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What Causes "Burning Knees" and what can I do about it?

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What Causes "Burning Knees" and what can I do about it?

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Old 11-22-14, 07:21 AM
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Jinkster
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What Causes "Burning Knees" and what can I do about it?

Gentlefolk...I'm trying my best to get back into bicycling for a number of health reasons...like keeping my mind off the marlboro man I evicted nearly 3 months ago now and to save my legs from the ravages of diabetes and circulatory problems but...

The Best I can do it seems is a 10-11 mile ride and then I suffer for 2-3 days with burning knees...knowing that I'd better lay off for those 2-3 days to let them recover or suffer even lengthier consequences...and that kills me cause I do want to ride.

I set my seat heights up using "The Leg Fully Extended W/ Heel Too Pedal @ BDC" method and it seems to work just great...no early quad cramping with legs near full extension as I pedal and I try to maintain Martin Horn's suggestion of a cadence rate of no less than 1 1/2 revolutions per second or snick down a gear...which he claims maintaining at least 90 revs a minute helps preserve knee joints.

But even doing all of that?...the next day after a ride my knees got some fire in them...not unbearable and I'm still able to walk just fine and all but the pain will in fact last into a 2nd day which is bothering me...even with aleve.

Do I need to start looking at some supplements such as glucosamine/chondrotin stuff?...any recommendations here?...and please...don't refer me to go see a doctor....just share with me what has worked for you...please.

T.I.A. Bill.
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Old 11-22-14, 07:36 AM
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Who would you see if you had a painful tooth ache?

Take care of the knees.

You don't want this.

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Old 11-22-14, 07:46 AM
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Welcome to getting stronger and upsetting your ligaments. When you were 15 your knees felt just the same for a few hours, then it went away. Now that we are wise and older the pain lasts and lasts. Wait till you take a spill. It takes weeks to recover. I would try to slowly ramp up to longer rides and try not to stress yourself on your rides as you regain the strength in your legs. I believe your knees are just complaining because they are being pushed by your new leg muscles. I stay away from supplements and just try to eat good mix of nutritious and healthy food. Eventually they will come around. By the way you might need a bike fit, if not just a seat adjustment. You don't want your legs to fully extend on the downstroke. But almost. On the other hand, if your seat is too low there is also increased stress on your knees. Good luck and keep at it....
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Old 11-22-14, 07:47 AM
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There are a range of things you could be dealing with: bursitis, osteoarthritis, tendinitis, patellofemoral syndrome, etc. I'd get it checked out to reduce the possibility of doing some real damage to yourself.

You really don't want to end up with knees looking like mine.
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Old 11-22-14, 07:58 AM
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Originally Posted by 10 Wheels View Post
Who would you see if you had a painful tooth ache?

Take care of the knees.

You don't want this.

And from what I've experienced of my local medical community over the past couple decades?...they will wait until....."It Gets There"...before they do a darn thing...nobody does MRI's, CAT Scans, or even X-rays for a patient complaining of burning knees...meanwhile?...they will tell me to continue taking anti-inflammatory nsaid, cut down on my bike riding and do so with a demeanor of...."you're an idiot for even being here with such a frivolous complaint"...then send me home after collecting my $50 copay and charging my insurance company a fortune for their non-services....and this has been my continued experience with such...which is why I asked...."please".

We are living in a world where we need to look out after ourselves because the docs will wait until they can cash in on "The Big Job" and make you feel like a PITA fool until such time....ever wonder why the medical communities adopted a symbol of 2 snakes wrapped around a cross?....

The caduceus (☤; /kəˈdsəs/ or /kəˈdjʃəs/; from Greek κηρύκειον kērukeion "herald's staff"[SUP][2][/SUP] ) is the staff carried by Hermes in Greek mythology. The same staff was also borne by heralds in general, for example by Iris, the messenger of Hera. It is a short staff entwined by two serpents, sometimes surmounted by wings. In Roman iconography, it was often depicted being carried in the left hand of Mercury, the messenger of the gods, guide of the dead and protector of merchants, shepherds, gamblers, liars, and thieves.

So again....please....if anyone out there knows of a remedy that has worked for them?...I'm all ears and ready to hit the health food/vitamin store and/or pharmacy. Thanks, Bill.
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Old 11-22-14, 08:08 AM
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Originally Posted by Bendopolo View Post
Welcome to getting stronger and upsetting your ligaments. When you were 15 your knees felt just the same for a few hours, then it went away. Now that we are wise and older the pain lasts and lasts. Wait till you take a spill. It takes weeks to recover. I would try to slowly ramp up to longer rides and try not to stress yourself on your rides as you regain the strength in your legs. I believe your knees are just complaining because they are being pushed by your new leg muscles. I stay away from supplements and just try to eat good mix of nutritious and healthy food. Eventually they will come around. By the way you might need a bike fit, if not just a seat adjustment. You don't want your legs to fully extend on the downstroke. But almost. On the other hand, if your seat is too low there is also increased stress on your knees. Good luck and keep at it....
Thank you...and you're right...I used to be obsessive about my physical training a couple+ decades ago...at 32 I weighed 158lbs..could run 3 miles in just under 18 minutes...pedal 27 miles in 1hr/15mins....spent 1-2 hours with free-weights every evening and could cleanly bench press 350lbs (1 time)....and I'd hurt like heck the next morning but by the time I got off work?...I was ready to do it again...now? ...for days?...this getting old stuff blows...but I guess it beats the alternative.

Keep it coming folks...I'm all ears...anybody have good experiences with any particular remedial substances or routines?
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Old 11-22-14, 08:27 AM
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is this joint pain or muscular soreness? Either way I might cut back to 5 miles and gradually build up increasing about 10% a week. avoid hills for a while. you might also ice your knees immediately after a ride. I use a frozen vegetable "ice pack". Corn or peas work great because the pack molds to your knee. 15 minutes on and 15 off for about an hour. Do some stretching and maybe some massage. If it is joint pain then the icing still helps and take some "vitamin I" (ibuprofen).
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Old 11-22-14, 08:34 AM
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IMO your seat is a bit too high...There should be a bend in the knees at bottom of the stroke.
Do you warm up your legs at the start of the ride? If not try starting your ride with at least 5 to 10 minutes of easy pedaling then start your plan of the day. Same at the end of the ride.
Start slowly...your body is new to this activity thing from the sounds of it and needs time to adjust.
Have you had a physical? You may want to get a physical just to make sure your body is ok for physical activity.

Take an over the counter aid...Aleve, etc.
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Old 11-22-14, 08:59 AM
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Have you thought about a trainer for one of your bikes? I know its boring, but when I have knee issues, it is easier for me to do easy 30 min spins on the trainer. It will still take 3 to four days to recover, but your legs are moving and getting stronger with little stress.....if your fit is good. YMMV but this works for me

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Old 11-22-14, 09:03 AM
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Originally Posted by RISKDR1 View Post
is this joint pain or muscular soreness? Either way I might cut back to 5 miles and gradually build up increasing about 10% a week. avoid hills for a while. you might also ice your knees immediately after a ride. I use a frozen vegetable "ice pack". Corn or peas work great because the pack molds to your knee. 15 minutes on and 15 off for about an hour. Do some stretching and maybe some massage. If it is joint pain then the icing still helps and take some "vitamin I" (ibuprofen).
Feels more like joint pain..actually?...definitely joint pain...specifically?..."burning"...which gradually comes on during the ride but is then worse the following day...thanks...I'll be buying some ice packs or frozen peas...whichever comes first. LOL!

Originally Posted by Kai Winters View Post
IMO your seat is a bit too high...There should be a bend in the knees at bottom of the stroke.
Do you warm up your legs at the start of the ride? If not try starting your ride with at least 5 to 10 minutes of easy pedaling then start your plan of the day. Same at the end of the ride.
Start slowly...your body is new to this activity thing from the sounds of it and needs time to adjust.
Have you had a physical? You may want to get a physical just to make sure your body is ok for physical activity.

Take an over the counter aid...Aleve, etc.
Kia...my knees are slightly bent at the bottom of the stroke when I move the ball of my foot onto the pedal as one normally does...I only use the heel-too-pedal method to set the saddle height...maybe I should knock it down from there just a hair?....also...you brought up some good points regarding my non-existent warm-up and?....it just occurred to me...the ride I took the other evening on my newly acquired hybrid was a route I've not taken before...which involved crossing many stop/start..."push the button and wait for it"...multi-lane intersections...and with everyone of them?....it was like I really had to pour it on to make it across in time...I'm talking "butt off the seat..everything I got on the pedals"..."Pushing"...to make it across before the light changed...many times over both ways...even crossing an interstate exchange....maybe that's what's got me typing about burning knees this morning...dang it.

I knew the weight of the hybrid was going to cost me a bit on my average time...and waiting for lights certainly didn't help matters much....here's a link to the ride I did 2 nights ago and my knees still have just a touch of fire in them...

&action_type_map=[%22fitness.bikes%22]&action_ref_map=[]]Rode 10.87 mi on 11/20/2014 on 11/20/2014 | RUNNING Training Log Entry | MapMyRun

so?...pedal slow at forst as a warm-up?...ice packs when I get home?...anything else folks?....I'm headed to town to do some shopping so maybe I'll air my dilemma out to the health food/vitamin store folks and see what they recommend as well...last time it was glucosamine/chondrotin..but I guess anything that will help me ride more is a help.
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Old 11-22-14, 09:10 AM
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Originally Posted by pinsonp2 View Post
Have you thought about a trainer for one of your bikes? I know its boring, but when I have knee issues, it is easier for me to do easy 30 min spins on the trainer. It will still take 3 to four days to recover, but your legs are moving and getting stronger with little stress.....if your fit is good. YMMV but this works for me

P2
Yeah...I thought about it...my rich friend at work has a computerized one that cost him $1,700 where it shows the course he's riding on his computer screen and replicates the drag to the grade of te roads he's seeing on the laptop but he also rides a $10K trek Madone...me?...I'd ride in the rain before I'd pedal in my living room! LOL!

And I dang sure ain't spending that sort of cash on a trainer. LOL!

But you just made an interesting comment....am I supposed to be taking 2-3 days off in between rides?...I've been trying to get at least a little in everyday if not a lot in every other day and screwing around with test/adjust rides in between...but I want to ride everyday...am I in fact just asking too much of my old diabetic chicken legs?
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Old 11-22-14, 09:42 AM
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Originally Posted by Jinkster View Post

I set my seat heights up using "The Leg Fully Extended W/ Heel Too Pedal @ BDC" method and it seems to work just great...no early quad cramping with legs near full extension as I pedal and I try to maintain Martin Horn's suggestion of a cadence rate of no less than 1 1/2 revolutions per second or snick down a gear...which he claims maintaining at least 90 revs a minute helps preserve knee joints.
You also might want to tinker with your saddle position relative to KOPS (forth and aft). If your pain is back of the knee or before the knee cap chances are fairly good that your saddle position is not right for your rotation.

Otherwise, if I were you I'd cross-train: yoga, weights, walk/run, dynamic stretching...you can re-invent your body if you are patient and put in the work. Glucosamine/chondrotin stuff works for me, but I rarely use it - nice if you do a long ride or long run unexpectedly, without any build up.

I suspect there are many members of this board that run 10-15Ks, ride metric or imperial centuries regularly with no drama. This a very realistic goal regardless of age if you are fundamentally sound and put in some basic training, get weight under control. As you recover from smoking you will develop an enormous amount of cardio endurance, perhaps more than the average person of your age - you can become a hill climbing stud. Congrats on your journey and good luck.
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Old 11-22-14, 09:48 AM
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Get a Professional bike fit.
It will cost you $200 to $300 approx.
Will be worth every penny.

Or,Monkey around with your fit yourself.
Who knows? you might get lucky.
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Old 11-22-14, 10:22 AM
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A good fitting bike is probably the first thing to have on your side after just being young. It will take a while but your body will adjust to the work, given enough time. In my case, as a 76 y.o. man, I take chondroitin sulfate every day to relieve knee discomfort. I can't prove it helps but I'm convinced it does.
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Old 11-22-14, 10:31 AM
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Originally Posted by FrenchFit View Post
You also might want to tinker with your saddle position relative to KOPS (forth and aft). If your pain is back of the knee or before the knee cap chances are fairly good that your saddle position is not right for your rotation.

Otherwise, if I were you I'd cross-train: yoga, weights, walk/run, dynamic stretching...you can re-invent your body if you are patient and put in the work. Glucosamine/chondrotin stuff works for me, but I rarely use it - nice if you do a long ride or long run unexpectedly, without any build up.

I suspect there are many members of this board that run 10-15Ks, ride metric or imperial centuries regularly with no drama. This a very realistic goal regardless of age if you are fundamentally sound and put in some basic training, get weight under control. As you recover from smoking you will develop an enormous amount of cardio endurance, perhaps more than the average person of your age - you can become a hill climbing stud. Congrats on your journey and good luck.
Thanks French...the burning feels like it's just behind my kneecaps (if that's of any help)...maybe even "in" my kneecaps....but not behind the knees...yes...both of them....and yes...maybe some cross-training is in order...I remember one of my old USMC D.I.'s screaming at us (as they always did) that we are going to be one hurting pack of puppies for the next 3 weeks (as he commented that this was "The Tear Down Period")...and he was right...everything on all of us hurt for 3 weeks and for awhile there?...we all actually got weaker before we got stronger...but once those scales tipped?....life still sucked but our fitness levels were improving dramatically!

Originally Posted by Cyril View Post
Get a Professional bike fit.
It will cost you $200 to $300 approx.
Will be worth every penny.

Or,Monkey around with your fit yourself.
Who knows? you might get lucky.
Thanks Cyril...and while I've considered doing just that?...here's my current list of excuses of "why not"....

1. I got this book called..."Zinn & The Art Of Road Bike Maintenance"...and I read through the fitment section thoroughly...several times over...took all my body and bike measurements, did the math and made the appropriate adjustments...and along with that?...

2. I think I've watched every you tube bike fitment video there is...twice.

(but more significant too me?)

3. My hard core road biking friend at work who travels hundreds of miles to go ride centuries in the mountains several times a year?...(told me when I asked)...don't waste your money on a bikefit session...at least NOT YET...because...as you start rolling the miles on?...your body is going to go through many changes and you're going to find that the bikefit session you paid $200 for and felt great last week?...won't feel worth a flip next week and you will begin to change on your own things in short order....I did.

and I believe him...as he also told me that if I feel it's something I absolutely want to do?...wait a year...and when you go buy your next new Road Bike?...pay for it then and see how it works out for you...but followed with...even he noticed of himself...despite all his years of riding and experience...that the last few times he sprung for a bikefit session?....only a week or two would pass before he make subtle changes anyways...and I know he knows two things...

1. He knows me and?...

2. He knows we both know we are both OCD to the extreme!

But thanks man...I know it's probably class A advice for normal folk.
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Old 11-22-14, 10:39 AM
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Originally Posted by berner View Post
A good fitting bike is probably the first thing to have on your side after just being young. It will take a while but your body will adjust to the work, given enough time. In my case, as a 76 y.o. man, I take chondroitin sulfate every day to relieve knee discomfort. I can't prove it helps but I'm convinced it does.
The first thing I did after going through opiate withdraws and getting clean and sober was get back into my traditional archery and drug out my old recurve...and Lord did that kill me...my shoulders sounded like a truck on a gravel driveway and ached bad the next day...but I kept shooting...and did use just a little milk on my bowl of aleve each morning. LOL!...but I still hurt...so then I did go on the glucosamine/chondrotin and things gradually got better....but not in a noticeable way...and the only way I realized that the gluco/chond was working?...was when I STOPPED taking it...so I started again and quit several times over but haven't taken it for the past couple years now as my upper body is now in pretty good shape after 100's of thousands of bow shots taken...I guess now I'm going through pretty much the same thing with the bottom end...I'll be grabbing some chondrotin sulfate today...never tried that before...thanks...does it get into your system quicker than the glucosamine does?

Thanks, Bill.
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Old 11-22-14, 10:49 AM
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Jinkster,

From what you've said so far, I'm going to (somewhat unhelpfully!) +1 several comments above:

1. Get yourself checked out medically; if you can't or won't do that,
2. Get yourself to a properly-qualified sports physiotherapist, preferably one who works with cyclists; if you can't or won't do that,
3. Get your bike fit professionally checked out.

That said, I do have one question. It's not clear to me if this is happening on all (three?) of your bikes, or just one/the new Crosstrail? I'm wondering about crank length. I usually ride a 'medium' frame (hybrid or mountain); 54 road. Most "medium" hybrid or mountain bikes come stock with 175 mm cranks; I can't tolerate anything more than 170, even though I do have quite long legs for my height (at 5'8" tall I have a 33" [84mm] true cycling inseam) and should be able to. If I use 175 cranks, I quickly develop knee pain (and hip pain). 175s, relative to 170s, inevitably push your knees 'up' higher as you come over the top of the stroke, and close your hip angle. It may seem a small thing, but some of us just can't tolerate this on a repetitive basis. I needed the help of a sports-medicine physiotherapist to figure this out. Might be totally irrelevant to your situation, but thought I'd throw my experience in fwiw.
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Old 11-22-14, 10:52 AM
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Whoops. I meant to say glucosamine sulfate. My experience is the same in that I notice if I've not been taking it.
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Old 11-22-14, 11:13 AM
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In addition to glucosamine sulfate you can try MSM.

You probably have chondromalacia patella.

Raise your saddle about 1/2 cm. For the next couple of weeks, ride only about 1/2 hour per day, but ride every day or almost every day and ride very easy. Keep the cadence up like you're doing, but ride in a low gear so that your legs never feel like they're working. Try to pedal with your heels. Try to stay on the flat. If you have a trainer or rollers, use that instead of riding outside.

And read this post:
http://www.bikeforums.net/training-n...l#post16081392
and do the exercises.

You might also benefit from doing these stretches:
http://www.bikeforums.net/road-cycli...l#post15372967
in any case they can't do any harm.
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Old 11-22-14, 11:16 AM
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Originally Posted by badger1 View Post
Jinkster,

From what you've said so far, I'm going to (somewhat unhelpfully!) +1 several comments above:

1. Get yourself checked out medically; if you can't or won't do that,
2. Get yourself to a properly-qualified sports physiotherapist, preferably one who works with cyclists; if you can't or won't do that,
3. Get your bike fit professionally checked out.

That said, I do have one question. It's not clear to me if this is happening on all (three?) of your bikes, or just one/the new Crosstrail? I'm wondering about crank length. I usually ride a 'medium' frame (hybrid or mountain); 54 road. Most "medium" hybrid or mountain bikes come stock with 175 mm cranks; I can't tolerate anything more than 170, even though I do have quite long legs for my height (at 5'8" tall I have a 33" [84mm] true cycling inseam) and should be able to. If I use 175 cranks, I quickly develop knee pain (and hip pain). 175s, relative to 170s, inevitably push your knees 'up' higher as you come over the top of the stroke, and close your hip angle. It may seem a small thing, but some of us just can't tolerate this on a repetitive basis. I needed the help of a sports-medicine physiotherapist to figure this out. Might be totally irrelevant to your situation, but thought I'd throw my experience in fwiw.
Hmmm....I do have one old chiropractor friend I trust and have used many times over...he straightened out my back and squared my hips after numerous sport bike racing accidents...also gained me a ton of range of motion in my neck and?...he's a flat out health nut and fitness freak....and only charges me $25 (and a handshake) per session...I'll go see him and see what he has to say besides....

"Where the hell have you been!" LOL!

And that's an interesting point you bring up regarding crank length...I always giggled at such thinking what a bunch of brew-ha-ha...figuring if I have too much pressure cranking?...whats the difference between the leverage of longer cranks VS just downshifting a gear or two?...and with me at a whopping 5'6+"s on a good day?....my inseam is just shy of 29"s short...so I also thought if I have short legs?...what business do I have with long cranks?....nevertheless?...all I have is a tape measure and the best I could measure was just a hair under 6 3/4"s fron center of crank to center of pedal spindle on all three bikes...which metrically converts too 170mm cranks on all 3 bikes...also?...the seat tube on my Giant RB is 19"s while both my Trek MB and my Crosstrail hybrid the seat tubes are 18"s....so I'm good there right?...or is it possible I need even shorter cranks?...with the seat height up where my legs are near full extension they don't feel like my knees are getting jammed...but with just a slightly lower seat height they can.

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Old 11-22-14, 11:16 AM
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Much of the above seems good advice to me. Not only do I ride but I'm a climbing guide in the mountains and coming down is the worst possible impact on my knees. My recommendations are:
1. I agree, don't go to your family doc, but rather go to a sports medicine clinic and make sure you don't have some knee damage that needs to be fixed.
2. Unless the clinic recommends supplements, they are a waste of time and money.
3. Care for your knees with stretching and exercises to strengthen the component parts. My favorite is leg lifts that you can do at home or at the gym on a machine. Simply sit in a chair (or couch) and lift your feet so that your legs are parallel to the floor - repeat. You can add ankle weights to increase the effort. If you do these at the gym don't add a lot of weight, especially at first, just enough over time to keep your knees healthy. If your "burning knees" are what I think it is, leg lifts will immediately relieve them.

Good luck and let us know how you resolve this.
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Old 11-22-14, 12:48 PM
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Jinkster way too much thinking and over thinking going on regarding bike parts, etc.
Your 170mm cranks are fine and don't need replacing.

You've only made one slight mention of your bike...you mentioned hybrid in one reply...what are you riding for your everyday bike? What kind of pedals?

If you've spent a long period of time abusing your body it is going to take some time and most of all patience for your body to rebound and return to a reasonably fit form...doesn't matter what you did or did not do in the past, it is the now that matters.
Take your time, do a bit of stretching before an activity, start any activity slowly until your body warms up. Start activities slowly...don't try to do too much too fast...typical attitude, and commendable just not smart, for people recovering, trying to improve their lives, etc...
Relax and enjoy...your body will thank you for it.

Pain is a good thing...it tells you when you are pushing to hard, have exceeded your bodies current capability and/or are doing something that is causing injury or potential injury.

Typically riding a hybrid, or any upright type bike, means you are pushing in a downward motion much of the time...almost like stair climbing. If you are using standard platform type pedals you are pushing down more because that is the most stable position. The strain of the motion is more centralized thus potential for pain/injury.
If you are using toe clips/straps or clipless pedals you can and should push forward as much as downward. Also, as has been said, dropping your heels down a bit changes the load on the muscles a bit giving some a rest while others work.
Using your gears to keep the load lighter is also important...higher rpm's puts less strain than lower with more "push".

Spend time looking at your environment...enjoy the ride...your fitness will improve, you may as well enjoy the view even if it the same one on nearly every ride...we all have that "problem"...eventually you will get to know every stone, etc. on your routes.

Make sure to stretch after the ride...maybe an hour or so...gentle, light stretching is as important after the activity as before...your muscles, etc. have tightened up after the ride and need some gentle stretching. Learn some basic self massage...YouTube videos should help...and give your legs a massage after your ride while relaxing. Some people also lie on the floor and put their feet on the wall so their legs are at an upward angle to promote blood flow...try it...if it works it is good.

Keep it up...most important of all.

Cool you mention the traditional bow...I've been thinking about trying out traditional archery for a while now and am close to buying a bow, want to make one at some point. I've spent a lot of time looking at traditional long bows and recurves...probably going with a starter recurve, Samik Sage in the 25 pound range as I'm 59 years old, 5'5" at 155lbs...It looks like fun and I can shoot in my back yard, plenty of room.

Good luck and keep us informed.
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Old 11-22-14, 03:35 PM
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Originally Posted by Carbonfiberboy View Post
In addition to glucosamine sulfate you can try MSM.

You probably have chondromalacia patella.
CFboy...your stock just went way up on my market and thanks!

You're right...it appears I do in fact have...

chondromalacia patella

I just read all about it at the link below....

Chondromalacia Patella: Read About Treatment

Description and Symptoms are bang on...and?...everything makes sense...as I spend probably 8 of my 10 hour workdays sitting at computers creating and running milling programs for two cnc 3D mills I keep set-up and running all day long...for decades now....also?...no doubt my quads are nowhere near what they should be..2+2?...the bad news is I have it....but the good news is...

The recommended pain management is in fact either ibuprofen or naproxen and the recommended therapies are?...

"Pool Running"

"Flutter Kick Swimming"

(and here's the great one...)

"Low Resistance/High RPM Bicycling"

So I guess I'm back to adopting the old philosophy of...."Pain Is Growth"

Lord...what a wuss of a chicken legged old man I've become....glad it wasn't anything serious...Thanks again, Bill.
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Old 11-22-14, 03:59 PM
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Originally Posted by Jinkster View Post
CFboy...your stock just went way up on my market and thanks!

You're right...it appears I do in fact have...

chondromalacia patella

I just read all about it at the link below....

Chondromalacia Patella: Read About Treatment

Description and Symptoms are bang on...and?...everything makes sense...as I spend probably 8 of my 10 hour workdays sitting at computers creating and running milling programs for two cnc 3D mills I keep set-up and running all day long...for decades now....also?...no doubt my quads are nowhere near what they should be..2+2?...the bad news is I have it....but the good news is...

The recommended pain management is in fact either ibuprofen or naproxen and the recommended therapies are?...

"Pool Running"

"Flutter Kick Swimming"

(and here's the great one...)

"Low Resistance/High RPM Bicycling"

So I guess I'm back to adopting the old philosophy of...."Pain Is Growth"

Lord...what a wuss of a chicken legged old man I've become....glad it wasn't anything serious...Thanks again, Bill.
You're welcome. But also do raise your saddle that 1/2 cm, the idea being to somewhat reduce patella movement up and down, and for a while way cut down on the pedal effort. Ride easy until it goes away. In this case pain is growth only if you can get it to go away! So try the therapies to build up your VMO and ease off on the knees until they're better.
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Old 11-22-14, 11:11 PM
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Ah, good old CMP, my friend for the past 36 years. (In the letter I included below, I called it just CP. My google just now was the first time I saw CMP.) I'll post what I wrote about 13 years ago on my experience with it. (When I was diagnosed '78, CMP was not thought to be a cycling issue. The doctor who diagnosed me was also a newbie bike racer and he made the connection. He diagnosed me in a very cold van at the parking lot of a March bike race in New Hampshire. Charged me zero and even took follow up phone calls.) I have never seen all that doctor told me in one place. Since I wrote this, I have ridden around 74,000 miles, so you can see CP isn't the end, At the same time, I never get to ignore it. Doing so would mean getting those 3rd party knees. I like my OEMs. Here's what I wrote:

Chrondomalacia patella. Yes, I can tell you a little about it. I was diagnosed in ’78 and given very good advice by the doctor (an orthopedic in sports medicine. He was also a novice bike racer, so he had more understanding of the cycling aspects of CP than most). I will do my best to pass on what he told me.



In CP, the kneecap is not aligned with the knee under it, hence there is chafing as the knee is moved. This causes wear, first to the cartilage, then to the bone under it. The wear accumulates with number of repetitions and pressure. At some point, the wear can cause permanent damage.

Some people are more prone to CP than others. It can be triggered by exercising in cold weather, exercising without adequate stretching of the hamstrings, i.e. touching your toes or less extreme stretches of the same tendons. It can be brought on by exercising without adequately strengthening the small quadriceps muscles just above the kneecap.

I brought on my CP by training to return my body to racing form after a very serious accident. (I was weak enough after my hospital stay that I was no match at 24 years old for any 7 yo. The accident was in November, and I returned to riding miles in March. I did nothing to keep my knees especially warm and did no stretching exercises (rationalizing that since my leg never extended to anywhere near straight, there was no chance of injury, hence no need to stretch). I was wearing just full tights and thermal underwear under them in Boston. The temperature was probably not much above 30. The ride that started it was 100+ miles on my racing bike, my first outdoor ride on that bike. It had 175 cranks. My trainer, with fixed gear and very low BB, had 168’s. After the ride I had a dull pain in my mid to upper knee in front. That Saturday was the first race of the season. I was forced to drop out, my knees hurt so much.

After that race, the race promoter introduced me to an orthopedic surgeon who diagnosed me in the back of a cold van. He laid out for me then and in later phone calls a plan that I will pass on here.

He first stressed that I had to stretch my hamstrings, touch toes or lean forward against a wall or post with one leg back and straight and stretch that hamstring or sit and touch toes. I now prefer the lean forward method. Very specific and hard to hurt yourself. (I am now a 48 yo, I damage if I am not careful.)

Second, he had me sit on the floor and do leg raises. He had me raise one leg at a time and hold it several inches off the floor for a while (I don’t remember the time, but 15 secs should work. Important – while the leg is raised, tense up your quads big time and tense up those little quads just above and beside the kneecap. Feel for them and get to know them. It is those little guys that keep you kneecap aligned. If you are in riding shape, you can do this with say 5 pounds on your ankles, but the tensing up is much more important than the resistance.

Third, KEEP YOUR KNEES WARM WHEN YOU RIDE!! For me, this is critical. I wear these dumb looking “knee warmers” for most of my rides, always below 70 degrees, often under tights. Since keeping the hamstrings loose is important, I had to stretch the elastic. To keep them from falling down, I sewed on garters that I clip onto my shorts.

Fourth, back off riding until you have been doing these two things long enough to make a difference. Keep up the exercises and especially the stretches after you resume riding. Build up your riding slowly. The doctor stressed this to me and it has been very true. My ability to come into real form and resilience on the bike is limited more by my knees than by my lungs/muscles.

After rides, take aspirin or Ibuprofen to speed recovery. I personally think aspirin is better, that my knees recover more with it. I disagree with the ice. I have always felt that moving my knees when they are cold is causing the damage I am trying to avoid. Perhaps ice speeds recovery, but I feel it also continues the damage (at least in my knees).

Big gears are the enemy of CP knees. I love to climb hills standing. I love to ride hilly country on fix-gears. It is a fact of my life that I can only ride certain not-so-steep hills on my commuter and that I have to have and use a granny ring on my custom. It is a fact that there are days, weeks and months when I have to let whippersnappers blow by me on hills where I know I can humble them.

Lastly, what you did not want to hear, but again what the doctor told me. Get used to the idea of CP. If you are at all like me, it will be a fact of your cycling life for a long time. 23 years later for me and I am feeling my knees now because of a very easy ride I did in street clothes without knee warmers at noon today.

Sorry to be the bearer of bad news, but you can still do a lot of riding. I raced that season (I already knew it was my last) and have done 60,000 (?) miles since. I still commute, but only on alternate days. (But for the first 7 years with CP, I did not own a car and rode everywhere.)

I took the time to spell all this out because in the 23 years I have had CP, I have never seen all of this in one place. In fact, I have only heard about the importance of keeping the knees warm from that one doctor. That is the single most important aspect of the program for me. Thank you Dr. Kish, wherever you are. I will probably ultimately need those carbon fiber knees, but by following the regime, I figure I can wait until a) the product improves, b) the price comes down and c) I’m old enough that my cycling level will be within the abilities of those knees. I hope to delay another 10 years.

Since I wrote this a year plus ago, my physician has recommended that I take glucosamine. He was very specific, that I should take 3000 mg/day in the form of glucosamine sulfate or glucosamine hydroxide, but to avoid chrondroitin. This I did faithfully for 9 months. Between riding steadily starting two years ago and the glucosamine, my knees never felt better than they did last summer. I was passing whippersnappers uphill. Then my riding tapered off, I tapered down on the glucosamine and got sick so my riding and conditioning dropped. Thanksgiving I rode 50 miles with 2500’ of climbing on a cool day. My knees hurt. How many of those rules outlined above did I break?

Ben
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