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Yet, another knee pain thread

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Yet, another knee pain thread

Old 12-12-10, 07:08 PM
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Yet, another knee pain thread

So I went through and searched all the previous threads on knee pain and went through all the websites that were linked:
like this one: https://www.cptips.com/knee.htm

But I didn't really find anything that accurately described the pain I've been in.

I do 99% of my riding within Washington DC proper, mostly for commuting. A few weeks ago, I got off work early and went for a nice ride around Potomac park.
Now, I tend to ride faster than most of the other commuters I find on the roads, but this particular day I decided to time myself and really push it around the park for a few laps. On the second lap, my right knee got a weird pain, probably a sharp pain. Can't remember the exact details since it was almost 2 months ago.
But afterwards and continuing to today, I've been getting a consistent aching pain in my knee.
The pain is localized in the patella region, almost feels like a bruised bone. The pain is slightly off centered to the left (inner portion of the patella). It aches, and the pain becomes fairly pronounced just after getting on the bike for even short rides around town. I've found myself compensating with the left leg at times, and I figured that's about the time I should figure out what's wrong before I end up with two bum knees.

Also, I've been having some tightness on the same knee just sitting around, either with my legs crossed or bent and relaxed. It hurts to the touch as well after my ride with the pain tapering off after an hour or two or three.

I ride without cleats.
My bike is a pretty good fit, at least I think.
I do have flat feet, but that has never been an issue before so I don't think it's an issue here.
I'm 23 and never had knee pains before, so this is a little out of place for me.

Thanks.
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Old 12-12-10, 07:11 PM
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Time for a doctor visit.
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Old 12-12-10, 07:21 PM
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I would go here. A physical therapist that knows cycling is always better than one who doesn't.

https://www.ssptdc.com/about/our-staff-severs.asp
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Old 12-12-10, 07:39 PM
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It's funny that you didn't find anything in your search, b/c this sounds like classic PFS symptoms to me. Aroundish the patella, feels like a bruised bone, aches off the bike, started sharp and now is constant. It's not unusual that you had no problems before and now have problems, since PFS sits right below the surface for a long time until one thing tips it over the edge; that's why it's overuse and not acute. I would guess that there is something just a teeny bit off in your fit, could be something as simple as the seat is 1 cm too low, or even just .5 cm, and the one hard ride exacerbated it.

That being said, I'm not a doctor, and it sounds like its time you visited one.

And don't despair. I had knee pain over the summer that I thought would completely stop my riding, but now it's a thing of the past. It can be solved.
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Old 12-12-10, 08:44 PM
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It is funny I didn't come across PFS. My reading comprehension must have decreased significantly since finals started last week. But you're right, after reading more on PFS, it does sound fairly classical.
This is actually kind of a bummer since my current health insurance ends at the end of the year. But I'm going home next week and I'm meeting with my primary care doctor for a check up. Maybe he could figure something out.
But while I'm home, I'll be off my bike for maybe 3 weeks or so. So I'm sure that'll help a bit.
I guess I'll just have to keep icing it and hope for the best.

What would be the worst case scenario if I keep pushing through the pain?
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Old 12-12-10, 08:46 PM
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Unlikely that it's a torn meniscus, though it could be. More likely to be chondromalacia. Had both. You can try the doc, but they'll probably prescribe NSAIDS and want to wait before trying an MRI. If you have insurance, might as well go in. In any case, the NSAIDs are a good idea. Try 600mg ibuprofen three times/day for a week (even if it doesn't hurt) and don't ride. Then raise your saddle until your heel won't quite touch the pedal at BDC and go for an easy spin. No force. See how that is. If it's better, do not jump back into it. Keep it down to 30' easy spins for a couple of weeks.

If this helps, go to a bike fitter and/or do everything at your link under Anterior. If it doesn't help, start bugging your doc.
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Old 12-12-10, 09:10 PM
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Originally Posted by Carbonfiberboy
Unlikely that it's a torn meniscus, though it could be. More likely to be chondromalacia. Had both. You can try the doc, but they'll probably prescribe NSAIDS and want to wait before trying an MRI. If you have insurance, might as well go in. In any case, the NSAIDs are a good idea. Try 600mg ibuprofen three times/day for a week (even if it doesn't hurt) and don't ride. Then raise your saddle until your heel won't quite touch the pedal at BDC and go for an easy spin. No force. See how that is. If it's better, do not jump back into it. Keep it down to 30' easy spins for a couple of weeks.

If this helps, go to a bike fitter and/or do everything at your link under Anterior. If it doesn't help, start bugging your doc.
I'm gonna try the cheap/non-medical solutions first. NSAIDS, ice, re-fit my bike.. etc

I'll be getting health insurance again in the Spring, once my families insurance company rolls out the new regulations on depended coverage.

I don't think it could be a meniscus. My dad just tore his, and he has trouble walking most times. But since my family has a long history of knee issues, we have a really good doctor.
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Old 12-14-10, 08:26 AM
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Just make sure if you're going to put your money into a bike fit and not into a doctor's office that you get a good, professional fit. They are more than worth the money IMO, and it's what ultimately fixed my knee problem, as it tweaked the poor fit that caused the knee problem in the first place, where-as the doctor just told me to stop riding.

Sometimes doctors don't know everything! Though most of the time they do.
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Old 12-14-10, 01:43 PM
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Acquire a foam roller and start rollering your IT band at least once daily. It will be quite painful at first, but as the IT band relaxes, it will become less painful over time. A tight IT band can pull at the kneecap, causing pain. That is my problem (confirmed by x-ray) and the relaxation of the IT band has caused my pain to go almost entirely away. If your kneecap is maltracking, that will cause PFS and chondromalacia, and if you try to push through it, you will cause damage to the cartilage, which is permanent.
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Old 01-07-11, 11:30 AM
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straight-ish leg kicking exercises with light weights worked wonders for my chondro (assuming this is a possible cause of your pain), coz it tones the middle quads. The middle quads, among other things, are responsible for pulling the knee cap up and out of the way of the end of the femur during leg extension. With cycling, the middle quads don't get as much work as the lateralis and medialis, so they can lose tone (not visibly ), causing the quad firing order to get out of whack. When the quad firing order is out, the middle quads (or quad? I can never remember if it's the femoris or the intermedius) don't pull the cap up quick enough, so it can rub on the femur, causing grinding and the subsequent pain and inflamation.

Other than that, there's PFS, which, as others have said, is usually caused by a maltracking of the cap, usually to the outside, coz cycling works the lateralis more than the quads, and coz of a tight IT band.

Other other than that, generally, for anterior pain, the cause can be as simple as too much flexion under load, and/or too-tight quads; and for inside pain, it could be as simple as too much pronation
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Old 01-08-11, 05:06 PM
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Since IT band sydrome was brought up.. I have been having bad problems with that all summer. Ortho doc didn't tell me anything. So I finally found some stretches that started working in three days! Also I use the foam roller daily now as well. Just started jogging again after a month off of the bike/running. Here's a couple links to the websites I found helpful. If going to a doctor, I would recommend a sports doctor. The guy I went to has a great reputation and is a great knee/hip replacement dude, but I got no info from him other than not to do the same thing everyday.
https://www.athletestreatingathletes....ome-treatment/

This guy has a lot of youtube vids that I found informative and useful.
https://www.youtube.com/watch?v=Ba4k5...eature=related
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Old 01-10-11, 11:11 AM
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I had the same kind of thing. For me it was my patellar tendon. No biking for a month and 800 mg of ibuprofen every 8 hours fixed it. I also got orthopedic inserts (in the spring go get some). There is an exercise the PA gave me as well. Basically from laying down, cock the knee less than 15 degrees then straighten it. You can do this by placing a pillow under it. It builds the muscles above the knee and helps prevent the problems (that is what the PA said). Good luck. Also, my bike was too small and I ended up buying a new bike that fit me. I still have some knee paint, I'm going to get speedplay zero's and see if that will help. If not I'm going to get fit at UC Davis.

Last edited by sjvcycler; 01-11-11 at 02:30 PM. Reason: added
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