update: pain and discomfort is severely down. i havent biked in 2 weeks. weather sucks here anyway at this time of the year with 70% humidity with around 95 degrees at night.

i don't even notice the discomfort in my knees anymore when I walk.

Should I go back to 10 miles per session with low gears, 2 to 3 times a week?

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I know this forum is not webmd.com but I thought maybe I can state my problem and maybe somebody can help.

A few things about me before I state my case. Im 28 years old. 163 pounds. 172cm tall. for the past 2 years ive been constantly looking for the next fun way to keep fit as I'm not getting any younger.

So here goes....

I began doing intense cardio last year. Always went for full incline (15 degrees) on the treadmill and high gears on the indoor cycling machine. I never went for speed, instead high resistance. Over time my right knee began hurting. I went and did an MRI and the doctor said I have a mild knee effusion and should avoid high impact sports (anything that causes me to suddenly stop). I think I was just too hard on my self on the treadmill, cycling and cross trainer. I continued going to the gym and only working my upper body.

Here is what happened next...

I had a week long conference I was managing and ended up walking 20k steps per day. the first two days were painful but on the third day, the pain magically went away. My only explanation to that was that my quad and hamstring muscles had gotten strong and helped support and pick up the slack off my bad knee. In a few weeks I went back to cardio. The pain was always there but it was very minor. I would just ice my knee for a few minutes and suck it up. I never had a limping problem or never felt I had to stop walking cause of the pain.

My main motive to begin cycling was that if I cycle 2 to 3 times a week for about 2 hours every session my quads and hamstring will become strong enough to decrease my knee pains. The only pains i ever experienced on my right knee were mild upper inner pains with lower outer pain (PHOTOS BELOW MARKING THE AREAS). I would ice it after exercise and the pain would be there next day but barely noticeable. It would just feel stiff sometimes but I got use to it. The doctor insisted that no surgery is required for this as its very minor and I just need to rest it from intense cardio and try and walk as much as possible to strengthen my quads.

I have been cycling for about two months and I can only cycle every 3 days as my knee needs the rest. My hamstrings and quad are significantly stronger by now but that minor pain is always there. As I cycle I always feel in the beginning like there are needles slightly poking on my patella as my foot goes from the 12 oclock to 6 oclock position. Eventually after 5 or 10 minutes with the right gears in place I feel normal and can go for a good one hour without any issues.

Last session (Tuesday night) which was 2 days ago lasted about 10 miles. Next day and until today I feel discomfort on the when I get up or sit down in my left knee patella. When I walk no issues what so ever. It just clicks when I wake up in the morning or have been seated for a long time

To sum up... I gotten use to the right knee pain and only recently my left knee patella has began irritating me. I am really bummed out because I genuinely enjoy every second of cycling and would like to know if I should rest for a few weeks or give it up all together which would really mess my head up, as I've been quiet misrible with the same routine Ive been having until I took up cycling.

I am always riding in easy gears (when on flat surface always on middle ring, and 5 or 6th gear) which apply barely any pressure on my knee. I wanted to go for a midnight session a few minutes ago but am afraid Im slowly destroying my knees.

Any advise would be so greatly appreciated as my heart is broken seeing my beautiful bike just sitting there with me afraid to ride on it and further hurt my self.

Thanks
Jad

you probably need to significantly reduce the intensity and duration of your activity, whether it be cycling, gym, stretching, everything.

i had to learn the hard way that rest is as important as activity and without sufficient rest you will continue to ruin your joints and musculature. it may prove difficult for you to believe that punishing yourself with excessive activity is not to your advantage in the short term or long term.

BTW, it's not unusual for doctors to not realize how much some people can abuse their bodies and consequently not advise strongly enough the necessity of rest. i have never had nor have ever advised anyone to seek the advise of any sort of professional sports coach or advisor, but i might recommend that you contact a professional sports coach experienced with highly motived athletes. you may need someone that you trust to help you moderate your activity.

You're over doing it. 15 degree in line on the treadmill and high gear on a stationary bike just starting out sets you up for injury. However at 28 years old, you should be able to do a lot of things older people can't. Since you have knee pain, I woukd see a chiropractor to check for biomechanical issues. You might need inserts in your shoes if you overpronate.

Joints, ligaments, and tendons don't have a direct blood supply. There are no arteries or veins in any of them. The only way repair can happen is for those structures to get nutrients by being "washed" in lymph fluid, which is really the part of the circulating blood that leaks through the vessels into the tissue, and eventually returns to the circulation through the lymph system. In other words, those structures will take significantly longer to heal and/or repair than muscles or bone, since muscles and bones have a direct blood supply. You will need to give your knees a break for several months. That does not mean laying off exercising them completely--- part of the lymph circulation depends on the muscles flexing to pump the fluid through. But, avoid doing things that cause sharp pain, and try not to injure the knees further. Moderate exercise and adequate rest will likely allow your knees to rehabilitate. You can also try massage and acupuncture. It will take a while, on the order of 4-6 months, at least, and maybe as long as a year. Ligaments, tendons, and cartilage just take a long time.

I guess im currently learning the hard way on what I should not have done.

I use to do the intense cardio exercises last year and eventually had to stop because of the pains. I thought i was bionic or something and i refused to listen to anyone as I was losing so much weight and getting really fit in a short period of time.

thanks for giving it to me as it is i think my biggest mistake was doing 25 mile sessions on mixed terrain for a few weeks. I will definitely give my knees a rest and maybe stick to cycling once a week or twice for 10 mils every session. Ill see what I can do and try and figure out the best solution to my discomfort and pains. I kind of gave up on seeing doctors as they are not willing to do anything unless its something serious.

thanks again for the detailed info!

You indicate pain on the outside of your right knee. That suggests to me that one or more of your activities is putting "sideways" stress on that knee. This happened to me when I ran daily on the shoulder of the road, causing the "downside" knee to flex outward with every step. I switched to level surfaces and the problem disappeared.

According to an orthopedic surgeon, my right foot also has a slight misalignment that aggravated the problem. For a while, I wore a thin shim in my shoe that raised the outer edge of my foot. I eventually quit wearing it because the change in running surface completely solved my problem. You might benefit from an exam by an orthopedic specialist. As others have suggested, however, the intensity of your activities is the most likely source of trouble.

Yep, classical symptoms of pushing too hard. You need to drop a gear or two and spin. Pushing hard is good for building strength, but that needs to be limited to a small part of your overall training or you'll be a candidate for titanium knees in a few years.

all of what has been said...spin...

Try a podiatrist. That's what I meant to say in my prior post. Knee problems often result from a biomechanical alignment issue. A podiatrist will take immediate actions if that's your situation. Often they prescribe inserts for your shoes, give medication to reduce inflamation, show you stretching and exercises to help get you right, and occasionally refer you to PT if necessary.

physical therapy can help you get ready for a demanding sport like cycling. Especially the older we get. One thing I've noticed, the older I get is that I need a considerable amount of early season easy rides to get my muscles back in shape before I start digging into the steep climbing. Your muscles need to support your joints.

thank you for all the great advise and response guys. i will give my knees a rest from cycling for a week or so and see how it goes. I have to admit I can be a real idiot when it comes to high intensity. I don't seem to learn and one day I will pay the ultimate permanent price.

When you say drop a gear or two and spin you just mean to spin with alot less effort. Correct?

yes, pick a gear that does not require you to push so hard...
in the beginning that was hard for me to do, I just could not get it in my "macho" head that spinning was better than mashing....it took a while to get used to, but after I got to where I could keep a higher spin rate, I actually wound up being faster...I try to keep my spin rate constant and change gears as needed.

I will try and do that as right now thats my only option left if I wanna continue cardio-ing.

Anyone who goes from 0 to 100 like you are will break stuff or hurt yourself. Condition yourself a bit at a time until your body can handle the extra load you want to put on it.

A bicycle is a fun device not one built for self torture!!

What can I say pal. Im an idiot and everytime i get up to walk and feel minor pain I am reminded of that.

update: pain and discomfort is severely down. i havent biked in 2 weeks. weather sucks here anyway at this time of the year with 70% humidity with around 95 degrees at night.

i don't even notice the discomfort in my knees anymore when I walk.

Should I go back to 10 miles per session with low gears, 2 to 3 times a week?

Have you considered running in the front foot/barefoot style? This style of running spares the knees.

I switched around 5 years ago and many of my previous problems - knee soreness and shin splints just went away.

you mean cycling with the front part of your foot? like road cyclists with clips?

If you're looking for a cardio workout, you should be aiming for a cadence of over 100 rpm in a gear that doesnt put a lot of pressure on the pedals. If you're riding clipless, you can also use your hamstrings to lift the pedals on the backstroke. When you're in the groove, it feels like your feet are floating.
Since you've already caused some injury, keep the gears low and start at 80 rpm and move up in speed- NOT in gears.

your advise seems very interesting. I have honestly tried the method you are suggesting a few times but didn't make it stick or try and pay attention to what muscles are being utilized

I will defintely try and execute it next time I go riding.

Thanks delcrossv!

Actually I was thinking specifically of running or jogging in context of what you said about the treadmill. Landing on the front part of the foot and only touching the heel (to relax the muscles briefly) is good for the knees. Your calves will take a hit but rest them and slowly build them up and you should be fine.

But translating to cycling, it would be just like using clipless I guess since most clipless shoes fix to the front of the foot.

If you use platform pedals then adjusting the position of the foot so that the middle of the heel is not in direct contact with the pedal will probably help.