Knee pain for first time

[Bice]

I have just acquired a bit of right knee pain, at the front under the patella: which seems to be the commonest type for cyclists.

The pain is mild, and does not affect me walking. Just a bit of a twinge on the stairs.

I was due to do a 80kms today with the club, but gave it a miss as they would be a bit faster than me on the whole, and I did not want to strain it.

It has been hurting for more than a week, but then I have also been cycling as I use the bike daily, for shopping etc.

I have not paid much attention to it, TBH. I suppose on tour I have had a bit of knee sensitivity, if I think about it, but I just ignored it and the next day was fine. This is the first time I have had soreness of this sort lasting more than a week.

I am now resting it until Sunday, when I have to lead a slower ride.

Not sure what has caused this. Straining seems to be the most frequently cited cause.

I have a weak left hip owing to Perthes disease and my left leg is nearly 20mm less than my right, which is very much dominant. So that is not going to help, when it comes to straining the right leg.

I use SPDs on road bikes; the bike set up has been the same for years (more that 15 in the case of one bike), so I don't think that is relevant.

Any tips, apart from just rest it a bit?

[Stradageek]

Sounds like the problem I've had for years. My solution is rest, paracetamol or ibuprofen before bed then gradually build up the mileage. If the twinge appears at the end of a ride use anything that will stop the inflammation getting worse. I've used ice packs, painkillers and recently ibuprofen gel. Also, avoid riding hard if you're feeling at all unwell (which tends to trigger inflammation) and spin lower gears on the climbs.

By this means I've coped with the issue for 50 years and still ride everywhere

[531colin]

Patello-femoral pain syndrome?

[pjclinch]

Could be some change brought about by that wretched "time" stuff...

May be worth seeing a physio about it. My knee problem presented quite differently to yours so is very probably not your issue (mine was a mis-tracking knee cap caused by muscle imbalance), but where the doctor had no idea (GPs are by definition generalists and this was quite a niche musculoskeletal thing) they did refer me to a physio and she had it figured out very fast and gave me a regime to prevent it re-occurring.

Waiting lists can be pretty terrible at the moment, so if you'd be waiting ages consider private, which won't be cheap but set against having a knee that stops you getting about is likely money well spent.

Pete.

[gbnz]

I have just acquired a bit of right knee pain, at the front under the patella: which seems to be the commonest type for cyclists.

The pain is mild, and does not affect me walking. Just a bit of a twinge on the stairs.

I was due to do a 80kms today with the club, but gave it a miss as they would be a bit faster than me on the whole, and I did not want to strain it.

It has been hurting for more than a week, but then I have also been cycling as I use the bike daily, for shopping etc.

I have not paid much attention to it, TBH. I suppose on tour I have had a bit of knee sensitivity, if I think about it, but I just ignored it and the next day was fine. This is the first time I have had soreness of this sort lasting more than a week.

I am now resting it until Sunday, when I have to lead a slower ride.

Not sure what has caused this. Straining seems to be the most frequently cited cause.

I have a weak left hip owing to Perthes disease and my left leg is nearly 20mm less than my right, which is very much dominant. So that is not going to help, when it comes to straining the right leg.

I use SPDs on road bikes; the bike set up has been the same for years (more that 15 in the case of one bike), so I don't think that is relevant.

Any tips, apart from just rest it a bit?

Avoid pushing the ride on the hill's (Nb. Climbs)

@ 52yr's, past two years have been the only period I've ever walked the steep bits'. Primarily due to a leg smashed up, two years back, but with a knee itself becoming the dominant issue, the past several months. Cycling 1100' up on a moderate gradient, hasn't been an issue, but have walked all those super steep 100' sections, for two years now, probably 1st time I've ever worked a steep bit

Have been using the secondary bike the past fortnight, had the full gear range of 24 gears, as opposed to 8 gears due to knackered front derailleur. Even cycled those steep bits, secondary bike was literally just gliding up the climb, no effort required. Somehow, even with a super low gear, half walking speed climb, doing a steep bit 3-4 occasions in a fortnight, has knackered the knee

And past fortnight, has reinforced how important not to cycle those steep bits ! Main bike put into storage, secondary bike had full range of 24 gears, was incredible, bike simply glided up those 100' steep bits, no effort required. Absolutely wrecked the knee, been limping on one leg, as the steep bits were simply easy beyond belief with gears properly set up - still has wrecked the knee, the past fortnight !

[Cyclothesist]

With a 20mm difference in leg length I wonder what you're doing to mitigate that? For instance are you using a shorter crank on the left to equalise the hip and knee angles with the right leg? 531colin's DIY bike fit is worth a look to check your current set up. Remember that what was perfect 10yrs ago may not be now due to body changes associated with age or habitus. Your bike fit is going to be more complicated than many due to the leg length disparity.

531colin may well be correct in the suggested diagnosis of patella-femoral syndrome but it is a bit of a 'bin' diagnosis with multiple causes.
I suggest you go and see a sports physio. You may need to go privately to be seen quickly but often 1 or 2 sessions can be enough to provide a biomechanical diagnosis and a remedial plan. Meantime a period of rest is necessary to allow repair.

[atoz]

I found that changing from toe clips to SPDs helped with knee issues. My (now retired sadly) physio said that it felt like I had quite a bit of wear under the patella but given the ridiculous level of miles I've put in over the decades it's a case of " no s**t Sherlock". A work colleague has knee issues but they've not done anything like that level of activity so there's no guarantees whatever you do.

I also found that gearing down and some gym work helped.

[fastpedaller]

Weirdly I've recently suffered the same (but L knee) for the first time. I'm thinking I've been overexerting as well. It seemed to start when I rode the Brompton (2-speed) - with gears of 54" or 72" I seemed to be either mashing or twiddling. I rode 66 miles a week ago on my road bike and (it has to be said) I was trying up any inclines. some pain the next few days, and I thought nothing of it. I rode another 32 a couple of days later and found it painful for the first few revs . As the ride went on I felt ok, but kept to lower gears, however starting from rest was painful. I've since had pain, typically getting in and out of chair. If I can't calm it by rest and gentle stretching I'll try to find a sports physio. IIRC it was known as 'Easter Knees' in my cycling club.

[531colin]

Google "Vivian Grisogono self help"
I have this book https://www.awesomebooks.com/book/97807 ... t=TS100%2B
Most common thing in people who exercise without completely straightening the knee is the Vastus medialis is under-developed so the rest of the quads group pull the knee-cap laterally, giving pain under the outer edge of the knee cap.
Cure is straight leg isometric exercises, which target Vastus Medialis, because that muscle works when the knee is close to straight.

[fastpedaller]

Colin, thanks for that!