underway so i assume you didn't do any riding over the winter and are starting back up again. Sounds a bit like you may have just overdone it and need to break yourself in a bit easier. Also, how old are you?

rumrunn6

all knee conditions; diagnosis; treatments and projected outcomes are well documented on the internet. with enough research and through the process of elimination one can pretty accurately provide decent basic assessments. the trick is the accuracy of the diagnosis which you may need a sports doctor / surgeon for. orthopedic surgeons are incredibly knowledgeable about the body and how it works and doesn't work!

good luck!

Brando_T.

yeah I've got knee pain right now, and I'm putting it down to "beginning of season" fun.

When I was having issues with pain on the inside of my knees this time last year, I called a local shop to talk about a bike fit. One question was "are you sure it's just not beginning of the season pain, I usually spend a lot of time with bags of ice on my knees this time of year" which sorta raised my eyebrows.

tenzing211

I always heard the basic mantra: pain in front=seat too low, pain in back=seat too high. Also, early in the season be kind to yourself. Don't ride in big gears and stay in small chainring.

artimus

-past week alternate days of 40 km, 25 km avg. with a day off in between
-no activity over the winter
-age 44, 217lbs

artimus

Good points that have been filed. I find it tough some days to be kind to myself

artimus

Yes, does a great job of numbing up the whole works.

Could some one remind me of the proper times for the on/off of ice?

CPFITNESS

Bingo! Too much too fast! With zero activity over the winter your body doesn't know whats hitting it right now. I'm 32 years old and I know my body responds a lot differently than it did at 22! cut your mileage in half of that for the next week or definately make sure your keeping the cadence high and the gears low. Ice immediatlely post exercise may help. Also supplementing with glutamine which is available at any GNC may help you recover faster and better as well.

I suspect if you scale it back for one week and then kick it back up you'll be fine in 2 weeks or so.

BigUgly

I have been dealing with knee pain for the past several years but not much from riding but from playing volleyball and I thought I would chime in with my 2 cents worth from my expereinces from the several physical therapist visits(I am not a medical professional). The biggest thing is do not ice it. Ice contracts the muscles and reduces the blood flow that is needed to help fix the area in pain. Blood flow is what your body uses to cure what is ailing it, the more blood flow to the inury area the better. Icing a large area will reduce that and contract the musles around the knee joint. Stretch, stretch, and stretch some more. Most knee issues are caused by tight muscles. Quads, Hamstring, and calf muscles. Even your lower back muscles. Rest also helps. I start by stretching my lower back which is essentially reaching down and touching your toes. You don't have to keep your knees perfectly straight because you want to stretch your lower back muscles. Each stretch should last for a solid 30 second count(1 mississippi, 2 mississippi, etc.) Then move on to your hamstrings. Place your foot up on a chair and reach for your ankle for 30 seconds. You really do not have to keep your knee straight. Striaghten it out as you get more flexible. Then do your quads, heel to butt, and as you get more felxible start pulling your heel up higher and press your knee backwards. Then your calves. Do this 3-4 times a day, it only takes about 5 minutes. I used to think all this was hokie until I started doing it often. My knee pain has dissappeared (except when I don't stretch for about a week or so and they go play volleyball or ride hills). Give it try, it doesn't cost anything. I just want to say that I am not a medical professional and there are no gaurantees, this was just my experience. If you need to use ice, just use 1 cube for a couple of minutes to pinpoint the exact pain and kind of do an ice massage directly on the pain point. (I know several people that have had their hip or knees replaced and the docs want them up and moving right away so that they heal properly. Keep the blood flowing)

artimus

I think that I might be getting some where. Thanks everyone.

CPFITNESS

I disagree with this. You shouldn't ice it just to ice it, but you should ice it AFTER working out. Working out pedaling a bicycle is going to give all the blood flow to the affected area you could ever hope for. however, the side effect is that you also build up inflammation in the area. this is what the ice treats. So no, don't ice it arbitrarily because it hurts but do ice it after exertion to help relieve the inflammation in the area. also, work on stretching the lower back and increasing abdominal strength, sounds like you have tight hammies going on and of course IT Band stretching can't hurt. If your not familiar, you can google IT Band and probably get a ton of info.

artimus

I was taught is, ice to bring the swelling and heat to prompt high blood flow for healing.

I am guilty of using my large chain ring too early in the season.

CPFITNESS

heat is overrated and rarely needed in most instances. The nature of cycling is such that you can get range of motion in the affected joints with limited impacte and stress. Strengthening the muscles is key to recovering from and preventing injury. As you just indicated, you are guilty of going a bit too hard. but basically get back on the bike and just go easy, that will do more to promote bloodflow and healing than simply heating the injured area. I think heating gets overused simply because to the touch it FEELS GREAT, but it's doing very little to help. Heat is generally desireable for areas like the lower back where it's very difficult to move the joints (in the case of the back, the joints are the vertebrae) but for something like knees, ride the bike easy and in a couple weeks you'll be good to go!

artimus

CP,

Thanks a ton!! After having my knee on ice all morning and with the sun shining like it is I MIGHT go for a LIGHT ride this afternoon. How could ANY of us stay home on a day like this: https://www.weatheroffice.gc.ca/city/..._metric_e.html

Jman2224

I have been having the same thing -- my left knee hurts after 30 minutes on the bike. Went to a Specialized dealer Saturday and got a 2D fit. Turns out my left leg is shorter than the right. He put shims under the left cleat to correct for this. Have only ridden once since then but no pain so far!

Good luck with yours

artimus

That's funny because that same though has crossed my mind. That sure would explain why one leg hurts like **** and the other one is fine.

BigUgly

Many physical therapists in my neck of the woods no longer believe in ice for non-swollen injuries which is why I said what I said. I tend to believe them because I live in a college town and they fix D1 atheletes all the time. I guess there are many schools of thought. My injury was more tendon related which may be why they told me not to put a bag of ice on my knee. I was told to take an ice cube and give the tendon and ice massage so to speak to try to relieve any pain. That an ibuprofin(spell?). More than anything the most important thing is to stretch.

CPFITNESS

Yes, Ice massage is a tecnique that is often used for shin splints as well. Exercise causes inflammation which may or may not include swelling. Ibuprophen or Naproxen is also a plus. I'm in NYC, and my orthopaedic is the former team doc for the yankees and currently the NJ Nets team doc so i've got good resources at my disposal! I've been to see him more times than I care to over the years nfortunately and I'm going to need to see him again this fall to get my other ACL done. He did the right one in 2005

Fastflyingasian

2 years ago i pulled a hamstring in my right knee. it was right where it goes behind the knee. i feel it was because it was too early in the season for the type of riding i was doing and the temperture dropping from 75 to 50 didnt help. i felt a twing after a short hill with 16 miles till home. this was in march and i was off the bike for a whole month before i could pedal without lots of pain. my knee wasn't 100% for over a year. i just had to slowly get back to my prior form and be careful when sprinting or climbing with the skinny guys. i would feel something in the back of the knee right when i hit a certain power level and have to back off until fully back to 100%.

Now this year during the off season i did alot of weight lifting and cardio and what a difference for this season. i feel way better than a year ago starting the season. well that is as long as i can stay reasonably injury free.