# ...another knee issue..burning pain....



## Dzzi (27 Jan 2014)

...im 47 before i discovered the joys of cycling again (around 3-4 years back) i played basket ball 3-4 times a week between the ages of 16 & 30, i've also played football mostly 5-a-side at least once a week since i was 19 and was playing regularly to around Apr last year when i sort of retired due to lack of time while training for my first full 100 mile event...

So in brief ive had the odd knee injury/issue over the year but nothing major but i suspect there is some wear and tear on the knee joint by now...

For the last 3 weeks (since i played football late Dec) i've had this burning pain on the outside of my left knee just below the kneecap it only happens when i kneel down (mainly DIY stuff) or more annoyingly when i turn over in bed....it feels like a graze ? and this is now waking me up so it's serious !

It doesn't hurt when cycle....

I've had a quick look around and i think maybe this is prepatellar bursitis (house maids knee)

Anyone had anything similar and managed to figure out what it is or has any suggestions that might help ?

I really don't think my GP will be that interested !

Thanks

Dave


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## fossyant (27 Jan 2014)

If cycling does not irritate it, carry on.

You may be right, try ibuprofen or indeed the gel locally and see if it goes down.

The best advice is to see your GP for real medical advice. If it's keeping you awake, then it's serious enough to see the GP


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## BrianEvesham (27 Jan 2014)

I'll be watching for responses on this. Whilst cycling there is no problem at all but if I kneel down on my right knee it feels like a knife has been pushed in from just below the knee on the side and it has only recently started playing up.
I started cycling in sept 2012


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## Dzzi (27 Jan 2014)

it's more that i think it wakes me up when i turn over...than it keeping me awake, but i take your point fossyant
Brian do a google search on prepatellar bursitis......mines less pain than your knife description best i can say is its like the feeling i get when i've grazzed a knee on astroturf..but their are no marks, bruises etc...and i really can't kneel on carpet but if i but something a little more padded down then i can take it long enough to get most kneeling required jobs done....


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## Peter T (27 Jan 2014)

If you have not had a bike fit and in particular your shoe cleats I would be looking at that, but it may be something else as would have expected you to have soreness when pedalling if it was that. I have had similar sounding pain and it was my cleat fit that was wrong.


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## Dzzi (27 Jan 2014)

Thanks Peter, i've not had a bike fit and i think i may have "too much" play (side to side if that makes sense) in my cleats although that does let me vary my foot position which i like to do as it feels like a way to keep a little more circulation in my feet...maybe thats flawed thinking...


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## Doyleyburger (27 Jan 2014)

BrianEvesham said:


> I'll be watching for responses on this. Whilst cycling there is no problem at all but if I kneel down on my right knee it feels like a knife has been pushed in from just below the knee on the side and it has only recently started playing up.
> I started cycling in sept 2012


I have exactly the same (previous thread iv done)
Like a sharp stabbing pain to the outside of my right knee and down a bit if that makes any sense. I can feel it when cycling and it usually starts to hurt after about 8-10 miles or so. I can tolerate it whilst cycling to a degree but it's when I get off the bike I really notice it. The knee actually collapsed on me the last couple of times whilst trying to climb my stairs. In bed it's painful and usually worse when the leg is bent.
Doctors booked for next week to have it looked at. Doc happens to be a cyclist so that should be handy. I think my cleats are well set up and I keep playing around with saddle height to try and resolve it. I will also keep an eye on this thread


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## Doyleyburger (27 Jan 2014)

I should add that I have mtb spd's which I probably have too much movement on. I will definitely change to proper road shoes and pedals in the near future and get the red cleats which are more fixed. I have been told before that if I value my knees then the red cleats are the ones to have. 
See what doc says first tho


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## GrasB (27 Jan 2014)

Doyleyburger said:


> I should add that I have mtb spd's which I probably have too much movement on. I will definitely change to proper road shoes and pedals in the near future and get the red cleats which are more fixed. I have been told before that if I value my knees then the red cleats are the ones to have.


The reason you want to tighten down your foot motion is to enable easer releases without causing accidental release & to aid power transfer to the pedal (excessive foot rotation robs power by introducing another flexing motion). The latter is achieved not by mechanically reducing motion with float reduction but to reposition the rider so that their normal pedal motion is encompassed in a smaller float range. If one is restricting motion of the foot to prevent straining of soft tissue (stabbing pains etc.) then there is something *fundamentally wrong with your bike fit* & artificially restricting float is only going to hide problems which will often become apparent in a much more sever way latter.


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## Doyleyburger (27 Jan 2014)

Trying to make sense of all that.

I take it you're saying that a more fixed cleat will not resolve the issue and there is probably something wrong with my fit ?
Could well be


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## Rustybucket (27 Jan 2014)

see a sports physio - Its worth the money - Then you will 100% know whats wrong and how to fix it.

I hurt my knee badly last summer and its slowly on the mend now - I probably see the physio ever other week


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## Dzzi (27 Jan 2014)

i also have mtb spd's...
@doleyburger be interested to hear what the Doc says obv doesn't mean we have the same issue etc...
GrasB ... thanks for the post i think i understand what you are saying, i've been using the same cleats and set up for a good while maybe it's time for bike fit....
@Rustybucket im not sure i could afford to see the physio every other week, however i don't think my issue is anywhere near as bad as yours no specific trauma to my knee..... im glad your's is on the mend now :-)


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## Doyleyburger (27 Jan 2014)

Yes iv never looked forward to a doctor's visit so much lol
Definitely interested to see what he says.


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## vickster (27 Jan 2014)

Ice it?

I have lateral burning but then i have a meniscus tear and a defect on my cartilage.

If it doesn't get better with rest, ice and anti inflammatory drugs, certainly see a doctor. Unfortunately at 47, it could be some arthritis as you say. A very common cause of nighttime pain


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## ayceejay (27 Jan 2014)

_Definitely interested to see what he says._
10 to 1 he says "Rest it."
It would be a better use of your time to search out a sports injury clinic.
Meanwhile check this out to see if it relates to your problem.
http://www.tptherapy.com/unlock-your-body-anatomy-quads.html


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## Peter T (27 Jan 2014)

If your cleats are set in the shoe at the wrong angle and in the wrong position that can result in bad knee joint pain for sure. It is what happened to me. Everyone's natural foot position is different and if its set up wrong you can have a joint that is under stress every pedal revolution. I worked out that my typical 45 mile ride would be 180 mins x 90 cadeance = 16200 revolutions, easy to see how that can cause problems with poor setup. I couldnt do the stairs very well the day after a ride and bike fit cured it. I went to Manchester velo and saw a top guy and it was worth every penny.


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## PMarkey (27 Jan 2014)

I have a similar problem and went to a sport physio to have my knee checked out and was basically told that everything appeared fine and that the problem was a muscle imbalance , this would be about right as I did an Audax SR plus other rides and also ended up doing London-Edinburgh-London as a single speed due to my rear shifter breaking so a lot of km,s but very little non cycling exercise .
I have now embarked on a series of leg exercises plus stretches with some improvement and hopefully this will sort it .
I would definitely recommend a trip to the physio if only to see if there's anything serious going on and then look at bike fit if problems persists .

Paul


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## Peter T (31 Jan 2014)

Dzzi how are you getting on? There is a useful article on BC on cleat fitting at the moment. In addition to the advice given I would add that sitting on a table to observe the natural angle of the foot is a good way to get the cleat angle correct. When I had my fit it was the cleat angle that was the cause of the pain in my knee as my feet point outward and it was not reflected in my setup.

http://www.britishcycling.org.uk/in...ws+30th+January&dm_i=BM6,25B9Z,7FM1NQ,7R915,1


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## Doyleyburger (31 Jan 2014)

A guy at work reckoned it could be the IT band. 
Have a read. ....... sounds pretty spot on to what I have 
http://m.active.com/cycling/articles/tight-it-band-3-simple-exercises-to-fix-it-now


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## Dusty Bin (31 Jan 2014)

'Too much' float is rarely a bad thing, IMO. I've only ever heard of problems caused by not enough movement.


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## Peter T (31 Jan 2014)

Doyleyburger, yes its the same and the identical symptoms to my problem. Stairs were a killer but very little pain walking normally. In my case the cleat setup being too inward would have exacerbated the rubbing and caused the injury. I see the article has some useful exercises. Correct fitting and two weeks rest fixed it for me.


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## Doyleyburger (31 Jan 2014)

When I get home I'm dangling from the table


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## Peter T (31 Jan 2014)

Dusty Bin I totally agree but the guys who do not have a straight foot angle like me are probably more susceptible. I have never used anything but a 6 degree float SPD-SL or SPD.


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## Dzzi (31 Jan 2014)

thanks, both links very useful, i've only done 30 mins on the turbo since saturdays 30 miler, i think i need to check my cleat positioning and am considering a bike fit but not sure i can fully justify the cost to the FPO (Fun Prevention Officer aka the wife) !
Does sound IT band ish and on the leg thats effected on longer rides 50+ i think i can sometimes almost feel the IT band giving me some pain, not the whole thigh but a 1 inch ish band running down the outside of the thigh to my knee..

As with all these things i suspect its a combination of issues, poor fit/cleat position, maybe some pronation, not really ever streching (yeah yeah i know i know), still tying to play football with people less than half my age...

Thanks for all the replies....who was the guy going ot the Docs ? have you been yet ?


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## Peter T (31 Jan 2014)

This is the guy I went to see, my doctor didnt really have a clue not understanding cycling enough, suprisingly enough neither did my local physio. This guy was brilliant solving a number of niggles I had on the bike and improving my overall power and comfort cycling. I have a couple of prolapsed discs so fitting me was not straightfoward. Since watching him fit the cleats and getting measurements I have rented bikes overseas and been able to get everything in the right position myself and have not had any problems.

http://pedalprecision.com/about_us/


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## vickster (31 Jan 2014)

Shame he's in Manchester not London


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## Doyleyburger (31 Jan 2014)

Just dangled ......
(make of that what you will)

Anyway, my left foot is practically dead straight whilst my right angles out a fair bit. 
Have adjusted my cleats so ill see what that's like :/


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## Peter T (31 Jan 2014)

I was just going to ask if it was your right knee, then checked back on previous posts. If it was the left I would have been accused of talking bolloocks for sure  Hope it gets better now.


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## Dzzi (3 Feb 2014)

so i bought a foam roller...looked up IT band and foam roller on youtube....Oh My Lord that hurts


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## Doyleyburger (3 Feb 2014)

You've tried it then ?
Just had a butchers on YouTube. Let us know the results


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## Dzzi (3 Feb 2014)

well i've tried it briefly i think in need to mtfu and give it another go tonight.....pain just being weakness leaving the body etc etc


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## Dzzi (4 Feb 2014)

antther go last night...slightly better technique on my behalf and not quite so painful...I've also decided not to cycle, run or play football for 8 days and hope that this combined with the roller-hell massage will go someway to resolving the issues....


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## vickster (4 Feb 2014)

Are you stretching all your leg muscles too? Try ice as well perhaps


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## ayceejay (4 Feb 2014)

A simple but effective way to ease the pain overnight is to put a spare pillow between your knees.


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## Dzzi (6 Feb 2014)

@vickter well ive used the roller to do IT Band and Quads...im really not very good/willing/tough enough to do lots of stretching...i know this isnt helping :-(

@ayceejay thanks not sure i could sleep like that might give it a go


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## jarlrmai (9 Feb 2014)

Do you also get pain in the knee after sitting in a chair for any length of time (not necessarily in the same place as after cycling)


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## Doyleyburger (10 Feb 2014)

Just returned from doc and he is referring me to a surgeon as he thinks I have a tear in my cartilage. 
Told me to play around with my seat height again as it's probably to low.
Good job he's a cyclist and knows what he's chatting about


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## vickster (10 Feb 2014)

Good luck with it ... I am nursing my second meniscus tear 

One thing, don't rush into surgery for a meniscus tear unless the knee won't straighten or it gives way. Ask the specialist for an MRI, and depending on the result, physiotherapy could be the right way to go


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## Dzzi (13 Feb 2014)

Went to see a Physio last night...quite interesting and a little painfull !
Apologies if some of this isnt 100% right but i've put the general jist of what he said below in case it's of interested to anyone ele.

His diagnosis is that i have muscle imbalance, the outer muscles of my thighs are the same on both legs but the inner muscle on the left leg (the one where my knee issue is !) is visibliy small and therefore weaker..you don't look at your own thighs much well i dont anyway.

So what he did was tape my knee up to correct the misalignment caused by the muscle imblance he then told me to try kneeling again..which i did with some trepadation....and guess what no pain at all...amazing eh?

He took the tape of and to use his phrase "threw his elbow into my thigh) i was lying on my side and he was working the IT band area OH MY GOD that hurt !

He then showed me the 1 exercise he wants me to to 2x10 reps twice a day for 2 weeks (bit hard to explain...sit on the floor legs out in front of you body at 90 degrees to legs...pull good knee towords your chest...wrap arms around it....relax bad leg, let foot fall outwards, press back of knee into the floor and slowly raise your leg as high as you can...hold for a count of 2-3 then SLOWLY lower.

I told him i'd been using the foam roller and he approved of this....as long as you dont go too close to the knee (you dont want to put pressure on the cartlidge around the knee cap)

No cycling for 2 weeks...so that will be 4 in total then back to see him on the 26th. He has asked me to bring some Kinesio tape so he can show me some knee taping techniques that i assume will help with knee position while i cycle....

I was about to buy some but then thought hold on ask the good people of Cyclechat where the best place to get Kinesio tape is ....so anyone got any recomendations ?


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## Dzzi (13 Feb 2014)

oh he did also say that my knee is likely to be swolled internally around this specific bit of "stuff" that holds the kneecap in place so did recomend icing it periodically as well


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## vickster (13 Feb 2014)

Dzzi said:


> I was about to buy some but then thought hold on ask the good people of Cyclechat where the best place to get Kinesio tape is ....so anyone got any recomendations ?


Physios generally sell it if part of a practice. Otherwise physioroom or Amazon


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## vickster (13 Feb 2014)

Stuff holding kneecap = tendon??


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## Dzzi (13 Feb 2014)

Ligament maybe ?...stuff is the technical term i believe

Re the tape...they do sell it but he very kindly advised it maybe cheaper to look on the internet....PhysioRoom looked reasonably priced....have you used them @vickster


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## rualexander (13 Feb 2014)

Rocktape is the best kinesio tape I've tried, stronger adhesive and more stretch than others, also survives showering well, they do an h2o version too which is more water resistant. Pricey compared to some though.


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## vickster (13 Feb 2014)

Dzzi said:


> Ligament maybe ?...stuff is the technical term i believe
> 
> Re the tape...they do sell it but he very kindly advised it maybe cheaper to look on the internet....PhysioRoom looked reasonably priced....have you used them @vickster



I bought a tennis elbow support from them. Been taped by physio but no charge for the materials


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## vickster (13 Feb 2014)

Be careful with tape if you have sensitive skin, allergies etc


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## Dzzi (3 Mar 2014)

saw the physio on Wednesday, some ultrasound and a session of acupuncture, he then showed me how to tape my knee to assist with the correct location of my knee cap...got the ok to cycle although he advised not to get out of the saddle much and particularly not before im fully warm which at my age (48) takes about 10 miles i reckon....

Anyway did 25k on Saturday took it very slowly (not much choice as fitness seems to have vanished in the month that has passed !) Some soreness just above kneecap but no massive flare up of the intense buring pain so im hopeful that im heading in the right direction.

Another visist this week and i will then have to call a halt as it's not cheap, i think longer term i need to look at my bike fit so will need to budget for that...

Got on fine with the tape, although ripping it off on Sunday wasn't the best part of my weekend !


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## Dzzi (3 Mar 2014)

oh and physioroom delivered the tape no problems and at a very competative price compared to the walking into a running/bike shop in the city of London !


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## Andy Jeffery (3 Mar 2014)

Hi. I had a similar thing going on but a month off the bike and proper bike fit did it for me. I was just about to get back on the bike when I was rushed to hospital with a burst appendix. It will now be June before I get back on the bike as they had to cut across the stomach deep joy. Good luck with the knee and I hope all get better soon.


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## vickster (3 Mar 2014)

Dzzi said:


> saw the physio on Wednesday, some ultrasound and a session of acupuncture, he then showed me how to tape my knee to assist with the correct location of my knee cap...got the ok to cycle although he advised not to get out of the saddle much and particularly not before im fully warm which at my age (48) takes about 10 miles i reckon....
> 
> Anyway did 25k on Saturday took it very slowly (not much choice as fitness seems to have vanished in the month that has passed !) Some soreness just above kneecap but no massive flare up of the intense buring pain so im hopeful that im heading in the right direction.
> 
> ...



hint...always always remove the tape in the shower or bath, hurts far less.


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## jarlrmai (3 Mar 2014)

I haev my physio appt tommorow, been able to do an hour or so on the bike with stretching before and after but I still get discomfort afterwards and towards the end of the hour.


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## Crackle (3 Mar 2014)

Interesting Dzzi, I'm currently out with a misaligned pattela and I meant to ask the physio about tape but forgot: Next time.


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## Dzzi (4 Mar 2014)

@Crackle did the physio have a view on what was causing yours ?
@vickster i have an awful feeling that doing it on the bath is a clear violation of rule #5 :-)


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## Dzzi (4 Mar 2014)

@Andy Jeffery sounds pretty awful, best wishes for a speedy recovery..


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## Crackle (4 Mar 2014)

Dzzi said:


> @Crackle did the physio have a view on what was causing yours ?



In my case it's slight and it's a muscle imbalance but not as obvious as yours sounds. I think my right quads are pulling it out of line and I have exercises to pull it back and stabilise it. She also 'worked' on it, which was initially painful but less so the 2nd time. I don't know what triggered it but my hamstrings are really tight as well and I'm generally sore around my knees which she thinks are all at muscle insertion points. So whatever I did whilst running has triggered it and I've ignored the initial warning signs, probably because I didn't recognise them.


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