How to fix my hurting knee?

[chris-s]

I've done something to one of my knees, probably a ligament strain or something and wonder if anyone has any tips on how to encourage it's recovery.

How it happened is a bit stupid, about a month ago I was stood in a queue for over half an hour without moving, then when I stepped forward by leg/knee just kind of collapsed, most bizarre and highly embarrassing as I felt myself lunging forward in slow motion. Never had anything like this happen before, it must have been something to do with how I was standing, don't really know. There wasn't much pain, just a little discomfort for maybe a day at the most and that was that - so I thought.

Following that, I did a couple of easy weekly rides, 30 mil'ish or so no problems at all, then a week ago I went on a harder ride and was stonking up the hills, dunno where the energy came from! I've ridden much harder in the past with no after effects. The next day I started to get a pain on the inside leg of my knee, and a week later it shows no sign of improving, if anything it's getting worse, probably due to extra walking round the shops doing christmas shopping. It feels 'tight' and if I try to bend it tightly, it won't go as much as the other knee

Other than resting it as much as possible, anything else I can do to aid it's speedy recovery? I haven't been to see the doc, there seems little point, it's not like he can prescribe a pill to fix it.

Chris

 

[montage]

The doc will tell you to rest it for 6 weeks, then he will point you to a physio. Go to the doc in about a week if it is still a problem and say you've been resting it for agesand tried stretching etc etc etc and that you really want to see a physio.

That way, if it is still an issue, you will be on the waiting list for the physio....if it gets better, you can easily cancel!

good luck

 

[Yellow Fang]

Sounds a bit like patellofemoral pain syndrome. I tend to get that a lot through running, but cycling can be bad for it too. There's a band running up the outside of your thigh called the illiol tibial band (ITB) which stabilized your knee. If the band gets too tight from having to work too hard, it starts pulling your kneecap out of line, so that it doesn't run up and down its groove properly. This causes inflammation and pain. When I had it before, I saw a physio who gave me various exercises to stretch my ITB, which is a hard muscle to stretch. They also gave me exercises to strengthen the inner thigh muscles to even out the forces on the kneecap. I also saw a podiatrist once, who prescribed me orthotics. These were to stop me over pronating while running, but I think they can also help with cycling.

 

[Garz]

I tore my quadricep tendon recently by playing football it hurt for a few days but took ages to heal properly. The main thing to do early on is rest, raise the leg often and use a bag of peas strapped to it helped me a lot. After about a week I could conduct normal activities like walking up stairs with my body weight but I was so cautious it almost made me walk funny at first. I would say to fully recover took me a few weeks but you will know when it's okay to resume cycling and keep it light don't overdo it for a while.

 

[Adasta]

Could you elaborate on where you feel the pain and "how" it feels as well? The knee takes a fair bit of punishment and it also props up the majority of your body weight. It's not necessarily in the knee where the problem lies...

 

[Adasta]

Also, it's possible that you have Patella Tendinitis. I suffer from this and it's pretty painful; ironically, cycling is one of the suggested treatments for it! That's what makes me suspicious as to whether you suffer from it: I imagine you have quite well-developed Vastus Medialis muscles...

 

[HLaB]

I doubt its ITB; my knee never collapsed with it but it was agony (but thats my experience), get it checked out Chris. If you can I'd miss out the docs bit and go straight to the physio but again that's based on my experience.

 

[ventoux50]

Hi Chris-s,

firstly its NOT patella tendinopathy.

From the very bare details you give in your op it sounds quite likely that you have either

• torn fibres of the medial collateral ligament (MCL)of the knee
• trapped part of the medial meniscus and possibly done some sort of damage to it.

However, the mechanism of injury you describe is very unusual. I would suggest that you have had a minor injury for a while that you've been unaware of, and then standing still for a period of time (in the cold ?) followed by sudden movement may have overstressed the already delicate structure.

To attempt to be more precise can you answer the following questions:

At the time of the injury did you hear any 'popping' noise ?
Has the knee felt as if it's about to give way under you since the initial problem ?
Does the knee feel as if it is about to lock, or has it locked in one position ?
Was there any swelling or bruising around the knee (if so - where ?)
Did / does the knee feel unstable, if so is it worse if you are ascending / descending stairs ?
Is there any warmth to the knee if you touch it ? (where)
Is there any point tenderness ? (where)
Place your affected foot on the floor whilst standing, put one hand either side of the knee joint and GENTLY press inwards and outwards, does this cause any unusual pain or reproduce the pain you originally felt. Does the knee feel like it has more 'give' in one direction ? (compare it to the good leg).

Initial treatment has to be RICE
Rest
Ice - bag of frozen peas wrapped in a damp tea towel - press into position 5 mins on, 10 mins off, max of 5 times.
Compress - use a neoprene or tubigrip bandage to help support the joint
Elevate - raise the limb

Ibuprofen tabs are good if you're ok to take them, and ibuprofen gel applied to the affected area works too.

If you can answer the points above I can make a more accurate educated guess as to what's going on BUT not a diagnosis - for that you need to see a doc or )preferably) a physio who will perform specific manual tests to diagnose the problem.
I'd certainly recommend you see one, you might risk further long term problems if there is a specific problem which needs specific treatment.

 

[Adasta]

I'm pleased you don't have Patella Tendinitis - it's a bitch!

 

[chris-s]

However, the mechanism of injury you describe is very unusual. I would suggest that you have had a minor injury for a while that you've been unaware of, and then standing still for a period of time (in the cold ?) followed by sudden movement may have overstressed the already delicate structure.

To attempt to be more precise can you answer the following questions:

At the time of the injury did you hear any 'popping' noise ?
Has the knee felt as if it's about to give way under you since the initial problem ?
Does the knee feel as if it is about to lock, or has it locked in one position ?
Was there any swelling or bruising around the knee (if so - where ?)
Did / does the knee feel unstable, if so is it worse if you are ascending / descending stairs ?
Is there any warmth to the knee if you touch it ? (where)
Is there any point tenderness ? (where)
Place your affected foot on the floor whilst standing, put one hand either side of the knee joint and GENTLY press inwards and outwards, does this cause any unusual pain or reproduce the pain you originally felt. Does the knee feel like it has more 'give' in one direction ? (compare it to the good leg).

Initial treatment has to be RICE
Rest
Ice - bag of frozen peas wrapped in a damp tea towel - press into position 5 mins on, 10 mins off, max of 5 times.
Compress - use a neoprene or tubigrip bandage to help support the joint
Elevate - raise the limb

Ibuprofen tabs are good if you're ok to take them, and ibuprofen gel applied to the affected area works too.

If you can answer the points above I can make a more accurate educated guess as to what's going on BUT not a diagnosis - for that you need to see a doc or )preferably) a physio who will perform specific manual tests to diagnose the problem.
I'd certainly recommend you see one, you might risk further long term problems if there is a specific problem which needs specific treatment.

WOW, so many questions!!

I'll try to answer them as best I can. If it helps any, I've attached a photo and marked two areas, firstly, they aren't my legs honest! Area 'A' is where most of the pain is felt, around the side of the knee. Area B tends to ache a little if the knee is kept in a bent position for any time eg when sitting.

Firstly, I really don't believe I had an underlying injury and it happened whilst standing in a queue in Tesco's of all places, so not cold, but the way I was standing was with my knees locked 'back'. What happened when I went to step forward is a bit of a blur, but I think my knee just didn't bend.

At the time of the injury did you hear any 'popping' noise ? - No

Has the knee felt as if it's about to give way under you since the initial problem ? - No

Does the knee feel as if it is about to lock, or has it locked in one position ? - No

Was there any swelling or bruising around the knee (if so - where ?) - None now and none that I noticed at the time, but I didn't look for any.

Did / does the knee feel unstable, if so is it worse if you are ascending / descending stairs ? - No

Is there any warmth to the knee if you touch it ? (where) - Possibly, but could be just because I'm tending to rub it - area A on the photo

Is there any point tenderness ? (where) - If I stand and poke around the bottom edge of the knee cap, that is a little tender. I can poke everywhere else with no pain right now.

Place your affected foot on the floor whilst standing, put one hand either side of the knee joint and GENTLY press inwards and outwards, does this cause any unusual pain or reproduce the pain you originally felt. - Nope, that feels fine.

Does the knee feel like it has more 'give' in one direction ? (compare it to the good leg). - No, it feels pretty solid all round and I can't tell much difference between the two, EXCEPT, the knee cap seems to move a little easier on the injured knee, but could just be me holding less weight on it or something like that.

The only thing I can add to this is that as I bend my knee, the more I bend it it feels like it gets 'tight' and a little uncomfortable. It bends pretty far, but I can't fully kneel, it is too painful over the knee and oddly down the back of my lower leg where it almost feels like cramp.

Me thinks I'll ring the quack and get myself booked in after the christmas weekend. Thru work we have private medical plan which has physio services, so might be an opportune time to see how I get referred.

Thanks for everyones replies!

Chris

 

[ventoux50]

Hi Chris,

Thanks for the info.

From what you say it sounds to me as though you either

• have a damaged MCL
• or most likely, what has happened is that (in laymans terms) your muscles have temporarily switched off !

What I mean by this is that there is a natural 'hard-wired' reflex circuit built in to our muscles, each muscle has an opposite (antagonistic) muscle, this arrangement allows for us to move effectively.
i.e. to bend your knee you primarily use the hamstrings at the back of the thigh ...... to straighten it you mainly use the Quadriceps at the front of the thigh.

In order to move correctly there is a nerve feedback loop that limits the amount of contraction in either muscle group so that they work together and don't fight each other.

However, occasionally, and for various reasons the feedback loop can be 'switched off' or at least its level of excitability drops to a level where the feedback doesn't occur.
When this happens (as I suspect in your case), the moment you move your leg to begin walking, because the muscle tension is not correctly monitored, the limb 'gives way' due to the muscle groups not being prepared for the movement.

The best way to think of this in an easy to understand way is either by thinking what happens if you kneel for a long time in an uncomfortable position - your leg goes to sleep and when you stand up it feels difficult to walk . . . this is because the nerves / blood flow to the muscles has been temporarily compromised.

I would recommend seeing the doc or a physio for a check up to rule out anything else, but I suspect this will have been a one off occurrence.

Merry Christmas, hope that helps