Rockrivr1

My question is this. Once you've had a knee injury while riding, does it ever go back to being strong and pain free like before the injury?

Last year around this time I damaged a tendon on my left knee while riding. It's the upper inside tendon and after 3 plus months of physical therapy it felt better, albiet not 100%. The physical therapist said it would take time and keep working it so it will become stronger. She was right as I continued to train hard and rode the Pan Mass Challenge at the end of the summer with no problems.

Now that winter is over I'm finally getting back out on the bike after several months of working on the trainer in the basement. Now that I'm back in the saddle and outside I'm noticing the pain in my knee from last year is returning. It feels OK when I'm riding, but afterwards it has some small swelling and a little throbing. Plus its sore most time except when I'm riding. I've cut back on the difficulty of my rides to not put a lot of pressure on my knee at the start of the season. I figure this will be what I have to deal with from now on until I can get back into shape. Looks like that will take longer then expected.

Unless I'm mistaken, I'm thinking my knee will never be the same and this is just something I'll have to deal with from now on.

Thoughts?

Caad 8

How old are you? I had a knee problem on my left knee tendon. It wouldn't go away and I could feel pain even when I wasn't on the bike. But I had an "operation" of sorts and a year later its completely normal like nothing happened. After the "operation", when I was getting back into cycling after each ride I would ice it for about 15 min, right when I was done. Now that its stronger I don't have to do that anymore.

Rockrivr1

I'm 42. If you don't mind me asking, what did your "operation" consist of and how long were you off the bike for? I was hoping it was just due to the knee being used hard again, but if it keeps up I guess I'll be on my way to the doctor again. Damn!

Nachoman

I've got hamstring issues that have been nagging me for two years now. I've tried lots of different remedies, without success, and now I'm just learning to live with the pain. good luck with the knee.

Caad 8

My "operation" was a PRP injection, or Platelet Rich plasma. Its quite new, NFL and other pro atheletes use it when they have similar tendon problems.

They take your blood, spin it around at a very high speed to active the plasma, and to separate the plasma from the red and white blood cells. Then they inject the plasma around your tendon. It speeds up the healing and re-strengthens it.

I was off the bike for a couple months. However since I'm only 19 they said the older you are the longer it will take to recuperate.

CPFITNESS

It's not that new, it's been around for about 10 years. It's the same procedure Tiger Woods had done on his knee by the Canadian doctor being investigated for steroids.

If you've been off the bike for awhile, start very slowly and work your way back into it. to some extent, you've had an injury and you won't ever be back to 100%. But by doing the right things to take care of it, you should be able to beat it and avoiding the knife is always desireable. the fact it doesn't hurt WHILE riding is encouraging. Be sure to ice and take anti-inflammatories after working it hard.

I would also be sure to constantly do the exercises you learned in physical therapy, even when the knee if feeling good to keep it that way.

cachehiker

My massively inflamed ITB took a good long year to heal completely. After staying off the bike for a month, I limited myself to flat 20-40 milers for another 3 months. Second year it would still bother me here and there on sustained climbs, something to do with the lower cadence I use to climb stuff upwards of 8%. Four years later, it's stronger now than it probably ever was but I still feel it on the earliest rides of the season. Will your knee ever be the same? I doubt it. Will it heal? Most likely.

echappist

that's mostly correct. speaking from a sample size of one, so definitely wait for more answers

my right knee has always bothered me. i don't remember for how long, but at least for the last 3.5 years. it pops sometimes when i bend it, and i have grown resigned to the fact that it's not going away. i try to reduce burdens put on it by strengthening the muscles around it. so far, it has held up quite well while cycling.
my left knee is a new problem created when i crashed and hit the same region within five weeks earlier this year (once on and once below the patella). it has never popped when bending until the injury, but i start to get that at times as well. it's recovered alright, though i'm not putting too much stress on it. as always, i think having strong leg muscles really helps. icing the knee for about 15-20 minutes before going to bed also helps.
it may not be a bad idea to stretch your quads and hamstrings on a regular basis (daily, though preferably twice a day), make sure you do them properly so that the muscles are isolated when stretching. good luck with your recovery

Hunt-man

I would look at your fit, saddle height / saddle fore-aft and what pedals you are using. I am very sensitive to all of these. If they are not right I get knee pain. I had a "pro" fit last year and it f'd up my knees. Fitter changed too fast, put in orthodics, slammed my saddle forward. Taken me a long time to recover.

My seat height is basically .9 x inseam. I keep my knees behind the pedal shaft. I started using Look Keo's with red cleats and knee pain is better. I had been on eggbeaters and wider cleats seem better, don't know why.

Rockrivr1

After I injured my knee last year I had a professional fit done with my bike. (Felt Z25) I also changed out from basic SPDs to Speedplay Zero pedals. It was a vast improvement. I didn't make any changes to the bike over the winter and I didn't grow anymore. Well, except gaining 10lbs that is. Wouldn't think that would change the dynamics of my fit to much though.

Thanks for the replys everyone. I'm thinking I should give the physical therapist a call and see what she thinks. Can't hurt.

Mose

Ok, I had two questions but you answered one of them. See a PT again for sure. I date one and have found a good PT is invaluable for something like this.

The other question is what treatment have you done besides scaling back mileage? Do you frequently do the RICE (rest, ice, compression, elevation) routine? Stretch a lot/enough? Use a foam roller for SMR?


BTW, this year will be my 5th PMC, good to see another PMCer around.

rumrunn6

some injuries you will have the rest of your life. this might be one of those.

Rockrivr1

I've only done the ice part. I think I'll need to do the rest going forward. I'm very bad at the stretch part. It's only something I've started doing since the injury and I've been a little lax doing it this year. I'll have to get back to do that as well.

Definitely good to run into another PMCer. You're not all that far from me. I'm in Uxbridge and ride down Rt 16 through Dudley on my way to Sutton to catch part of the PMC route up through Mendon. Great riding through there. Let me know if you ever want to meet up for a couple of training runs!

Hunt-man

Was it a good fit? Pro fits vary a lot. You might consider having another fitter look you over, if it is someone people know and trust and recommend.

Physical therapy is a must. You should be there now and doing regular exercises to help your knees. $.02

Mose

RICE treatment is best, but if you're off to another commitment after a ride, taking an NSAID to reduce swelling is better than nothing.

I'd love to meet up sometime for a ride. As you know, groups are hard to come by in this neck of the woods. Closest thing I know if is Seven Hills Wheelmen in Wormtown and they're pretty much only touring, nothing competitive. Too bad too, because you're right, there is some great riding around. I grew up in Woodstock and have some great hilly training rides around NE CT where the roads are also smoother.

TMonk

To treat you injury, be diligent about RICE as other posters have mentioned. (Rest, Ice, Compression, Elevation)

To prevent a future injury, continue doing the PT exercises and stretch alot. It is always likely that these types of injuries occur because of chronic tightness or strength imbalances.

Caad 8

Maybe not for the Pro's, but its new for the general public.

TwoHeadsBrewing

I don't have knee pain, but I have noticed tightness in my right knee only. It's kind of odd, but there is no visible swelling. I'm trying to put more "load" on my left knee for now and turn a higher cadence in general. I'm hopeful some rest and not mashing will alleviate the stiffness. I did check out my cleats and noticed they were in front of the ball of my foot, so that may have something to do with it.

Rockrivr1

I have an appointment next week with the physical therapist that worked on my knee last year, so hopefully she'll give a good idea of what's going on. It's supposed to be in the upper 70s for a couple days later this week, which is great for April in New England. I'm going to try and do back to back days and see how the knee holds up.

I also just swapped out my shoes from a pair of Specilized to new Sidi 5.5s. I moved over the cleats myself, and matched them up exactly like they were on my old shoes. Hopefully that doesn't cause me more issues as my first time out with them will be this weekend.

pathdoc

I can tell you one thing for sure, as we age we can not take as much abuse and our powers of healing are slowed down. I'm 44 and now I realize my joints are just downright fragile. Any exercise requires a slower ramp up phase. Take it slow and gradually work up to your goals.

rumrunn6

one nephew (now in his 20s) told me recently that one of his memories of me from when he was younger is me saying: "protect your knees" and he has been trying to do that his whole life. maybe the next generation will not need knee replacements, etc

gwchem

To add some personal anecdotes, I had a knee problem this year (cartilage tearing and tendon inflammation) that went away with good PT, RICE, and strengthening. But if not for a good bike fit at the time, I'm 100% confident it would be back immediately. The keys to keeping my knee strong and pain free are fit and daily stretching.

On a related note, I've had hamstring problems for the better part of 2 years that are just now starting to get sorted out.