In kneed of advice

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lejogger

Guru
Location
Wirral
For as long as I can remember I've had slightly dodgy knees. A combination of mostly football, a bit of running, and probably my first LEJOG as a very inexperienced cyclist, I've suffered with aches and pains in both knees, but it's something I've lived with and hasn't stopped me at all, it's just been a little uncomfortable or mildly painful at times during/post exercise.

At the end of 2009 I saw a consultant and he recommended an arthroscopy in my left knee, which I had. I never saw the consultant again post-general anaesthetic - a junior dr appeared at my follow up review. I was offered no physio, and wasn't even told what procedures they had carried out during the surgery - cartilidge trim etc.

I therefore carried out my own rehabilitation, returning to cycling and football when I felt able, and I've pretty much managed any discomfort for the last 4-5 years. I don't have full flexibility in the joint, I occassionally get locking or catching in what feels like the tendons, I can't sit with a bent knee for long periods without stretching it, i.e. work meetings, cinema, flights etc, but on the whole, it's been perfectly manageable for riding to work most days, playing football at least once a week, club runs and a few time trials.

I therefore don't know if the pain I feel in my left knee when I cycle now is a recurrance or a sign of things worsening, or a bad cleat or saddle position.

Specifically, it's in the gap between the kneecap itself and the medial muscle on the inner front of my left thigh, and also slightly behind the kneecap. It can come and go during rides, and is definitely a manageable pain that I'd probably refer to as a niggle more than anything more serious, but here's the next issue...

I've certainly upped my mileage recently as in May this year I'm attempting to live up to my username and complete my second LEJOG. I'm getting really concerned that this is either going to stop me from taking part, cause me major problems during the ride, or if I do complete, will be left in a very poor state afterwards.

I guess the first piece of advice I'm looking for is positional. Does anyone know what sort of incorrect set up might lead to pain in this area of the knee. e.g. seat too far back/forward, cleat set up too far forward, heel too far in etc.

It may simply be a small reaction to an increase in mileage, and therefore given a bit of rest it might subside and I'll have been worrying over nothing. I just don't want to go racing off to the GP and get dragged back into surgery before exploring all options for fixing it myself. Am I therefore perhaps better off getting a decent bike fit as a first port of call to rule that out before getting drs involved?

Cheers guys
 
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vickster

Legendary Member
How old are you? No surgery should be done prior to imaging, X ray, MRI if nothing on X ray

Perhaps pay for a session or two with a private physio if relief not found, certainly before the chop

I don't think anyone can predict what may happen if you do LEJOG, certainly not without a diagnosis :smile:
 
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lejogger

lejogger

Guru
Location
Wirral
How old are you? No surgery should be done prior to imaging, X ray, MRI if nothing on X ray

Perhaps pay for a session or two with a private physio if relief not found, certainly before the chop

I don't think anyone can predict what may happen if you do LEJOG, certainly not without a diagnosis :smile:

Cheers Vickster. I'm 33.. so in my prime!!
I may have had an Xray before the last one, but vaguely remember them saying they couldn't see anything obvious and they'd just take a look while they were in there.

It may well be just my body's way of telling me that I'm pushing a bit too hard, but my current training is certainly nothing like End to End will be...
 
Funnily enough I was just reading the symptoms of runners knee as I manage my own aching knees. It may be nothing at all like you are experiencing but Google it, it sounds like you have some similarities.
 

vickster

Legendary Member
AKA Patello-Femoral Syndrome

Rest is the only true solution in many cases and then a very gradual build up. Surgery won't help unless there is a clear mechanical cause and not overuse

I'd spend £100 and see a physio if happy with bike set up :smile:

At 33, it should be arthritic wear and tear which is what I was getting at

That said, I am 41, almost in my prime and my poor knee is knackered :sad:
 

Cuchilo

Prize winning member X2
Location
London
Im 40 and going down hill fast :laugh: I had an issue with my knee that I put down to my dodgy leg that hadn't troubled me for years . After switching bikes it hasn't re appeared even though I have been going further and faster . I guess I just had a bad set up .
 

slowmotion

Quite dreadful
Location
lost somewhere
If the angle of the cleat is wrong, you stress your knee every time you turn the cranks. Sit on top of a kitchen worktop and dangle your legs in the air. You feet will point in the directions that suit them naturally. If you adjust the cleat angles so that your feet point in the same directions when you are clipped in, you stress your knees a lot less.

I believe...
 
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lejogger

lejogger

Guru
Location
Wirral
Didn't know there were so many amateur doctors on here!
Why post if not to contribute? And especially why criticise posts answering exactly what I've requested?

I've specifically sought forum advice from cyclists as many of them have probably had similar experiences. That's the whole point of a forum. Why have a mechanical section open to anyone but qualified cycling mechanics? Why have a racing section open to anyone but professional riders? Why have a what bike section open to anyone but salespeople?

If you don't have anything useful to say... Jog on!
 
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lejogger

lejogger

Guru
Location
Wirral
Funnily enough I was just reading the symptoms of runners knee as I manage my own aching knees. It may be nothing at all like you are experiencing but Google it, it sounds like you have some similarities.
Thanks Tim,

I'll check it out.
 
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lejogger

lejogger

Guru
Location
Wirral
Im 40 and going down hill fast :laugh: I had an issue with my knee that I put down to my dodgy leg that hadn't troubled me for years . After switching bikes it hasn't re appeared even though I have been going further and faster . I guess I just had a bad set up .
The good news is that I have a couple of investigations that I can start...
New cycling shoes a little bit ago means a possibility of poor cleat set up.
I've moved seatposts and stems around on my bikes, as well as adjusting saddle and lever positions - on the winter bike I've actually not felt properly comfortable since I rebuilt it for this cold season, and while I might have got away with it for 20 miles of commuting a day, in the last three weeks I've done three 80+ mile club runs, plus an increased commute to my new workplace and a few extra training miles. It may be that the poor set up is finally catching up.

The good news is that I'll be end to ending on the carbon summer bike which I'm very comfortable on. Just need to make sure I don't ruin myself before the start though.
 
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lejogger

lejogger

Guru
Location
Wirral
If the angle of the cleat is wrong, you stress your knee every time you turn the cranks. Sit on top of a kitchen worktop and dangle your legs in the air. You feet will point in the directions that suit them naturally. If you adjust the cleat angles so that your feet point in the same directions when you are clipped in, you stress your knees a lot less.

I believe...
Good advice. I felt a bit of relief on the ride home tonight when squeezing my left foot to the very front of the shoe and edging towards the nose of the saddle. I'll definitely be moving the cleat back on the shoe if it's going to improve matters and try your technique.
My best bike has a seatpost with no layback, whereas the winter bike has 25mm. Might need to make a change there.
 
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lejogger

lejogger

Guru
Location
Wirral
I'd get it checked out by a consultant.......you wouldn't want to cause permanent damage. I know it's different but during my last tour in the summer, I gave myself carpal tunnel syndrome in both hands. I've soldiered on for the last six months but after a long ride my fingers go numb and tingle. I've finally decided to go under the surgeon's knife and get it sorted.
After my first end to end I couldn't feel any sensation in my third finger on the left hand for the best part of 6 months! It's not nice that. Hope it all goes well for you.

I'll certainly be off to the docs should I not be able to improve matters with position tweaking and a little rest.
 

rualexander

Legendary Member
Go and see a sports injuries physio.
Sounds like patella-femoral syndrome as mentioned above, but could be a couple of other things, such as plica syndrome, or tendonitis.
I've had intermittent medial knee pain from both knees every few years for the past 25 years, as long as I've been cycling really.
Generally brought on by overuse, either increasing mileage in springtime or too many big days at the start of a tour.
Doctors, especially GPs are generally useless in these circumstances, so a good physio is your best bet.
Usual treatment is stretching of quads and hamstrings along with exercises to build up the vastus medialis muscle.
While pain is still an issue, apply ice regularly, and physio may also give you ultrasound therapy and electrical muscle stimulation, or maybe laser therapy. Taping using kinesio tape can also help.
 
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