Amt0571

Hello,

I'm currently having some problems, and I'm looking for advice, just in case someone has suffered the same thing.

For the last month I've been doing my normal workout consisting of 2 or 3 mountain bike rides each week, totalling around 100km every week approximately, and also a daily commute to work 4km each way.

Suddenly, on December 22, I started to feel some pain at the left knee, so I stopped using the bike (even the one I use to commute), and on 25 and 26 I did two really short road bike rides (I figured out the road would be better for my knee than the steep mountains I have over here). I tried to use low gears and high cadence to avoid forcing my knee was able to complete the ride without issues. The pain didn't go away, but it didn't get worse.

On 27, however, my knee started to hurt more, and I also had some pain on my left buttock when seating. I noticed in the mirror my left leg quad was tighter than the right leg one, so I figured out this was the cause of my pain. I went to the doc, and he told me to take ibuprofen every 8h for a week, which I've been doing.

On 29, 30 and 31 were excrucicating as I could barely sit because of the pain on my buttock, and, since I'm a web developer, I just have to work seated. From 31 to today, the buttock pain has been slooooowly and gradually diminishing and my left quad has begun to recover its normal shape (it's almost there now). However, at the same time I've been having a lot of pain on my knee (it's a pain similar to a bruised knee), and my legs feel like I had done a marathon whenever I walk for a few minutes. If I crouch, I have a sharp pain when getting up again, and I feel weird when walking. My right knee is also starting to show similar symptoms, altough I suppose it's a consequence of me avoiding to overload the left one.

I have an appointment with a specialist, but since in Spain most people are still on Christmas holidays, he didn't gave me an appointment until 14th january... I'm currently really demoralised and just want to ride my bikes again

I'm a bit hypochondriac, so I'm thinking about it more than I should... has someone had similar symptoms? Some advice?

Thanks!!

FBinNY 

Do some research on Sciatica. The unexplained pain in the buttock is very characteristic of sciatica, so it's worth exploring. There are also some types of muscle and ligament strains that manifest the same way. I'd follow your doctor's advice with heavy Ibuprofen (6-800mgs every 4-8 hours - if your stomach can tolerate it) for a while to deal with the inflammation, and see if thing improve a bit.

While you research sciatica, find the information about exercises for managing it. I've been dealing with sciatica for the last 20 years - originally diagnosed as a problem hip, and managing it very successfully with exercise alone as needed (a few days every few months or so). You might also avoid things that seem to bother it, such as (for me) sleeping on your back, spending a long time sitting with legs extended straight (I was advised to get rid of my sports car whose low seat was a suspected factor, but didn't).

I'm not saying here that you have sciatica, which can be hard to diagnose properly anyway. I'm just offering it as a possibility, and since the exercises can't hurt, you can try them as a diagnostic - if they work it was sciatica.

BTW- IME these kinds of sudden unexplained pains tend to self resolve if left alone, so give yourself time and avoid aggressive interventions unless there's a confirmed diagnosis (with concurring 2nd opinion).

Note, cyclists who don't counter with stretching exercises often have short hamstrings (can you touch your toes? how close?) which can be a contributing factor for sciatica.

Amt0571

I already supposed the buttock pain had something to do with sciatica or pyramidal syndrome, but what I don't understand is why my knees hurt so much and my legs feel so tired. I've been doing some pyramidal and quad stretches to no avail so far.

I usually sleep face-down, but since it puts pressure on my knees and I'm unable to sleep on my back, I'm sleeping on a side with a pillow between my knees... I'm starting to feel like I'm 60... and I'm still 29! My wife bought me a road bike for christmas, and I'm mad looking at it being unable to ride!

And yes... I can touch my toes and even go 10cm past them! No short hamstrings!

FBinNY 

Give yourself and the drugs some time for the inflammation to ease, then see what there is to see. The knee pain may be a secondary result of muscle spasms, so may resolve when the spasm eases. I'm much older than you are, and can tell you that with age you tend to learn a lot about anatomy (not by choice). In my case, movement is part of the healing process, so you might try to stay active, with light non stressful activities.

I'd stay off the bike a while, on the off chance that it's a cause of the problem, possibly because of a poorly aligned cleat or one without enough float. I don't like medical intervention so I usually try to get my body back to a baseline, before resuming activities to see if they might be the problem.

IMO- unless there's other stuff going on you're kind of young for sciatica or other chronic conditions. But mtn biking can be hard on the body, so anything is possible. The knee pain may be

Carbonfiberboy 

No, not overtraining. Something odd going on. Doesn't sound quite like sciatica to me. Could be more than one thing at once, too. Knee and buttock/legs may be unrelated. Did you crash?

I also advise stretching, but gently. My favorite stretch series is here:
https://www.bikeforums.net/road-cycli...l#post15372967

Ibuprofen is good.

Amt0571

No crashes, no impacts on my knees either.I forgot to say that I had similar symptoms in June, but they only lasted for 5 days. The first 3 were knee pain, and the last 2 mostly buttock pain. I went anyway with this symptoms on a mountain bike tour for 4 days, 250km and 6000 climbed meters, and the 3rd day it went away. Having had similar symptoms before however, seems to rule out the more than one thing at once...

I don't think I could ride like I did in june however. I have stronger pain, and tried with almost no resistance on my spinning bike and it didn't go well.

At this moment it seems my buttock is burning again, and I'm seating on top of two soft pillows... it seems it comes and goes during the day without reason.

Today I just bought new cycling shoes just in case my old ones had something to do with it (they're quite worn and flex a bit more that they should). Anyway, I don't think shoes are the problem. Hope at least I can try the new ones soon...

Carbonfiberboy 

OK, here are a couple of websites to look at and see if anything rings a bell:

SCIATICA SELF-RELIEF | piriformis syndrome | sciatic nerve pain | radiating pain down the leg, clinical somatic education | somatics | somatics hanna | somatics.com
Piriformis Syndrome: A Real Pain in the Butt! | Dr.Crystal Draper

Amt0571

Thank you, I'll have a look at it

FBinNY 

Also search under "sit bone pain" You'll find info on how tight or stained hamstrings can be the issue, and also tendonitis in the buttocks. There can also be inflammation where these attach to the "sit bone" part of the pelvis.

In short there are plenty of non critical causes of the kind of pain and inflammation you have, and it can often be resolved with exercise, stretching, or in more serious cases professional physical therapy. Give it some rest time, then experiment to find what works best (or at all) for you.

Amt0571

Currently my main problem is that, due to my job, I have to speed at leaset 8hr a day sitting, which is not helping at all.

When I'm standing I feel better about my buttocks, but worse about my knees... I think I'm only confortable while sleeping hahaha!

Carolstone

Have some knee issues myself and found that sleeping face down with my feet hanging off the bottom of the bed worked well. It brought my knees down in contact with the mattress and supported them better. Good luck!

Amt0571

I was finally able to go to a orthopaedic surgeon. He told me that it seems to him that I have cartilague inflammation, and told me I needed an MRI to know for sure. I'll have the MRI done tomorrow, and the results next week. This does not explain the pain in my buttock however.

Anyway, this prompted me to check my bikes seat position and it seems I had it 1cm too low at least since I replaced it on august when the old one broke.

As of today I feel better and noticed a lot of improvement during the last 3 days, but I'm not sure if it would be a good idea to do a short and flat ride at a slow pace... it's been 15 days without riding a bike, and I'm starting to think that not doing any excercise may be counter-productive.

Has someone here suffered the same? how much time can I expect to recover?

Thanks!

GeorgeBMac

Just be careful! Last May I injured my right hip doing a piriformis stretch in a Pilates class that was being led by a physical therapist. I had considerable pain in the hip and running down my leg to the calf.

When I went back to her, she took one glance and told me:
" You never injured your hip. You're just an old fart with a bad back"

So, I went to see an orthopedist who specializes in hip injuries. Who took one glance and told me:
" You never injured your hip. You're just an old fart with a bad back"

So, I went to see a physiatrist (physical medicine doctor) who took one glance and told me:
" You never injured your hip. You're just an old fart with a bad back"

So, I went to see a sport medicine doctor who took one glance and told me:
" You never injured your hip. You're just an old fart with a bad back"
... but he did offer to placate me with an MRI of my hip...

I got the MRI and also got a CD of it and the written analysis that showed trauma to the gluteals and torn labrum cartilage (then one that holds the femur in the hip socket). When I returned to him he walked into the office and told me:
"" You never injured your hip. You're just an old fart with a bad back"
.
When I pulled out the results of the MRI and read them to him he finally took a look at the MRI and said:
"You were right! You do have a hip injury'

So, he gave me a diagnosis of a torn cartilage and piriformis sydndrome and prescribed PT. When I went to PT, the therapist told me:
"Your hip is sore because you are an old fart with a bad back"

Basically the only thing that has worked for it is:
-- Time (while it heals on its own -- very slowly)
-- Prednisone

The prednisone is the ONLY thing that reduces the inflammation enough to reduce the sciatica (I've had to take it more than once after reinjuring the hip). OTC NSAIDs simply do not touch it.

The moral of that long, sad story is most physicians see sciatica and ASSUME it is caused by a bad back. While that is probably usually true, it is not always true. And, respect the knowledge of the physicians, but also trust your instincts, your feelings and your own knowledge of is causing it. And, finally, if the sciatica does not resolve quickly, get a prednisone taper. I hate the stuff. But it is better than letting the muscles atrophy from the lack of a nerve impulse. The sciatica can be caused by the sciatic nerve being pinched by either bone or muscle. If it is inflamed muscle, then the prednisone will most likely take care of the problem...

I don't know if any of that relates to you. But, in either case: Best of luck to you!

Amt0571

Today I took the dog for a 40min walk. Something I had been unable to do since 26th december. When I came home I barely felt any pain, so I decided to check if I had placed the cleats correctly on my new cycling shoes and went for a 5min ride with my new road bike. My knees didn't complain, which I didn't expect, and it seems that the higher seat position works way better. It seems unbelievable that being an experienced cyclist, I've ridden more than 3000km with the seat too low! I'm really starting to believe that this was the origin of my problem.

It was only 5 minutes, but it felt fantastic to ride a bike again after 15 days... I'm really hoping that the little pain that remains goes away and lets me do a short ride on Sunday without worrying too much.

Thanks

GeorgeBMac

Well, that's great! Glad to hear that!

The fact that it is resolving on its own after a couple weeks suggests to me that it was inflamed muscle(s) pressing on a nerve rather than something structural... B

But, the knee pain may really have been caused by your body compensating for some other problem. The muscle systems in our bodies are so complex that they are perfectly capable of over-using one set of muscles to compensate for another set that are not pulling their weight for some reason -- which can then cause the muscle that is being overworked to injure itself or its tendon...

While I am glad that you are doing better, this may or may not have been caused by a saddle that was a centimeter too low. Be open to the idea that you may have an out-of-whack condition elsewhere in the lower back, hip or leg area that could be identified with a competent analysis and corrected with competent physical therapy (well, physical therapy seldom corrects things on its own but it can get you headed in the right direction)...

Again, best of luck with it -- and here's hoping it was all due to a misplaced saddle!

Amt0571

I finally went to the physiotherapist. She made me realise that my legs are everything but symmetric. They're totally different in fact!

It seems I have the internal part of the left leg quad (I don't know it's name in english) underdeveloped compared to the right leg, probably because my left heel tends to go to the inside when walking. She says that this is probably causing a kneecap misalignment which is causing all my pains, and told me some excercises I have to do to strengthen it. She also recommended me to have a biomechanical study done because it's possible that I need some form of insoles to help me correct my leg and knee position.

She recommended me to rest for 15 more days, which I think I won't be able to do at all, and then bring the results from the MRI to her to see the best way to proceed.

At least I'm more optimistic now

GeorgeBMac

I wanted to say: "That's Great!" -- but I think need to make that: "Well, That's Progress!"

Anyway the first step of fixing any problem (whether its a human, bicycle or computer) is figuring out what the problem actually is -- which is a step many gloss over. But it sounds like she know what she is talking about...
.
And, physical therapy can, normally, only help and not make anything worse. But it sounds like your's may be an ongoing project as you get multiple things that are out of balance into balance...
.
I'm glad to hear you are headed in a good direction because too often these kinds of problems end up in surgery and, as my Sports Medicine doctor advised me: "No problem cannot be made worse with surgery..."

Again, Best of luck !!!