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Help diagnose my knee pain...PLEASE!

Old 06-07-10, 10:42 AM
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Help diagnose my knee pain...PLEASE!

The short of it is, I am having knee pain and I am hoping someone could help me diagnose the problem. Here is some important background information:
I recently got a professional fitting done on my geared road bike. The knee pain started on that bike, but it is also present on my single speed road bike. The pain itself does not feel muscular, as I have had that pain before. It isn't on the sides of the knee, or deep inside the knee, it is directly in the middle of the knee cap. There is almost no tissue there, it is just skin, then knee cap, with some ligaments. The pain is not always present; it pops up after about 30 or so miles, and lasts for about a day and a half after riding.

I am thinking it might be tendinitis, but I cant be sure.
Does anyone have any ideas? Is tendinitis likely? Has anyone had similar pain?

Any help is so very appreciated. I really need to solve this problem.
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Old 06-07-10, 10:58 AM
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Originally Posted by marcusedvalson
The short of it is, I am having knee pain and I am hoping someone could help me diagnose the problem. ... it is directly in the middle of the knee cap.

I am thinking it might be tendinitis, but I cant be sure.
I'm going to jump in here only because no one else has replied yet. (Most of the time when I reply to something someone immediately jumps in to contradict...)

First, how could it be tendonitis if there is no tendon there? I suggest it is inside the kneecap (the patella) and you simply feel it as on top.

Second, what sort of gears and cadence are you running? And just how well-fitted is your bike. Pushing hard, which often means you are running a low cadence in too high a gear, and especially with the seat too low, can exaggerate this problem. I suggest you run a lower gear, push less hard, and spin faster. Unless you are already spinning at 110+rpm.

Some people will say it is the angle of your shoes. I dunno' yay or nay but that argument does come up.

My orthopedists strongly recommends icing and compression (the usual "rice" treatment, rest, ice, compression, elevation) as the best way to treat knee issues. Can't disagree.

Maybe you know all this already, maybe not. Don''t know how experienced you are, nor how good that shop's fitting was.

And of course I'm not a doctor and have never played one on TV. And this probably didn't help.
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Old 06-07-10, 11:13 AM
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Thanks Jim! My fit was done by a pro fitter, not just the normal shop fit. It may well be that there is some more slight tweaking to be done on the fit. The thing that makes me think it isnt the fit is, it happens on both my bikes. It started on the bike I got fitted on, but it persists on the single speed.
I generally spin at around 90-100rpm, so I am thinking it isnt the result of mashing a gear.
Heh, if there arent tendons in the knee, then I am sure you are right that it isnt tendinitis. I guess I thought you could get tendinitis in ligaments as well. I am embarrassingly wrong I suppose.
Anyone else have ideas?
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Old 06-07-10, 11:31 AM
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Originally Posted by marcusedvalson
Heh, if there aren't tendons in the knee, then I am sure you are right that it isnt tendinitis.
I wasn't suggesting there are no tendons in the knee, only that there are none directly on top of the kneecap. Hmm, maybe I misread your description of the location. If you mean directly above the kneecap, well, there are places the quad attaches. By definition one get tendonitis only in tendons. There are a few key ligaments which stabilize the knee (I had a minor tear, a.k.a. a sprain of the MCL). The ACL is a series or ligaments which locate the patella. But what you are describing doesn't sound like a problem with any of the knee ligaments unless you have a chronic tear and aren't letting it heal. Injuries to the ligaments often accompany particular traumatic events, and you'd probably know if you had suffered one.

Have you seen a doctor? Duh, that's the obvious question, innit?
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Old 06-07-10, 11:38 AM
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I havent seen a doctor. They are such a ****ing hassle. Besides, they would probably offer me some half assed answer like "Well, if it hurts after 30 miles then dont ride longer than 30 miles". That simply isnt an option.
Yeah, the pain is in the very middle of my knee cap, just under the skin. Like, dead center in the middle of that little puck shaped bone.
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Old 06-07-10, 12:25 PM
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Originally Posted by marcusedvalson
I havent seen a doctor. They are such a ****ing hassle. Besides, they would probably offer me some half assed answer like "Well, if it hurts after 30 miles then dont ride longer than 30 miles". That simply isnt an option.
Yeah, the pain is in the very middle of my knee cap, just under the skin. Like, dead center in the middle of that little puck shaped bone.
I have run across two types of knee problems, and in the same left knee. First, I have wore the cartilidge away, and it is mainly bone up against bone. The last time it swelled and hurt on me, I went to the doctor thinking they were going to tell what they had told me before, and that is, I might need surgery. To my suprise is was another villlian attacking my knee, ARTHIRITIS!!

IMO, if they do an MRI, they will be able to tell you exactly what it is, and plan out a solutions. And we don't always have to like the solutions either.

Luck to you,
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Old 06-07-10, 01:05 PM
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Originally Posted by cehowardGS
IMO, if they do an MRI, they will be able to tell you exactly what it is, and plan out a solutions.
MRI, marvelous invention. Noisy but marvelous.
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Old 06-07-10, 02:07 PM
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Make sure your saddle height and position is good. I find that if my knee is too far behind the spindle of the pedal at 3 O'clock then I get knee pain, also if the saddle is too low / high then I get knee pain.
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Old 06-07-10, 09:19 PM
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Have you tried stretching? It makes all the difference in the world to me...
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Old 06-08-10, 07:40 AM
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You have an over use injury. Rest it until the pain goes away, use lots of ice and ibruprofen, and work on strengthening the muscles on the front of your legs. If it comes back find a physical therapist. You can try every random thing from every guy with a keyboard, and treat yourself by trial and error, but only physical therapists actually study how to treat over use injuries.

em
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