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  1. #1
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    Knee Pain - Can you help?!!

    Hi, I would really appreciate hearing from anyone out there with experiences regarding plica syndrome or pain and problems from plica related acute trauma due to overload type injuries or other causes. It would also be great to hear from any PTs or other health pros.

    I have seen PT's and an ortho specialist and had an MRI and it seems at this point that I have plica problems - whether its full blown plica syndrome I don't know. Right knee is main problem with some pain, 30% as much in left knee also.

    It is from a cycling overload injury whilst hillclimbing. ie. too much force through the joint during high flexion when the plica is most readily damaged. I have also done this before about a year or so ago but this time it's much worse because I was mainly seated with very high force and hard gearing. It has been four weeks and I have seen a 50% improvement. I did go for a ride today and pushed it a bit because it was feeling much better, and now I'm feeling some dull pain and am walking a bit gingerly again. Took anti inflam also. Yeah, I should take it more easy and I intend to now, but the lure of the bike! Now I'm just focussed on long term management for best outcome and intend to rest as much as necessary. I'm seeing another PT soon to get some management - prob all those exercises and stretching etc I've been reading about. Ie strengthen the quads and increase flex of hamstring and calf etc.

    I have researched this and am familiar with the condition but it would be great if anyone could answer these questions:

    1. How long did it take to get better to where you could use normally again? Has it reoccurred? Can you ride like you used to after it completely settles down?

    2. What was your management program and how well did it work?

    3. Any other info or tips.

    Any input would be very much appreciated because I'm struggling after only four weeks without really riding and I can't imagine a long term problem that keeps me off the bike.

    Thanks for any help you can give :-)

  2. #2
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    I had knee problems a while back, following a LONG day on a road bike. It was primarily related to bike fit. For the next 6 to 8 weeks, I had to back off on the hill climbing. I had to spin at a higher cadence on the hills. At the advice of a pharmacist who cycles, I took ibuprofen (8 per day, 2 every six hours), fish oil, and started a 3-month regimen of glucosamine. I also raised my bike seat and put some Lemond wedges between my shoe and cleat in order to tilt the inside of my foot up just a bit. I've not had any problems since, even on the longer (200 mile) rides. I still sometimes feel some tightness in my knee joints after a hard afternoon on the mountain bike, but it doesn't turn into lasting pain or soreness.

    Good luck. Just take it easy for a while, take some anti-inflammatory, and make sure your bike fit (seat height) is right.

  3. #3
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    I did something similar once. Went from 170 to 180 cranks thinking I could pull a bigger gear. My Chiro ordered me off the bike for 2 weeks, Ice and Alleve (contains sodium if you have hi BP issues use Ibuprofen). Once things settled down I started doing a couple exercizes with ankle weights to balance the support of the knee. One that was prescribed is forward leg extensions with the foot turned out. This works the inner quad that doesn;t get much use cycling, and helps center the knee. Also leg curls to develop the hamstrings which also are under used. I'm not a doctor so please check with one first about this. But it's working for me. I'm back on 180 cranks and 48x11 gear, but only with a strong tailwind.
    Last edited by William P; 04-27-2008 at 09:14 PM.

  4. #4
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    I also have what you are referring to. My lbs used varus wedges to correct my pedalling
    motion (I was bow-legged) and lowered my road bike seat. I also found alternating MTB
    and road alleviated the pain. I also use Icy-Hot, ice packs, and heating pads as well as
    NSAID's (be careful to mix dosages between Bufferin, Ibuprofen and Aleve and try not
    to take unless hurting a lot). I also seem to benefit from using an ace bandage over the knee to keep it warm. Also, very important are hamstring, calf and quad stretches and
    some hamstring weight training. One other thing, sometimes I have to get out of the saddle when climbing. This situation is very delicate and mine is not going away completely. If anyone has any other ideas, I would also be greatly appreciative.

  5. #5
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    The purpose for taking the Alleve is to reduce swelling and thereby improve circulation.
    A bag of frozen peas wrapped in a cloth makes a good icepack-same purpose.
    Time is a big part of the equation. Time to heal, and time for the exercises to produce results, before another hard effort.
    I've made these exercises part of my normal routine, and haven't had knee problems since.
    As far as standing on the cranks , I've found that being careful not to overextend the knee helps.
    Tiger Balm, or some of the Pharmacuetical grade DMSO ointments can help too.
    DMSO penetrates quickly and takes other substances (or impurities ) with it. I wear an exam glove when applying DMSO so it goes where I want it, and not into my hands.
    Again please check my recommendations with your healthcare provider.

  6. #6
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    Hi, just a really quick message to say that whatever I find out I'll keep you posted so as to help anyone else who has same or related condition. Secondly, thanks, I really appreciate people taking the time to respond

    Here are some links I've found related to this...

    1. Excellent info about knee joint and synovial related stuff
    http://www.orthosupersite.com/view.asp?rid=26361

    2. Article from the Journal of Bone and Joint Surgery re plica - watch the date though!
    http://www.ejbjs.org/cgi/reprint/62/2/221.pdf

    3. Plica discussion in a runners' forum but relevant to bike too
    http://forums.runnersworld.com/eve/f...7/m/9791029693

    4. Knee pain thread in Single Speed but relevant also - see comments from physio
    http://forums.mtbr.com/sitemap/t-231818.html

    5. Check out these PDFs from this lady - PT and Elite Cyclist
    ps. the one on correct clipless pedal technique ('Power to the Pedals') is pretty interesting re the finding of the studies
    http://www.topbike.com.au/physio.htm

    6. Brief but good on problems with extension of the knee
    http://www.emedicine.com/radio/topic856.htm

    7. Seriously useful link on Plica problem with exercises and management stuff
    But - sorry if this not needed but exercises and management should be done in consultation with a PT or other health pro cause you could do damage or aggravate injury
    http://www.sportspodiatry.co.uk/knee_plicaknee.htm

    That's all I got at the mo, hope that helps at least a bit - not least because it could help you with what you may be dealing with and then aid the process of working with a PT to best fix what you got!

    Damn, where's the robot bodies they promised!!!

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