# Knee pain...total rest the answer? Also MRI question.



## Johnny K (Mar 14, 2005)

Hello all, couple questions. Hopefully some others in here will have had something similar.

I raced 300 or so miles on my mtb in April, with medial knee pain the last half of the ride. This came from wayyyyy more seated climbing than usual. I normally stand. I got home rested it for a few weeks started riding again and it was fine. Totally normal.

Five weeks later I raced a 200 miler in KS and the knee was totally fine. A week later I started commuting to work and noticed some low level knee pain. I kept riding for a few weeks and finally went to a doc.

He said do an MRI and NO activity beyond easy walking for three weeks.

MRI didn't show anything of significance and three weeks later my knee feels the same. Doesn't really seem the rest did much good which sucks.

I need to call the doc back this week and discuss this but was hoping to get the experiences of others that ride who may have had similar issues. I am a physical therapist BUT I only get runners as patients, no cyclists!! 

Symptoms:

I suspect a plica inflammation that won't go away due to the pain over the medial femoral condyle with popping squatting down. This could just as well be a saphenous nerve entrapment but those are quite rare.

The knee also hurts inside the joint with any active hamstring contraction, prolonged sitting, or crossing my legs. Effin hurts. Suspected meniscus issue here but MRI says ok????

Couple questions:

1) Anyone been down the road of the negative MRI and found an answer to their knee pain? Is having a scope done reasonable in this situation? I seem to have more pain just kicking around the house than riding. I rode thirty minutes yesterday and it seemed fine.

2)Those of you with overuse injuries like this...did you totally stop riding until all pain went away or just ride easy and build back up? I'd like to ride but would be willing to wait a couple months if that was the answer. I'm also worried sitting stagnant is preventing the knee from getting bloodflow that would help tissues heal.

Meh, any thoughts welcome here. Before anyone hops in with get a bike fit and stretch and do core work...thanks but already went down that road. Thanks all.


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## Livelyins (Sep 4, 2012)

MRI can be utilized to make a 3-D photograph of several areas of the body by employing radio waves and magnetic poles. The 3D photos of your knee area are generated in the check for a good knee pain analysis. The injuries of soft tissue inside the knee region will be instantly known through MRI.

The CT check might help in producing a photograph of the internals of the body of a human by taking ultraviolet photographs from a variety of paths. Not merely bone tissue troubles are noticeable via this particular technique, quite a few other inner body problems likewise.


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## dcc1234 (Nov 5, 2008)

Does knee feel like there is 'gravel' in there? Mine does. Orthopedic Doc said don't grind pedals keep a good cadence. He only did an x-ray in my case. He was no help. I just live with it.


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## Johnny K (Mar 14, 2005)

No gravel feel, its smooth. Don't think there is damage.

Question is: Ride easy for a few weeks or totally take time off until it feels normal. Leaning towards the easy riding, dont think inactivity is the way to go. Unless someone else has been through this and that is the only way to get it better!


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## SSearchVT (Sep 6, 2007)

Free advice from a non-doctor... I have knee problems as well, and had the full spectrum of scans run last year - The outcome was that the last 40+ years of stupid things I've done are catching up to me. It's not going to get better, and in a few years I'll more than likely be looking at surgery...

Until then - Drink plenty of water, eat right, take low doses of OTC pain killers when needed, stretch (consider taking up yoga), and continue to live my life. The most important thing - If it hurts, stop doing it... He was also kind enough to remind me that I wasn't 18 anymore...

Inactivity IMHO will do more harm than good. That said - If it hurts, stop doing it, or make adjustments so it doesn't hurt anymore...


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## dcc1234 (Nov 5, 2008)

SSearchVT said:


> Free advice from a non-doctor... I have knee problems as well, and had the full spectrum of scans run last year - The outcome was that the last 40+ years of stupid things I've done are catching up to me. It's not going to get better, and in a few years I'll more than likely be looking at surgery...
> 
> Until then - Drink plenty of water, eat right, take low doses of OTC pain killers when needed, stretch (consider taking up yoga), and continue to live my life. The most important thing - If it hurts, stop doing it... He was also kind enough to remind me that I wasn't 18 anymore...
> 
> Inactivity IMHO will do more harm than good. That said - If it hurts, stop doing it, or make adjustments so it doesn't hurt anymore...


+1........ Gotta listen to your body-- trouble is, at 43 my knees in particular TALK way more than they used to. In many cases, -outside of surgical intervention- docs just don't have solutions for some of what ails us. I always wonder if I had (have) my saddle incorrecctly adjusted for the past 20+ years and if so, if that has contributed to some of the excess wear and tear on the knees.

Never did get a pro bike fit that many have recommended.


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## Johnny K (Mar 14, 2005)

Just did a super easy ride and stretched some. Both knees feel good right now. Will keep on like this for a few more easy weeks and see how it goes.


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## BoiseBoy (Mar 1, 2006)

*Really?*



Johnny K said:


> Hello all, couple questions. Hopefully some others in here will have had something similar.
> 
> I raced 300 or so miles on my mtb in April, with medial knee pain the last half of the ride. This came from wayyyyy more seated climbing than usual. I normally stand. I got home rested it for a few weeks started riding again and it was fine. Totally normal.
> 
> ...


Are you really a PT asking for (ortho) medical advice from a public (non-medical) forum?


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## 4Crawler (Oct 30, 2011)

I've had some knee pain/popping the last 2 years and had x-rays and physical exam and showed no visible damage. I had been seeing a chiropractor for a neck issue and one of the things she uses for that is ultrasound to help the cartilage heal up. So I decided to try a hand held ultrasound massager on the knee and I was amazed, within a week, I had the pain under control. Used to use it 2x daily, and now only when I feel a little twinge, maybe once a week or so (15 minute session). Also take some glucosamine/chondroitin supplements. On the bike, I do sit and spin on most climbs, having a 20-36 low gear helps with that.


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## Johnny K (Mar 14, 2005)

Boise Boy...yeah.

Cyclists are a somewhat rare population in PT and people's anecdotal experience is worth something.


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## SundayRiverRider (Oct 29, 2008)

i have 2 bad knees, both with torn ACL's. I'm going to need a total knee replacement in one of them shortly. One of them is OK at the moment. 

I would advise to keep riding, but maybe at a lesser level to keep from enduring knee strain. Riding will keep the strength up. I hate suggesting road riding, but it can be a good way to keep biking without as much stress as mountain biking. Maybe try that for a few weeks.

I would ice after every ride, and take some stuff like advil/aleve to reduce swelling.

Sometimes knees get tweaked in weird ways, like ligaments get stretched and then they can just hurt for a while until they heal themselves up. 

Good luck.


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## albertdc (Mar 2, 2007)

Does your thigh and knee track straight when you pedal or does your knee come in towards your top tube? 
I always developed intermittent medial knee pain while cycling. Then one summer, the pain was so bad during a ride that I forced my knee outwards to alleviate the pain, completely messing up my lateral ankle/for tendons. Eventually ended up in the office of a cycling sports med doc who actually works in the pro tour as well. He pointed out how turned in my right knee was when I pedaled, which can cause medial knee pain. He put in a 1.5mm in-shoe varus wedge on that side. My knee tracks much straighter now and I have not had medial knee pain since.. 
Of note, this was on my road bike where I wear Specialized shoes which already have varus correction built in, so I now have 3mm worth of wedge in my non-Spec mountain bike shoes! 
Some say that a cleat wedge is better, but we started with the one in the shoe because of the nature of the associated, secondary foot pain. It worked, so I never bothered trying the cleat version.


Sent from my Galaxy S3


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## BoiseBoy (Mar 1, 2006)

Johnny K said:


> Boise Boy...yeah.
> 
> Cyclists are a somewhat rare population in PT and people's anecdotal experience is worth something.


Yes, I would agree, but anatomy and injury/healing processes do not change!

You are supposed to be the "expert" and you are asking people off of the street how you should remedy your injury?
I would be asking these question to colleagues, other MD's, and possibly on professional discussion forums. 
At the very least, I would do some research!!


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## Dan Zulu (Jul 5, 2008)

*MRI false negatives*

I had an MRI report on my wrist which didn't reveal much of a problem, but when the symptoms persisted the doctor did a scope and found synovia that was acting like sandpaper instead of smooth glass, in his words. He also said that it is not uncommon for him to find more damage inside a wrist or hand during a scope than the MRI revealed. Likewise my hip MRIs didn't show too much damage but in surgery a large amount of damage was discovered when viewing with the arthroscopic camera.

If a doctor told me that my MRI didn't show much damage but he or she had a strong suspicion that there was something more going on inside the joint which required surgical repair I would tend to believe them.


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## dcc1234 (Nov 5, 2008)

Finally had a pro bike fit done a few days ago. Took a couple of hours to do on 2 of my bikes. 

Some of you may have more serious injuries than my crackling and sore knees, but my knee pain MAY have been due to riding an incorrectly adjusted bike A LOT over the past 5 -10 years-- I've just kept on making it worse.... EVERY DAY. I have decided to give knees a bit of a rest before heading back out and when I do, it will be WITH THE PRO ADJUSTMENTS.


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