Sunday, August 3, 2014

Suggestions for Cycling and Knee Pain?

** First, and completely off topic for the post, I want to say that you all are some amazing people. My most sincere thanks to those of you who went to vote (and passed along the link to others) in the Pedal the Plains "Plain Pedaler" contest. I try not to ask much of others via social media -or the blog- but this was something I really would like to do, and I am so grateful that folks (many of whom have never heard of me, spoken to me, read here, etc) took the time to go and vote. There is no word as of yet in regard to the outcome of things, but regardless of what happens, I just wanted to say thank you.  :O)  **

As some are already aware, one of my knees is not the best. I had an injury in my early adult years that caused some water on the knee and other issues and since that time, that knee has never been quite right. As long as I don't do anything too terribly stupid, I seem to be able to manage things. Other than long flights or events in stadium seating, I seem to do okay, and even then, as long as I get up and stretch occasionally, pain is minimal. Once in awhile, I have some issues on the bicycle, but those are generally when I've been pushing too hard (either with climbing or distance - or both) and it subsides over time.

Over the last year (or so), I have started experiencing pain in my "good" knee, however, and I don't know quite why nor how to resolve the problem and I'm hoping someone may have some suggestions or ideas as to what is taking place.
*Image from Runner's World
Initially, I thought the problems were due to improper set up on the bike, but after many adjustments, fittings, etc, that doesn't seem to be the problem. I also do a decent number of knee-strengthening exercises throughout any given week and have for some time now. While it's possible that the exercises could be causing some of the problems, I would hope that something meant to strengthen the knee isn't actually doing it more harm (and I try to pay attention to the things that are perhaps less beneficial or are flat out painful).

Generally the thing that seems to set off the knee pain appears to be time. At a certain point in a ride, the knee simply starts to ache or sometimes has shooting pains through it. I have tried to make some associations with the way I mount or start riding the bicycle when stopped as this seems to trigger it late in the ride, but I'm still not convinced that is the problem either. I have noticed that when I push off with the bad side, I do seem to trigger something in the good knee though - and I still haven't quite put a finger on why or how I am doing this, as the majority of my body weight is concentrated more on the bad knee.

The exact location of the aching/pain is pretty well centered in the area of the green circle on the diagram above (so, on the inner portion of the knee, and sometimes the right side- just below the knee cap). I don't think the pain is anything that will prevent me from continuing to cycle (particularly as I have cycled through it for the last year), but it would be nice to find a remedy to what has become an ever-increasing problem.

Do you have suggestions as to what this could be, or have you tried an exercise that has helped you alleviate knee pain when cycling? I always believed cycling would be less stressful for knees (at least compared to running), but I seem to still experience pains and would be interested to know if anyone else has found solutions.

12 comments:

  1. Do you stretch or massage your IT band on a regular basis?

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    1. I do stretch almost daily, but haven't tried massaging the IT band.

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    2. May I just add, the IT band is very difficult to massage effectively on yourself! I get regular (every 4-6 weeks) messages by a sports therapist. Every once in a while she notes some IT band tightness and even for her it's a bit of a pig to really dig into.

      Once you've had it "released" though, stretches do really help. Just Google "IT Band stretch" and pick a website run by physiotherapists for some good examples.

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  2. Afraid you won't know the cause and thus how to treat it without seeing your GP and getting a referral on to an orthopedist. :( I was born with knee tracking problems and have had Osgood-Schlatter disease and bursitis. Alongside that, I've had arthritis developing for 20 years. Bike fit was essential, as was stabilising my feet. I've done physio and continue to do Pilates since my orthroscopy 4 years ago. Cycling *IS* less stressful for knees as compared to running (high impact) but you are still moving the joint and if there's something going on in there, movement will tend to make it show up. Muscles (weak and/or imbalanced) can be a cause or an aggravating factor. As can any degree of tendonitis.

    Suggest you see a doctor G.E. and do let us know how you get on!

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    1. I have no doubt you are correct, and a visit to the doc is in order. I keep thinking I can work through it on my own, but that never seems to quite happen. Since I have issues with the other knee, I suppose I've been avoiding any sort of real diagnosis, but I also know it's important to have the knowledge so I can hopefully move forward. Appreciate the kick in the rear. :O)

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    2. Hm, not sure what happened to my earlier comment. Definitely see a doctor, and sooner rather than later. If I'd seen a doctor when my knee pain first cropped up, I might not be looking at a total knee replacement at age 45. I'm not suggesting you'll need such major surgery, but an MRI will rule this out.

      Also, while you wait for your MRI/Ortho appointment, get physiotherapy and massage therapy, especially if your insurance covers it. It will help bunches.

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    3. As I was typing an apology for Blogger and its inability to get all of the comments through, I managed to lose my own comment into the black hole. It's strange, Cecily. I'm not sure what's going on... and it doesn't seem to be only here either as I've noticed it happening on other Blogger accounts.

      Anyway, as I was saying, it's easy to ignore things and believe that they'll just go away on their own, but on the other hand, at least if I know what's going on, I can potentially work on things to remedy the situation. I'm in the process of making an appointment - hopefully for next week - and I can simply add the knee issues to the list. It would be great just to know what's going on if nothing else and hopefully find some solutions to get me through.

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  3. Hi, I'm a runner and will get a "pull" on the inside of my right knee when I neglect to stretch my abductor muscles. My right side is a bit weaker than my left so my running has been a bit lopsided and this has manifested in various stability problems. I've just started a program to bring me back into balance. It's working! I realize that running and cycling are two different activities but maybe my experiences may be useful for you. Good luck!

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    1. That is interesting, May. I have injuries to my back on the same side as the "good" knee and I can't help but wonder if that plays a part in all of this as well. When you mentioned being weaker on your right side, that suddenly popped into my head as a possibility. I wonder if I'm trying to compensate for weakness, which is putting strain on that same knee? Running and cycling are definitely different, but I think stretching better/more effectively may help. Thank you.

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  4. When I have had knee pain from cycling, it was due to improper fit. The improper fit tended to irritate or inflame the tendons and/or ligaments. Three main factors made a difference. 1) Proper seat height, and 2) locating the saddle the correct distance fore/aft relative to the pedals. I have used the trick where you drop a weighted string from the outside of the knee cap and adjust the seat on the rails fore/aft until the string falls through the center of the pedal's axle - when the pedals are balanced and your foot is on the foreword pedal. Finally, 3), the location of your foot inward vs. outward on the pedal (that is, how far in or out from the centerline of the bike) has affected me too. Clipless pedals that forced my feet too far inboard for my size have caused some knee pain. Platform pedals let me position my feet a little further outboard. Sounds like you have eliminated bike fit as the problem.

    As pointed out by others, a exam by a sports medicine doc may be warranted. Meniscus tears are very common. There is some controversy whether anything should be done about them. I've know people that had surgery and others that were told to leave them alone.

    I agree with lots of gentle stretching and/or yoga - but be careful to not overdo it. I've always thought cycling was one of the best ways to strengthen my legs, because it is low impact.

    Besides exercise and stretching, do you ice? I ice my knees and back for 20 - 30 minutes when they get sore and it helps a lot. I figure if the ice is helping, it is probably inflammation that is the culprit.

    Good luck!


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    1. Thank you for your thoughts.

      I've been through multiple fittings at this point to get the bikes set up in the best possible position, so I'm hoping that this juncture, things are as they should be - but, who knows?

      I had considered that this is possibly due to small meniscus tears, but surgery seems excessive to me at this point. I think icing is a great suggestion though because it could very well be inflammation that would be helped through something fairly simple.

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