# Knee Pain



## Island20v (Apr 22, 2013)

I am 28 years old, 6', 175lbs and have been riding for just over a year consistently now. I typically average anywhere from 30-50 miles a week of moderate trail riding. Saturday I set out for a 15 mile ride at 5,500' with no problems. I ended the day with a concert which I was on my feet for a fe hours. Sunday morning, I woke up with pretty severe pain in my right knee primarily in the upper inside part of the kneecap. Does anyone have any suggetstions on what to do? Trying to stay out of the Doc's office for a couple days to see if I can just nurse it for a little bit.

I have iced it and taken minor pain medication to help with some of the pain.


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## mcrn12 (Feb 1, 2013)

Did icing it help? Are you going clipless? Is it swollen?


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## campergf23 (Aug 4, 2013)

I've had this, best way to deal with it is just rest


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## Island20v (Apr 22, 2013)

mcrn12 said:


> Did icing it help? Are you going clipless? Is it swollen?


Icing may have helped. I took some ibuprofen so that might have done it as well. I am running clips. Have been for about 10 months now. It doesn't look swollen.



campergf23 said:


> I've had this, best way to deal with it is just rest
> 
> Sent from my iPhone using Tapatalk


I know everyone is different but how long did it take you to recover?


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## campergf23 (Aug 4, 2013)

Well I took me just less than a week but I caught it before it got really bad


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## Island20v (Apr 22, 2013)

campergf23 said:


> Well I took me just less than a week but I caught it before it got really bad
> 
> Sent from my iPhone using Tapatalk


That's what I am hoping for. I didn't feel anything during the ride, I think it might have gotten tired from the concert afterwards. Going to take a week off and see how I feel on Sunday.


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## campergf23 (Aug 4, 2013)

Yea, it wasn't the first time it's happened to me, the first time was a lot worse. Took me almost 2 weeks. In pretty sure it's from over usage of the knee or lots of stress on the joint


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## Island20v (Apr 22, 2013)

Considering maybe removing the clips for a little bit to see if that helps out on the stress. Any thoughts on that?


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## Island20v (Apr 22, 2013)

Decided to hit the doctors office today. Did a few resistance tests and some X-rays. Should find out more tomorrow.


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## ColumbiaGorgeSoul (Mar 25, 2014)

*check foot angle*



Island20v said:


> Decided to hit the doctors office today. Did a few resistance tests and some X-rays. Should find out more tomorrow.


I hope your test show it's nothing too serious. When you get back to biking check your cleat angle relative to your natural foot angle. I've cut and pasted some info below that might help you. best of luck 
" Some knee problems result from incorrect placement of shoe cleats. Everybody has a natural angle that each of their feet prefers to be at; some are duck-footed, some are pigeon-toed, whatever. When you walk or ride with plain pedals, your foot assumes this angle, and everything is hunky-dory. If you use cleated shoes and matching pedals, it is important that the cleat is adjusted so as to permit your foot to be at its natural angle. If your cleats are misadjusted, the resulting twist on your lower leg will affect the alignment of the knee joint, and cause serious problems.This is less of an issue if you ride pedals with "float" (limited rotational freedom) in the cleat attachment. Most newer clipless pedals offer at least some float."


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## Island20v (Apr 22, 2013)

I appreciate it. I also have found some articles about that. I plan on making some changes to the cleats and the seat angle to correct this. Might also change up the pedals every couple of weeks on my longer rides.


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## Axe (Jan 12, 2004)

Island20v said:


> Considering maybe removing the clips for a little bit to see if that helps out on the stress. Any thoughts on that?


Switching to flat pedals? That helps if the cleats are not aligned well, as mentioned here, but they do have zero float through the pedaling motion - your foot stays where you put it on pins - and can make it worse, not better.

If you think a random bout of pain is troublesome, wait until you in you forties+. . Just rest it, and get one of those rollers to loosen up your leg muscles.


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## Island20v (Apr 22, 2013)

I just thought it might have something to do with the angle of the toes (inward or outward) so that might help. I am already stretching on a roller and have taken the week off. Planning on trying to do a short ride Sunday to see how it feels.


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## bikerbert (Aug 28, 2004)

When was the last time you had a bike fit?


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## Island20v (Apr 22, 2013)

It was fitted for me when I was looking at models. Having a dropper post doesn't help though


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## Darkstar187 (Sep 6, 2010)

I have the same problem I find mine increases with hard hard pedaling with my 1x system I am awaiting my bike with x01 I'm hopping this will help a little 


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## mcrn12 (Feb 1, 2013)

Keep icing it. Try flats or different cleats......being tired should not cause pain.....something is not right. And a x-ray will not show much...if this continues......get a MRI as it will show soft tissue....x-rays are good for seeing bone. Where are on your knee was the pain? Center like down the center under your knee cap? Left or right of your knee cap?


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## Island20v (Apr 22, 2013)

Did a relatively flat 7.5 mile trail ride at about 20%. Felt pretty good but I didn't want to push it. Before the ride, I slid my seat back and adjusted the pad on the bottom of my shoes away from the toe. 

The pain in the knee is in my right knee cap towards the inside, top at about 2-3 o'clock.


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## Island20v (Apr 22, 2013)

After a solid 4 week build up back into riding, it came back again on a short and relatively flat mountain ride. Going to keep stretching and taking it easy. Any other suggestions? Trying to avoid another doc appointment for a little bit but I am sure it'll be needed within the next couple weeks.


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## irishpitbull (Sep 29, 2011)

Stop icing it and heat it. There is insufficient evidence to suggest that cryotherapy improves clinical outcome in the management of soft tissue injuries. Study included in link.

People, We?ve Got to Stop Icing. We Were Wrong, Sooo Wrong. | MobilityWOD


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## Island20v (Apr 22, 2013)

I think that article is talking about applying ice directly to the injured area. I usually use a towel as a barrier to avoid any damage to the skin. If I had the ability to get heat pads at work after working out, I would do so.


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## irishpitbull (Sep 29, 2011)

Island20v said:


> I think that article is talking about applying ice directly to the injured area. I usually use a towel as a barrier to avoid any damage to the skin. If I had the ability to get heat pads at work after working out, I would do so.


No it's not, RICE is crap, don't do it.  Read bro. Stop being the twat that asks for help but doesn't take the advice.

Sports Injuries - RICE: Why We Do Not Recommend It | Caring Medical


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## primoz (Jun 7, 2006)

Irisihpitbull it's not really this simple. Cooling muscles/tissue/joints down works perfectly fine, just as well as warming them up does. But it depends on injury, so there's no "RICE works great every time" as there's also no "RICE is crap stop doing it". For some cases ice is solution, for other heat is solution. When it gets really bad, it's pretty easy to see which option you use. Basically it is, if your muscle/joint is hot, use ice, if it's cold use heat. But problem is, injuries need to be pretty severe to feel yourself if it's hot or cold, and here's the hard part to know which one you would use.
But one thing I stick with... I stay away from all sort of todays "health and medical gurus" you find on internet (and unfortunately more and more often in fitness centers and all sort of "healing" facilities). Most of them were cashiers in store or whatever their yesterday's profession was, until week ago they found out holly grail which changed their life, they read two web pages, one book and maybe went to seminar of another such "expert" who was in this business for whole week already, and all of a sudden they know everything about everything... including treating injuries. So unless you have lots of experiences and knowledge yourself, I suggest you try to find person with good knowledge and some official medical degree, not someone self proclaimed "expert" and listen what they tell.


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## Island20v (Apr 22, 2013)

I'm got an appt with my physical therapist next week. He's a former NY Mets trainer so hopefully he knows what he's talking about.


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## Maizie88 (Apr 29, 2014)

Did you at all hear a pop during the ride or later that evening (i'm guessing not if it was at a concert)? One of the most common knee injuries is a meniscus tear, and it is actually quite easy to occur. The upper inside of the knee can also indicate the MCL (medial collateral ligament). Have you gotten results from the MRI? I agree with everyone that cold therapy is really important. Once the swelling is down (and hopefully any internal inflammation), you need to start getting the blood flowing in there. The knee has the least amount of blood flow of any part of our bodies, this being why knee injuries take so long to heal. I wish you all the best.


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## Island20v (Apr 22, 2013)

No pop. They got the MRI back and it just showed a lot of inflammation. Just been taking it kind of easy compared to what I've done in the past. Thanks you all for the feedback


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## Dubbis (Jul 28, 2008)

All,

I can relate to the knee pain topic. I've wanted to join a forum like this to shine some light on this topic, as I am a licensed physical therapist who just underwent knee surgery for the removal of my medial plica. Island, my knee pain started the same way - medial knee pain that came after a long ride. It was my first of the season and my rig wasn't set up properly (seat too high). From there, my last riding season was affected by knee pain on and off, i.e. there was inflammation that would come and go.

First thing I did was get my bike fit dialed by a professional, but unfortunately once the inflammation cycle starts, it is hard to break, and unfortunately for me this recurrent cycle caused the formation of painful scar tissue in my knee. Inflammation is a part of a natural healing process, but it doesn't discontinue if there is repeat damage (from riding).

So here I am, 3 days out from my plice removal. Everything else looked pristine in the my knee joint, so removing the scarred/mechanically irritating tissue should be the fix. Knee is swollen and stiff (normal for post-op), but I know in a month it's going to be all good. Looking back, I wish I knew more about natural anti-inflammatory agents such as Concentrate Tart Cherry Juice. I get the best naturally grown Montmerency cherries directly from the farm in Michigan (King Orchards). Take a peak at this website: Choose Cherries | Cherry Marketing Institute too. IF I could go back, using this product could have kept my inflammation under control and decreased the amount of scar tissue formation, thus causing less pain. It will take commitment; I drink the concentrate 2x/day now. Let me know if you have any questions.

Eric


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## Dubbis (Jul 28, 2008)

I also wanted to mention that there are several other mechanica factors that can contribute to your patellofemoral pain. These can include tight soft tissue structures that cause a malalignment of your patellar tracking. This can also be due to weak quad muscles (VMO) and weak hip muscles. I encourage you to see a local PT that works with athletes. There is so much to review with the anatomy and physiology. Talking about it online doesn't do this justice. Either way, look into the cherry juice concentrate and highly consider a regimen. I noticed changes in 2 weeks.


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## Island20v (Apr 22, 2013)

I'll check that stuff out tonight when I get home. Thank you for your feedback!


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## Island20v (Apr 22, 2013)

Seems like a good concept. Not cheap by any means though! I am going to have to look around at local shops first.


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## Poe4soul (Nov 18, 2012)

Dubbis said:


> I also wanted to mention that there are several other mechanica factors that can contribute to your patellofemoral pain. These can include tight soft tissue structures that cause a malalignment of your patellar tracking. This can also be due to weak quad muscles (VMO) and weak hip muscles. I encourage you to see a local PT that works with athletes. There is so much to review with the anatomy and physiology. Talking about it online doesn't do this justice. Either way, look into the cherry juice concentrate and highly consider a regimen. I noticed changes in 2 weeks.


Great post. I was going to comment along the same lines.

Last time I had lower back pain I went to my doctor and asked for a script for a Physical Therapist. I really doesn't make any sense to me to have a doctor evaluate my motor function. I had great results with the PT plus it saved me a ton of money skipping all of the other diagnostics.


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## Dubbis (Jul 28, 2008)

Some states allow physical therapy to be "Direct Access", meaning you can skip seeing your primary physician and go right to PT. I see patient's through direct access on a daily basis. We will check patient's insurance to ensure there will be no coverage issues beforehand, so I recommend you and others do the same. Therapists' expertise is in diagnosing and treating musculoskeletal system. Spread the good word! 

PT, DPT


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## Dubbis (Jul 28, 2008)

I thought the same thing when I saw the price! Then I realized how much I would spend on Advil, Ibuprofen, etc. And then I thought about how much I put into my bike! It's really a nominal fee for your health. Without feeling good nothing else matters. Give it committed try. What do you have to lose, $20? Well worth it.


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## Island20v (Apr 22, 2013)

Dubbis said:


> Some states allow physical therapy to be "Direct Access", meaning you can skip seeing your primary physician and go right to PT. I see patient's through direct access on a daily basis. We will check patient's insurance to ensure there will be no coverage issues beforehand, so I recommend you and others do the same. Therapists' expertise is in diagnosing and treating musculoskeletal system. Spread the good word!
> 
> PT, DPT


A my work we have numerous physical therapists at our finger tips. They found a lot of inflammation so he has me on a recovery workout for the next couple of weeks.

Picked up some tart cherries and supplements and they aren't too bad. Going to give them 3-4 weeks and see what happens.


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## 127.0.0.1 (Nov 19, 2013)

.
.
.
.GET a LYME antibody test if pain does not resolve in 2 weeks
.
.


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## AC/BC (Jun 22, 2006)

If it's happening to only one leg, that leg might be your short leg. You may want to shim that sides cleat.


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## LB412 (Nov 28, 2012)

I have read in other forums that adjusting seat height helps. Most say this type of injury occurred when the seat was too low.


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## tednugent (Apr 16, 2009)

i got rid of my QR seatpost clamp.... for a regular one, to ensure my fit stays consistent, thus reducing the likelihood of knee pain (my left knee)


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