Knees not what they used to be
 

As a kid I rode bikes all the time. Never a knee problem. At 51 the knees are not the same. Got a new road bike and have been riding the hell out of it. Saturday woke up with Pes Something Bursitis? What the heck? I can hardly walk. Now I read there are so many things that can cause this, I may never be able to ride again. I am not sure getting old beats the alternative.

Get a pro to check your fit, slow down and take it easy, give yourself some rest days, Of course you can ride again.

Heck - you are just starting the aging process. Many years to go until you fall apart!!

Gear down and spin, and work up to longer distances. You can strengthen your knees, but you'll need a training plan. You can't just jump on and push it to the limit any more. Sorry.

I've been working on running after an IT band flareup. It's taken months, but I'm up to four miles now, on my way to 6. Plan on gradually increasing distance and intensity.

Knee problems on bikes are not unusual but in the main can be cured. Fit is the main thing with saddle position being very important. Cadence- or the speed you pedal at is another. Low RPM at the pedals with high gearing will put strain on them so another thing to look at. Exercise and training of the muscles round the knees (Called the quads). If you can improve the quads- then the knee takes less strain.

I've had surgery on both my knees, one or the other would hurt almost all the time, that is until I took up riding after 40 years. I started with short 5 mile rides and worked up to 40-45 so far. My knees have never been better for a 57yo, Aleve helps a lot.

After getting the bike fitted exactly to you if you still have problems consider a pair of "kneesavers" to get your pedals aligned with your stroke.

http://www.kneesaver.net/

I have no idea what "Pes Something Bursitis?" is, but-

I have one knee that doesn't have a full range of motion due to an old injury.

Shorter Cranks made a world of difference for me. Less knee bending.

I've had seven (7!) knee surgeries in the last 48 years - my knees are so bad that I can't walk for three or four days at a time - that happens several times a year. My only remaining option is new knees (or resurfacing if that technique improves).

There has almost never been a time when I could not ride and the more I ride, even when walking is difficult, the better my knees feel. Last week I could not bend my left knee enough to walk normally but I raised the seat way up on my mountain bike with road tires, used platform pedals and comfortable shoes, and knocked out 10, 15, and 22 miles in three consecutive days. My knees felt much better after each ride than before.

My left knee is still not working correctly but I did 45 miles (14 mph average) with 2,500 feet of climbing today. My knee felt good riding. Before I started the ride I fiddled with seat height and position to minimize stress on my knees.

Bottom line for me - I'd be a cripple and unable to walk if it weren't for the hundred thousand miles I've ridden in the last 50 years.

Most important considerations:

- fit is critical - seat forward/back and up/down.

- foot rotation (in cleated pedals) is important so you can find the angle that minimizes stress on those poor knees

- fast easy spin is mandatory - I can pound a big gear pretty well but I really feel it in my knees that night.

- I climb in the saddle and REALLY spin - I've always had a triple so I can spin easily - it is not geared real low (34/25 is the lowest gear) but I have lot's of low gears so I'm always turning over at 85+ on climbs

- experiment with your riding position and style - my knees really let me know when I am doing it wrong - they ache all night

Bottom Line - efficient bike riding is great for my totally wrecked knees (not to mention two broken legs and two crushed feet)

My wife has had both knees replaced. We searched for the very best surgeon we could find, and she is doing great, rides her bicycle, etc. Is there some reason you have not had yours replaced?

"Is there some reason you have not had yours replaced?"

The only thing that I can't do that I really want to do is run - I was a serious runner for 25 years but my knees are too sore to run now.

I can still ride as much as I wish, both mountain and street, and walking long distances is still OK.

SO - I figure the longer I wait to have my knees replaced the better will be the techniques and materials. My orthopedic surgeon and his predecessor have been taking care of my knees since 1980 and they both keep telling me that nothing I do now can make them any worse. I can not do any more damage than age, time, and abuse has already done.

They agree that the longer I wait the better will be the results.

And... my best friend, running, riding, skiing, climbing buddy since 1966 had a knee replacement three years ago. He has had two followup surgeries to clear adhesions (scar tissue) but he still has very limited range of motion and that is where it will stay. He is TOUGH and was overly conscientious in his recovery. He did everything and more they asked and still got bad results. He is also an advanced Yoga master and is the most flexible old guy I know. That bad result scares me.

On the other hand - my dad had both knees done and was still hiking and biking with me when he was 85 so that is an encouraging result.

As long as I can walk and ride, and sail my boat, I'll wait.

OK - I guess I got confused!!

Joint mice and hydraulics
 

It is pretty simple to understand

the cushioned linings of my knees are pretty much gone - the upper and lower parts of the knee rub bone on bone. That works OK but feels 'kinda gritty and "not quite right" as I walk. I've learned to ignore most of the slightly unpleasant symptoms and feelings.

occasionally a small piece of bone or something else breaks or chips off inside the knee joint. That chip (I've commonly heard them called "joint mice") tears the lining of the knee. The knee then fills up with fluid and knee motion becomes very limited due to hydraulic locking. The knee joint can't bend because the fluid in it will not compress.

If I have really bad luck the chip lodges in the joint and mechanically locks the joint. If I wiggle and flex the knee enough (painful!) the chip moves to a less painful location.

From the outside the knee begins to look swollen and eventually resembles a small American football. The pressure in the knee is somewhat painful while the knee is stationary and becomes progressively more severe as I try to bend it.

For example - two weeks ago today I was sitting in the cockpit of my boat replacing the tube in one of my mountain bike tires. I was pumping up the tire while seated. The tube blew up with a very loud bang which startled me. I jumped to my feet and it felt like someone had stuck an ice pick in the back of my knee. When I tried to wiggle the knee the ice pick sensation intensified.

Within 24 hours the knee was so swollen I had only about 60 degrees of motion in the knee. Walking is very difficult when the knee will not come within 15 degrees of going straight. Typically the swelling continues to worsen for about 36 hours. If the swelling is too great I go to my bone doc who sticks a really big needle in the joint and drains off a coffee cup of bloody fluid. That is a huge relief,

By Tuesday afternoon the swelling was down enough I could limp along without to much distress and that is when I raised my bike seat and started gently spinning the pedals.

By the next Saturday (8 days after the ice pick) I rode 62 miles on the road bike with only minor distress in the knee.

These episodes of joint mice tearing the knee lining occur with no apparent cause in both knees.

As long as I keep my weight down and ride the bikes a lot the knee swelling only occurs once or twice a year.

The big problem is when the joint mice bite the knee during a bike ride. That has happened several times and is a real problem.

five years ago - 30 miles from home on my road bike - in the country where I had not seen a house or car for five minutes - I stopped to take a picture - pushed off with my right foot and POW - my right knee locked - I could only bend it about 20 degrees. I was able to wiggle and flex my knee enough to get the offending piece in the knee to move to a less painful and motion limiting location. I was able to take a 22 mile short cut home. Next day the knee was the most swollen I have ever seen it.

20 years ago on the mountain bike - in the Cascade mountains 10 miles from the trailhead a knee locked up and would not loosen up. It was mostly downhill but I could not bend the knee enough to put in on the pedal. I was riding by myself so I could whine and cry all I wanted as I rode with one leg or limped on one leg using the bike as a crutch.

Bottom Line - 99% of the time my knees are sore but work OK - occasionally one or the other knee locks up, either mechanically or hydraulically, and I have 3 to 6 days of sore stiff annoyance.

Here is a link to an X-ray of a knee joint with a chip lodged in it - it is part of an article by a long distance bicyclist and his problems with knees

http://www.google.com/imgres?hl=en&s...r:15,s:0,i:105

It is good to wait since all joint implants have a limited life being man made. That said, there are certain activities that any knees replacement patient are no longer able to do. That being getting down on your knees for anything from sex to weeding the garden so that you don't loosen the implant in the bone!! So do wait as long as you can...........

boy, i should have read this earlier,,a few days ago i rode 20 miles,then came home and mowed the lawn,then needed to do some adjustments on the mower blade, that entailed getting down on knees, when finished felt some pain in L knee(the good one), and the next morning could hardly walk, have been sleeping with heating pad on it and a pad around the knee, for the last 4 days, and did a ride today and all seems well,a bit stiff in AM but after that all is well(I hope!!!)(I do not have artifical knees)
Bud

Pes anserine literally means goose's foot, because where a bunch of ligaments come together on the (medial, I think) side of the knee, it looks like a gooses foot.