Banzai

I started having some knee pain now and again a few months back. The worst yet was a few weeks ago after running quite a bit on a TDY.

It's concentrated on the outside of my knee around my LCL. When I relax there's no pain, and it doesn't hurt to touch...but when I put weight on it, like climbing stairs, or trying to push my bike uphill...it feels like something stabbing into the outside front of my knee.

Based on the symptoms and what I've read, it sounds like tendonitis. I've started treating with an Ace wrap and glucosamine and ibuprofen.

I'm afraid I may have to quit my commute for several weeks. I'm losing time and power, and the knee doesn't seem to be getting better. I tried to take a week off, and ride once my knee quit aching...and about 8 miles in I could tell that I had made a terrible mistake.

Mostly I'm whining, but if anyone has experience with knee issues I'm more than happy to hear your opinions/thoughts.

matthew_deaner

I don't know if this will help... but I get knee pain if I don't keep my knees warm. I use tights or at least knee warmers when the temp is below 60.

Also, the right saddle height and foot position can be a factor. You want your knee to be slightly bent at the bottom of the pedal stroke. Have you been professionally fitted?

Banzai

I haven't been professionally fitted recently, save for by me. I've been commuting/riding for a while now, and I'm pretty decent at fitting a bicycle and getting proper leg extension. (I fit three of my friends on their bikes as well.)

There was a while back on my new bike that I had the saddle a little bit too high for a couple of rides while I was fine-tuning the saddle height. It's possible that repetitive stress during that time contributed in some ways, though it was only a couple of times.

It could also have been the sickening impact of my knee on the upfront control when I was climbing into the jet once back in May. But the doctor said that with a blunt injury like that it should hurt to touch/manipulate if it was still affecting me.

I'm honestly at a bit of a loss. My wife wants me to simply take some time off, but I don't really like the idea of that. However, I don't want to do permanent damage, and I don't like the pain.

threephi

Yep, it sounds exactly like tendonitis. I would highly recommend a visit to a sports medicine doctor to identify precisely which tendon is affected, to get the correct brace or strap to stabilize it while it heals, and to get recommendations for physical therapy. Often tendonitis occurs as a result of imbalanced musculature or a flaw in your riding style that aggravates the tendon.

These kinds of injuries can take a while to heal though, so just be patient and take it easy until it's better.

Pinyon

I would suggest going to a sports doctor, and getting it checked out to make sure that it is not an LCL. Having said that, it sounds a lot like a patellaformis issue (spelling), which is very common with guys who have genetic bio-mechanics such that if the outer quadraceps are much stronger than the other muscles surrounding the knee, literally pull the knee off-track to the outside of where it is supposed to go. The result is that your knee cap rubs on the hard bone and other hard tissue around your knee, and rubs the back of your knee cap.

I have one knee cap that has a big, c-shaped divet taken out of the back of the knee-cap bone from this, and it hurts a lot when it is flaring up. The up-side is, that I have no pain if I make sure to do my stretches (especially IT band stretches, in my case - need to see doctor to see what you need to do), go down hill when hiking or running with the correct technique, and make sure that I don't swing my legs wide while cycling.

Sorry for the hijack. If it hurts that bad, and it is a knee, it is worth the money and worry to go to a sports doctor and get it checked out. You can prevent a lot of BIG issues later on, by paying attention to painful knees earlier rather than later.

JoebikerLa

+1

This is what I was diagnosed with. I was given exercises to help strengthen the inside muscles in my leg. I was told the quads were overpowering the other one. A good physical therapist can help a lot too. I still have a little knee pain, but it's not bad. I ride hard five days a week though.

b_young

Mine went away when I did get a professional fit.

rsdmag

Im going through a similar pain right now as well- Im just waiting for my MRI results to make sure I havent torn my meniscus. General exercise feels OK, but over 30 minutes of repetitive motion and it feels like an ice pick is being driven into my knee. Good luck.

DoB

When the ice/snow came I had bad knee pain on day two. Turns out my toe clips on the ice bike were too small for my new boots and my feet were about 1.5 inches too far back on the pedal.

Small details in fit can be critical.

idcruiserman

Maybe a tight ITB, but hard to tell from here. Stretch properly, get yer leg muscles balanced, and see a doc if needed.

craigdurkee

seems like a pro fit might be the way to go eh

unkchunk

Another option to consider is a chiropractor*. I don't know if there is a sports medicine doctor in my area. But when I had a shoulder problem last January my sister (who runs marathons) recommended this one chiropractor that many local marathon runners went to. He had better focus and more time to spend with me in determining how the pain started and recommending stretching and exercise remedies. That's why I put an "*" after the word. Not just any chiropractor, but one who specializes or participates in sports. Cycling even better. Ask other cyclists in the area and with your LBS.

I think it would be great if they had one who specialized in cycling here. When you go for an appointment you'd bring your bike and he'd check for fitting. Then video tape you riding and critique your riding technique and recommend improvements or strength conditioning. A sort of cycling coach/personal trainer/physical therapist in one package. For general health you'd go to your regular doctor, but for cycling specific things, you'd go to this guy or what ever it's called.

The Smokester

Banzai,
The above quote might be a real possibility. I have found personally that my knees have become quite susceptable to damp cold. It's very strange because dry cold (low humidity) at 60F is okay but damp cold (nearer the coast) can do me in with symptoms as you describe. Try knee warmers or tights AND knee warmers. Worked for me.

rhm

Consider shorter crank arms. I mean, consider seriously shorter crank arms, like 150 mm if you can find 'em. I've been researching the subject for the last week or so and have found many advantages and no disadvantages.

Mr. Underbridge

If it's an issue with the outer quads getting too developed, one way to strengthen the lower/inner quads is to drop the seat just a bit, and possibly pushing the seat forward slightly. Of course, one doesn't want to overdo it with that, as trading outer knee pain for patellar tendonitis wouldn't be the goal.

Hearing about things like this starts making me think that sometimes, overtraining and 'locking in' to a particular fit may cause injuries like this where a couple of the muscles become way overdeveloped. Maybe I won't complain about my constantly-slipping seatpost - at least it gives me a variety of knee angles, right?

But in general, seeing a competent sports medicine doctor is probably going to be the only way to really fix it. Good luck.

jmcgonig

This is a classic overuse injury on the ITB. You described it perfectly. Look it up on the internet, its a PIA to get rid of. Mostly get off the bike and RICE. Good luck.

Banzai

Thanks for the advice, guys. I looked up the ITB problem, and discussed it with the flight doc, and though he's not a sports medicine guy he seemed to think that is a possibility as well. Particularly considering that the knee doesn't hurt with any "manipulations" or with being poked and prodded. Just with certain kind of exertions.

I'm going to double check my saddle height very closely, make sure it's not still just a bit too high. I'm starting to think that it could be. I'm also going to start trying to heal this problem so I can get back to riding at full strength again.

rsdmag

MRI came back today- no damage to the joint itself, so looks like ITB here as well. Doc said RICE and begin building strength back gradually (no more than +10% increase in effort until full strength is back) and do some cross-training to help make sure the muscles are built as evenly as possible. Looking at a combination of weights, riding, swimming, and elliptical trainer sessions. Good luck!

HardyWeinberg

ITB problem most common,I gather, w/ tall people (or those who have ever had rocketing tall-for-their-age growth spurt)

Banzai

I'm very short, but I'm kind of bow-legged, and that's listed as a definite "risk factor" for developing ITB issues.

schlaefer88

I had the same (or a similar) problem last February. It kept me off my bike until July. I think the problem was due to my failing to realize until after a 40 mile ride that my LBS had failed to restore the seat height after a tune up. Somehow this really messed up my knee. I couldn't even climb stairs. Diagnosis, tendonitis. It seems that physicians vastly underestimate how long it takes for this to heal.

I ended up placing big arch supports in all my shoes to keep my weight going down the outside of my knee. This enabled me to walk and start to build my muscles back up without exacerbating by tendonitis. Once I got back on my bike, I found that the correct seat position (particularly in regards to the relationship between my knee and the pedal in the middle of the downstroke 3:00 position on pedals) was crucial. If my seat was too far back, the downstroke put too much pressure on my knee. Moving the seat forward a centimeter made a big difference for me. Also, I now do better using a lower gear and a faster cadence.

I can now ride my usual commute-- 25 miles per day--five days per week without hurting my knee.

Good luck and be patient with your knee to give it time to heal.

schlaefer88

I also recommend paying close attendtion to bike adjustments, both seat height and seat forward/back adjustment. I hurt my knee because my seat was too low (lowered during a tune up at LBS and I didn't notice until 40 miles later). I also suggest making sure you have good arch support in all shoes you wear, this will help stabilize the knee. Further, be patient. I have spoken to several folks around my office who have had tendonitis. The consensus is that it takes time to heal. Mine took 6 months. It could be longer if you don't take care of your knee.