Calling out the knee specialists

[gt6267a]

I am getting some pain in my knee and am hoping to get some advice:

Background : This spring I got the Serotta re-fit to me and have been very comfortable for the last two months. Wtih hundreds of miles everything seemed fine.

Yesterday, I rode down to Valley Forge. 37 miles mostly flat but a little climbing on the way home. Bored, on the flats, I changed up my peddling a bit. My natural pedaling has my heels up a bit higher, foot pointing down. Looking for something different, I dropped my heels down. For a while it felt great. Then, my knee started to hurt.

The pain is in my right knee. It feels like the tendon on the underside connecting the muscle(opposite the hamstring don't know the name) on the inside.

After the pain started, I went back to my normal peddling stroke. It didn't hurt last evening. Then, today, I went out and it was hurting significantly so I turned around and went home. The total ride was less than a mile. Now, this evening it is sore.

I don't think this is just a sore muscle which has me concerned. My question is, what do i do? Stay off it a few days? Ride through it? Stretch?

[Louis]

I'm hardly a specialist, but when I have knee problems (which unfortunately get worse as I get older) I take it easy. Knees are too valuable to aggravate. Patience is a virtue.

If I were you I would rest for a day or two - do some maintenance on the bike, so you feel like you aren’t wasting the time. If you don’t feel any pain walking or going up or down stairs you’re likely on your way to recovery. Take it easy on your first ride out, without any serious hammering or climbing and hopefully you’ll soon be as good as ever.

Louis

[dgauthier]

I don't think this is just a sore muscle which has me concerned. My question is, what do i do? Stay off it a few days? Ride through it? Stretch?

The recommended course of action, according to the Cyclist's Training Bible, is to curtail riding for 5 to 10 days. If it's not better by then, see a doctor.

[gasman]

It doesn't sound serious. If it was you would feel popping or tearing or have significant swelling or pain at rest. You should stay off it for a few days. Try to gently massage the area of pain and use heat if the injury is over 24 hrs old. I assume it is. You can alternate heat for 20 minutes with cold for 20 minutes, just make sure you don't use ice directly on the skin.
If after a week or two you still have pain when you pedal you should go see a doctor.
Good luck.

[Kevan]

Check this out and see if this might be your prob:

http://www.csuchico.edu/phed/atc/Projects/ITband/ITBFS.html

[gt6267a]

so i will stay off it for a few says and see what happens.

gasman -- it is not serious, yet. i have pulled many muscles in my time and this feels rather different. concerned, i am trying my best to not continue to injure myself.

kevan -- i looked at the site. lots of good info. the picture of where the pain is supposed to be has me thinking this is not it. the pain point is higher for the problem in the article. for me the pain is in the almost cable like connector.

i will admit that my inability to describe the problem due to a clear and present lack of anatomy knowledge is bothinging me. i will have to do some research ...

[djg]

Patient: Dr. it hurts when I do this.

Doctor: So don't do that.

Sorry if this seems to be treating a real problem lightly--I know that knee problems can absolutely suck--but I think the old joke has some wisdom in it. You messed with your pedal stroke and you hurt yourself. When you went riding again you likely hadn't healed, so even a reversion to the old technique didn't effect you (that is, painlessly) the way it had before. I guess I'd abandon the new technique, but I'd also go to ice and some NSAIDS and wait a few days before a nice easy ride in your old toes-down style (it's not the received wisdom of how to pedal, but there are always some very respectable pros in the peloton who pedal just that way--to each his or her own).

Changing the toes-down thing effetively changes your saddle height as well as your leg dynamics. If you have continued problems you should see a real doctor in person. "Dr." Andy Pruitt's Medical Guide for Cyclists has a nice clear discussion of some common knee (and surroundings) problems faced by cyclists--might be worth a look.

[Ahneida Ride]

I've found that raising my seat eliminates my knee problems.
Dropping my seat hight, even just a bit. leads to knee pain.

[Russ]

I find your post very timely.... I am having THE EXACT same problem!

However, I have made an appointment with a local Sports Medicine Doctor. He suspects my problem is associated with a stress fracture, but preliminary x-rays, did not show anything. He has ordered a knee scan and we are waiting for results.

I will keep you posted on my issue... perhaps we could exchange info :)

[gt6267a]

i ate dinner at my uncle's place. he is a doctor and ex-runner. we talked about my knee. most definetly the problem area is a tendon and not a muscle. he told me to take advil every 6 hrs and give riding a try but no effort. basically do as little work as possible. if i feel any pain, return home and ice it.

where i live is rather hilly, so this is somewhat difficult to pull off. i rolled down about 1.5miles to a flat area. i went real slow and had a lot more weight on my butt than ussual. i turned around after 30min. when i got to the hill, i put it in the 26 and rode very gently . i didn't even get out of breath or noticedmy heart rate increase.

while riding there was no pain per se, but it was definetly not 100%. now, off the bike, i have more discomfort than before, but do not consider it painful. i am icing it now.

i am hoping that with a few days of light or no exercise the tendon will heal and this problem will be behind me. in talking with my uncle he did say that tendon injuries require much closer attention and cause bigger problems if they continue.

[Eric E]

My understanding and experience is that if my seat is too high, I get pain in the inside of the knee. I use this to help me get an optimum seat height by raising the seat until it hurts and then dropping it. Dropping your heel would make your knee stretch more and do the same thing as raising your seat. Once your tendon starts to hurt, it may take a while to heal....

Eric

[Climb01742]

someone told me once--you're your own best doctor. meaning, you know your body better than anyone. i've found sports injuries particularly frustrating and perplexing. i have run/rode thru most of mine. they come, they go, without me ever really understanding why they came and why they left. most doctors in my experience simply don't understand athletic injuries or the minds of athletes. lowering your saddle just a few mm might be an interesting experiment. or getting a massage. but more than anything, i'd suggest listening to your body. test it until your body says no. good luck.

[gt6267a]

russ - i am definetly interested in how your treatment unfolds and wish you good luck. after todays ride, i am thinking(hoping) that my problem is quickly on the road to recovery. we'll see tomorrow. i am going to try and go a little further ...

eric e. and others -- the seat height changing is a definite possibility. after riding today and observing myself, i have another theory to pile on: my right cleat is making a bunch of noise rubbing within the pedal. automatically, i found myself re-positioning my shoe inside and out to make the noise stop. i am wondering if a different shoe positions place different strains on my knee.

i have look pedals and red cleats. the float business has been working for a while, BUT to make the creaking stop, maybe i am putting my food into an un-natural position...

before i go crazy trying new pedals et all. what is the solution for making look pedals stop creaking? a little grease?

[alembical]

My thoughts are that if you having any type of reoccuring knee problems, you should see a doctor, preferably an orthopedic or someone with knee and ideally cycling knowledge. One place I wont turn for medical advice is a phorum of cyclist who haven't seen my condition. It is your knee, take care of it.

Alembical

[Climb01742]

gt--you may have hit on it. definitely if your cleat is not floating or is out of alignment, could surely cause pain. check to see if the cleat screws have come loose. or if it's worn, so it's sticking. maybe get new cleats.

[Climb01742]

alembical--over the past 30 years of sports related injuries -- with the singular exception of broken bones i incurred while skiing or playing football -- classically trained doctors have been phenomenally useless in helping me recover. more specifcally, orthopedists have been the most useless. bottles of aspirin have been of more help to me. classically trained, western-oriented doctors seem to have a simple credo--don't do it if it hurts, and that'll be a hundred bucks. i absolutely agree that i am unqualified to offer medical advice to an athlete--as are most doctors. there are many areas of medicine where doctors are well trained. sports medicine just doesn't happen to be one, based on my personal experience. as you can probably tell, this is a particular sore point (no pun intended) to me. and i don't mean to jump on you. sorry. rant over.

[alembical]

Climb,
No offense at all taken. My view point has just changed over the past couple of years as my joints have had some problems. I have found a real good orthopedic doctor who is an athlete (avid cyclist, played in the Superbowl for Denver, etc...) and who listens and understands me, my concerns, and my wishes.

I typically agree with comments about Western Dr.'s but would add that they are likely to request an expensive test (non-covered by insurance of course) and give some expensive prescriptions. But that said, I do feel that Dr.'s do great work, and we as non-physicians really have a duty to do more research into who we choose as our physicians. People spend much more time researching much less important things.

Alembical

[Climb01742]

perhaps it's the training of most doctors, but many, being specialists, are somewhat narrow in their perspectives. holistic treatments have been more useful to me. but i surely agree that many doctors do great good. (just not, sadly, the ones i've been to. :rolleyes: )

[zap]

Spray some silicon lube on your cleats and pedals. I find that my right Look pedal on one bike gets "tight". The lube works for several dry rides.

It's interesting that my Look 256 pedals don't have any "stiction" problems compared to the Look 276.

Tendon injuries can take several weeks to heal. Advil/Motrin works well in addition to ice and heat treatments.

Going through this pain in t.. ... process right now with my left Patellar tendon. I've been riding really easy for the past 2 weeks to keep the tendon loose. Great fun getting passed by over weight people on beach bikes :crap:

I hope to turn up some heat this weekend :D

[gt6267a]

Tendon injuries can take several weeks to heal

i definetly do not want to hear that. i have the pa dutch tour ms 150 in 4 weeks. supposedly we are doing back to back centuries on very hilly rides. i really want to be hitting the hills training not looking after a banged up knee. ARGH! My friends are going to have to push me up like Cipo in Georgia. Oh the humanity, I mean humility, I mean humiliation. Heal knee, heal!

[vaxn8r]

perhaps it's the training of most doctors, but many, being specialists, are somewhat narrow in their perspectives. holistic treatments have been more useful to me. but i surely agree that many doctors do great good. (just not, sadly, the ones i've been to. :rolleyes: )


Climb, have you ever considered that the sports injuries you have sustained didn't require a doctor's care? Honestly most don't. Unfortunately, athletes are the biggest babies. They over-do it, get tendonitis, stress fractures etc. and then want it fixed so they can go race or whatever the next day. No not the next day, later today. I'm not surprised you were dissatisfied, more that you kept seeking help for what were clearly self-limited injuries. Most specialists order tests not so much to rule-in what they think you have, but to rule out the stuff they'll inevitably get sued for if they miss it. Happens all the time.

Holistic treatments....I won't even go there.

[Dekonick]

You are right about MD's ordering tests to cover their arses...

Even so - I still believe in more than just western medicine. I think you may be better served by working with a MD who has an open mind. My primary MD, for example, is a martial artist (3rd deg in Kempo) and believes in the usual stuff - tests, medications, etc but also believes in accupuncture, theraputic massage, and (Uh-Oh say it aint so!) chiropractors (especially Atlas Orthogonal specialists - not common) among other things like leeches, blood letting...

Just joking about the leeches and blood letting.

but if it hurts, the best medicine is rest. :help: