Results 1 to 19 of 19

Thread: Knee injury

  1. #1
    mtbr member
    Reputation:
    Join Date
    Oct 2012
    Posts
    17

    Knee injury

    Greetings to all fellow cyclists,

    I just signed up, i need advice for an injury i seem to have caused to my left knee.

    First of all i have to say i'm fairly new to cycling, i started up a year and a half ago, cycling gradually from 20km up to 120km.

    I took up cycling as a way to lose some weight and soon came to love it.

    I'm 1.76, 70kg by the way.



    A month ago i started training for a second long distance trip, i planned and completed an 80km distance on Wednesday and then had the rest of the days up until Monday for rest (excluding a 15km easy ride on Saturday).

    On Monday, after about 10km i started to have a minor pain on the exterior right side of the patela which gradually got worse over the trip. I didn't had any problem completing it but i have to say it did make me feel uncomfortable for most of the trip.



    After this trip i took some time to let my knee recover a bit. I made myself take a miserable week and a half away from the saddle. After this time, on the first trip after 2 full weeks from the trip, i got on the bike but i had a weird feeling on my knee, like it wasn't sliding ok, like it had some more friction than normal. Anyway, after warming up for 5kms i had just a minor pain like the one on the trip but it gradually got worse up until 30kms later when it was very distinct and really painful. Needless to say, i took some more time off for recovery.



    Last Wednesday i got on the saddle again and rode 32km... I warmed up pretty good but once again after the first 10km up to the first twenties the pain gradually got worse by a fair amount. By the time i got back home 10kms later, the pain was pretty severe. Not at the point i couldn't keep pedaling but it did become irritating.



    The following day after i woke up i had a feeling my left knee was hotter than my right, i took the temperature from both of them and it turned out i was right, the had 1,5C difference! I took some time to search this and i put some ice on the knee for some time, i also tripled the dose of the flax seed oil supplements i had been taking and added a couple of chondroitin MSM and Glucosamine pills i had been taking from time to time. I gave it some rest up until today. I had a feeling it was really better in those last two days rest than the previews almost two week rest.

    And i was right! i completed about 17kms with the first 5 warming up and the rest very active (i hit some hills, i didn't touched the saddle a lot) and by the time i got back home i didn't had any pain, just a feeling that my knee wasn't completely ok.



    This pain probably only comes up with the pedaling motion. I didn't really try running all this time in fear it could get much worse, but i tried taking the stairs, running and pushing the knee to see how it will react to pressure and it did pretty well.


    I also tried changing my saddle height and alignment a couple of times but it didn't make much of a change.



    I didn't had any problems the last year, and i used to cycle 50-60km during the night, with really cold temperatures....



    I'm always stretching with the slightest chance.



    I never had any collision injuries or any other knee problems...



    I hadn't been jogging lately (last time i went jogging was on July).




    I'm really thankful to anyone who read my post and I'm really looking forward for replies... I wan't to get back to the saddle and cycle like the old times as soon as possible

  2. #2
    dru
    dru is offline
    mtbr member
    Reputation:
    Join Date
    Sep 2006
    Posts
    2,636
    Google 'patellar femoral syndrome. It can occur in cycling. The knee cap doesn't track straight. Physio often involves weight training to correct muscle imbalances. Saddle position, height, and cleat position can also have a huge effect. Not pushing high gears at low cadence definitely helps the problem.

    Drew
    occasional cyclist

  3. #3
    mtbr member
    Reputation:
    Join Date
    Jul 2009
    Posts
    10
    My advice - get fitted on your bike by a respected professional bike fitter, including cleat position.

  4. #4
    mtbr member
    Reputation:
    Join Date
    Oct 2012
    Posts
    17
    Thanks for the answers guys.
    @dru
    I found some info on wikipedia and i'm pretty sure you are right about it. I have found the ice to be working miracles.
    The only contradiction to this is the weight training which i've been into since 6 month back.
    I guess i'll go with the overuse situation.
    As for the high gears in low cadence i have to add that in these cases i cycle of the saddle using my weight. I have the feeling it makes the matter worse when i do this though because the pain comes back more quickly and aggressively than when i'm cycling with less stress on the legs.
    What do you think?

    @phorest

    I live in Greece, so not many professional fitters are available. I had me fitted once by a friend of mine who has been to the sport quite a long time.
    I have to say that during the last year i've change bikes, saddle heights and ever saddles, more times than i bothered to count.
    At this point i can't say i could see something different in most of the positions besides getting a little more stress in different points.
    I am still not convinced about the fitting thing and its not really an option because i will have to travel around 600km to find a professional fitter and at this point i can't aford it either
    Anyway thanks a lot for your help!

  5. #5
    dru
    dru is offline
    mtbr member
    Reputation:
    Join Date
    Sep 2006
    Posts
    2,636
    Yes, standing up and using your weight will aggravate the injury. You want to stay seated and use a high cadence such as 90 rpm. Avoid really straining with your legs, use your lungs instead.

    Good luck, man from Hellas!

    Drew
    occasional cyclist

  6. #6
    mtbr member
    Reputation:
    Join Date
    Oct 2012
    Posts
    17
    Thanks for the reply Drew,
    i stayed out of the sport for a week or so, then i did a 45km ride, not really hard, mostly seated but as soon as i reached 25 i was feeling pain which by forties became really intense... I scheduled an appointment for wednesday... I'm gonna get this checked, i got pretty bored waiting in my chair all the week. I also bought a supplement, Animal pak from universal nutrition, i 'm sure its working but not the way i wanted to. I feel my bones smoother than before but it doesn't seem to do any good to stop the pain after some kilometers. Today i went for a very intensive ride after a week and a half from the last. Did 25kms total, 20 of them away from the saddle and it wasn't as horrible it was last time.
    I want to make sure i feel the pain to be able to describe it better on Wednesday...

  7. #7
    mtbr member
    Reputation:
    Join Date
    Mar 2010
    Posts
    105
    I ditto the patella femoral syndrome diagnosis. I struggle with this one too. It is mainly due to a muscle imbalance and the resulting pain from the knee cap (patella) not tracking straight. In your case it seems like the knee cap is being pulled outward (exterior). This is classic PFS.

    You should see a doctor for a correct diagnosis. He/she will then refer you to a physiotherapist which will likely direct correct stretching, correct strengthening exercises, and likely some electro stimulus. Sometimes taping can help but it has to be done correctly.

    http://www.sportmed.com/pdf/Chondromalacia.pdf

    Do lots of reading on it from trustworthy websites. See a good physiotherapist.

    You really need to stop cycling and get treatment. If you do, you have a very good chance to recover reasonably quickly and get back to cycling pain free. If you don't you are, almost 100%, only going to aggravate the condition, cycling will be too painful to enjoy and you will likely give it up for that reason.

    I wish you luck.

  8. #8
    mtbr member
    Reputation:
    Join Date
    Oct 2012
    Posts
    17
    Thanks for replying rottenronny, i took some time to read the pdf you posted, i noticed that most of the symptoms are different in my case.
    Since its been over a month and a half from when it first started i had time to experiment.
    I noticed that i have no problem going up stairs running even when my knee pains a lot from the last ride. i have no problem jogging or any other activity in general which is different from the cycling movement of the knee. Even if i try to run up some stairs without warm up i get no pain at all. I haven't tried squats yet but i know that if i try to push my knee to get up from a ducking position it will hurt.
    It must be related to the movement up to 70% of the knee bend, not the last 30%, which would explain why i have no problem jogging or running up stairs.
    On the stretching part, i've been doing all the stretches described and a couple more every time i have the chance since i started cycling.

    I'm not really sure its PFS although its seems very likely... I'll probably know by the end of the week but if the latest info helps you figure out something more let me know :/

  9. #9
    mtbr member
    Reputation:
    Join Date
    Mar 2010
    Posts
    105
    I remember seeing a graph of the enormous pressures generated in the knee joint with varying angles. In the first 30% of movement the pressures are not so great but nearing 90 deg of bend, the pressures are a lot higher than you might imagine. This may explain why you don't experience the pain jogging or going up stairs.

    One of the diagnosis tools for PFS is a compression test on the patella. Lie flat on your back with your legs out straight. Have someone gently press downwards on the knee cap. PFS sufferers will experience pain during this test. I remember experiencing great pain when my doctor tested me for it so just go very gently.

    Does your knee cap start to complain if you are seated with your legs bent for some period? PFS is also known as "movie goers knee". Also does it hurt when you bump it on something? This is also symptomatic of PFS which is inflamation under the knee cap.

    In the end, if you can, see a professional (preferably with a sports injury background). This is not an uncommon injury. Stretching is only part of the solution. You will also need to do strengthening exercises for the vastus medialis muscle which is a counter to the stronger vastus lateralis. Often this medialis can be a little bit lazy and when this occurs the knee cap no longer tracks straight up the leg when pushing with the leg and the resulting constant crooked tracking sets up inflamation under the patella. You can train this medialis muscle with the exercises in the PDF that I provided previously.

  10. #10
    mtbr member
    Reputation:
    Join Date
    Mar 2010
    Posts
    105

  11. #11
    mtbr member
    Reputation:
    Join Date
    Oct 2012
    Posts
    17
    Thank you very much, you've been very helpful.
    I tried the diagnosis test you suggested, it felt uncomfortable but it definitely wasn't painful.The same happens when i accidentally hit one of my knees in an object (which actually happens a lot lately, damn it). I feel both my knees weird in any impact, its not pain, the closest thing i could describe is numbness.
    As for the sitting part, i'm a computer person so my job requires me to sit on a chair many hours a day, yet i get no pain at all. Most of the day, as suggested, i keep my leg risen on a table, which seems to get the pain away a lot quicker. Something else that seems to help is the flax seed oil softgels i've been taking a lot more lately, i take like 3gr with my lunch and sometimes some more softgels later. I've noticed it helps a lot with the inflammation after a long ride.

    Yesterday i when i started i would swear it must've healed, but as soon as i reached fifteens i already had an annoying feeling on the left knee...

    What really makes me curious is the right knee, after all the stress i've put it into (completing over 90kms on the trip with most strain on it, and generally i started using it more) it still hasn't complain at all, which is a good thing but i feel bad for it :P

    Right now, i've had the left one at a 40-50 angle and i started to feel it uncomfortable, i'll experiment a little more with this and i'll write more later.

    Thanks again for your help

  12. #12
    mtbr member
    Reputation: Lost Biker's Avatar
    Join Date
    Jun 2009
    Posts
    639
    I am having similar knee pain as well. So I appreciate the responses in this thread. I have been riding over 3 years and prior to last month, I have NEVER had knee pains from riding. My typical trail rides are 10-20 miles and my typical road rides are 15-40 miles.

    A little more than a month ago, I participated in an event called Tough Mudder. It involves a 10 mile hike up and down steep fire roads with grades upwards of 45-60%. At every half mile or so, there are obstacles you need to complete, such as climbing a 10ft wall, crawling in a pool of mud, etc. About 7 miles into the event, my LEFT knee started to hurt. The pain got worse with every step downhill. That night, I gould not lift my leg and any attempt to do so felt like my leg was going to fall off.

    Took some advil and iced it, the next morning it was a lot better. Went to see a physical therapist and was told my knee is not tracking and causing the pains. Was given a harsh 10 minute massage of the IT band and was on my way.
    Rested off bike for 2 tough weeks.

    Since then, been riding short trail rides of less than 10 miles. NO pains.

    Fast forward to last week.

    I did a 20 mile road ride and afterwards my RIGHT leg was experiencing the knee pains. Wierd that it is now hurting on my other knee. My left leg was fine. I have plans to see the therapist again in hopes he can make it go away.

    Its frustrating having to deal with knee pains when for 3 years, I never had any issues. ARGH!!!!!

  13. #13
    mtbr member
    Reputation:
    Join Date
    Mar 2010
    Posts
    105
    Quote Originally Posted by Johnny91i View Post
    Thank you very much, you've been very helpful.
    I tried the diagnosis test you suggested, it felt uncomfortable but it definitely wasn't painful.The same happens when i accidentally hit one of my knees in an object (which actually happens a lot lately, damn it). I feel both my knees weird in any impact, its not pain, the closest thing i could describe is numbness.
    As for the sitting part, i'm a computer person so my job requires me to sit on a chair many hours a day, yet i get no pain at all. Most of the day, as suggested, i keep my leg risen on a table, which seems to get the pain away a lot quicker. Something else that seems to help is the flax seed oil softgels i've been taking a lot more lately, i take like 3gr with my lunch and sometimes some more softgels later. I've noticed it helps a lot with the inflammation after a long ride.

    Yesterday i when i started i would swear it must've healed, but as soon as i reached fifteens i already had an annoying feeling on the left knee...

    What really makes me curious is the right knee, after all the stress i've put it into (completing over 90kms on the trip with most strain on it, and generally i started using it more) it still hasn't complain at all, which is a good thing but i feel bad for it :P

    Right now, i've had the left one at a 40-50 angle and i started to feel it uncomfortable, i'll experiment a little more with this and i'll write more later.

    Thanks again for your help
    Maybe not PFS. Have a look at

    Iliotibial Band Syndrome - Iliotibial Syndrome - ITB Syndrome - PhysioAdvisor

    I use a foam roller to release and relax the ITB. 5 mins each side after a ride.

    Foam Rollers - PhysioAdvisor Shop

  14. #14
    mtbr member
    Reputation:
    Join Date
    Oct 2012
    Posts
    17
    @Rottenronny, you just hit bull's eye with this one! It has to be my injury.
    @Lost biker, if you feel exactly like the way your left knee felt back then, why don't you try the same things that worked for that too?
    Did you have any significant bump while on that event? I used to use my knees as suspension on trails last year then i decided i had gained enough muscle and left hills back for good for roads favor but i clearly remember i was feeling it was wrong for my knees health.
    I had a full year and a half with only minor muscle problems and this made me feel like a disabled... Knowing that i shouldn't ride when i am in perfect condition to do so is very frustrating.

    Anyway, i'll still see a physio this week to get some massages but i'd bet my good knee its ITB damned syndrome... Oh well i'll probably follow all the advice i can get and take as many time i can away from my bike... The weather is going bad so i wouldn't be able to ride anyway...And i don't have any friend to join me too...and its been weeks since i was trying to focus on weight training a bit more, i'll have plenty of time to do it now...damn

  15. #15
    mtbr member
    Reputation:
    Join Date
    Mar 2010
    Posts
    105
    Quote Originally Posted by Johnny91i View Post
    @Rottenronny, you just hit bull's eye with this one! It has to be my injury.
    @Lost biker, if you feel exactly like the way your left knee felt back then, why don't you try the same things that worked for that too?
    Did you have any significant bump while on that event? I used to use my knees as suspension on trails last year then i decided i had gained enough muscle and left hills back for good for roads favor but i clearly remember i was feeling it was wrong for my knees health.
    I had a full year and a half with only minor muscle problems and this made me feel like a disabled... Knowing that i shouldn't ride when i am in perfect condition to do so is very frustrating.

    Anyway, i'll still see a physio this week to get some massages but i'd bet my good knee its ITB damned syndrome... Oh well i'll probably follow all the advice i can get and take as many time i can away from my bike... The weather is going bad so i wouldn't be able to ride anyway...And i don't have any friend to join me too...and its been weeks since i was trying to focus on weight training a bit more, i'll have plenty of time to do it now...damn
    I'm glad I could help. And you have made a wise choice to see a physio. Hope you are back cycling pain-free soon.

  16. #16
    bt
    bt is offline
    mtbr member
    Reputation:
    Join Date
    Nov 2007
    Posts
    1,195
    move your cleats full rearward.

  17. #17
    mtbr member
    Reputation: Lost Biker's Avatar
    Join Date
    Jun 2009
    Posts
    639
    Quote Originally Posted by Johnny91i View Post
    @Rottenronny, you just hit bull's eye with this one! It has to be my injury.
    @Lost biker, if you feel exactly like the way your left knee felt back then, why don't you try the same things that worked for that too?
    Did you have any significant bump while on that event? I used to use my knees as suspension on trails last year then i decided i had gained enough muscle and left hills back for good for roads favor but i clearly remember i was feeling it was wrong for my knees health.
    I had a full year and a half with only minor muscle problems and this made me feel like a disabled... Knowing that i shouldn't ride when i am in perfect condition to do so is very frustrating.

    Anyway, i'll still see a physio this week to get some massages but i'd bet my good knee its ITB damned syndrome... Oh well i'll probably follow all the advice i can get and take as many time i can away from my bike... The weather is going bad so i wouldn't be able to ride anyway...And i don't have any friend to join me too...and its been weeks since i was trying to focus on weight training a bit more, i'll have plenty of time to do it now...damn
    I am planning to see a physical therapist on this new issue. My previous physical therapist was a bit expensive due to being out-of-network, $100 a visit. I am trying to practice ITB stretches + foam rolling to loosen my ITB too. Hopefully both these will eliminate my knee tracking issues.

  18. #18
    mtbr member
    Reputation:
    Join Date
    Oct 2012
    Posts
    17
    I just had a visit too, unlike Lost Biker it was fortunately free in a local hospital... I'm scheduled for an MRI next week because the physio couldn't find anything wrong with my knee...
    I told them everything i managed to collect from here an some other researches, it wasn't ITB since it was on the exact opposite site but it seems to be something very similar. The docs suggested Glucosamine, i told them i'm already taking Animal flex which had glucosamine chondroitine msm and some other **** and they let me go.
    I'm waiting for the next week MRI now...
    It seems my luck has run out though, last friday my motorcycle was stolen and i'm left with my bicycle now, which i use only when i really have to.
    I had a pretty good sprint to the police station last friday, without any warmup and i hit my legs hard enough to get them so sore that i couldn't lift myself up until Monday, but at least my knee is still ok after that, with no pain at all....
    I'm thankful for that at least...
    I'll probably go for a test ride today or tomorrow...I'll write back as soon as i have some news.

  19. #19
    mtbr member
    Reputation:
    Join Date
    Oct 2012
    Posts
    17
    So here i am, back from the MRI test i got to check with the physio... He told me 2 months off minimum, not just saddle even stairs!
    Had some cysts on the lateral cruciate ligament and some extra fluid in there... Gonna waste my life in here for 2 more months and see what happens.
    He said that if after 2 months i'll have to scan it again, if that fluid is still there i'll get subsc for heavy anti-inflammatory drugz.
    i'm so happyy i'm almost flying... He also bothered to mention i should start with 10-15kms after said two month period to check how this thing goes in practice...
    I'll post the MRI papers as soon as i find a flatbed scanner to let you in this fun too guys

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •