evaluating knee injury recovery

I've been browsing the archive reading up on people's knee injury stories, but I have a question that was not answered in any of the posts I found. First just a quick background. I raced on the road for 5 years before getting married and having a child. Now after 6 years basically off the bike, I've freed up some time in my schedule to get back into riding. In the fall I started to ride a couple times a week without any problems. Then in January, I overdid it and caused some inflamation which a PT has diagnosed as PFP. I knew better than to continue until the pain was acute, and managed to avoid severe inflamation or pain, but the classic symptoms of pain when descending stairs and mild burning on the inside of the patella were present. Specifically, the PT found that my glute is weak, allowing my knee to mis-allign under load, and cause the irritation. I have a strength and stretch routine, that I do 3 X/wk, and ride low resistance on the rollers 3 X/wk. I have not experienced any significant change in the condition of my knee after a couple weeks. What I want to know is at what point does the inflamation inhibit recovery? Do I need to completely stop everything until there is NO pain? This injury has never caused pain worse than a 3 on a 1-10 scale, so I've been cautious but not exclusionary about activity and rehab. Anybody want to comment? Thanks very much. Noah

 

I have been having knee pain for over a year now and haven't been able to go on bike rides. So your knee pain is on the medial side of your kneecap? Here is a very good article on knee pain and cycling.www.physsportsmed.com/issues/2004/0404/asplund.htm
As far as inflammation goes you should try to supress it as much as possible. From what I have read and experienced imflammation brings on irritation, which causes the pain to get worse. I ice my knee whenever I feel it getting hot and I take Asprin which fends off the inflammation well. Good luck with your knee problems.

 

I would suggest taking nsaids. Look up naproxen, ibuprofin etc. if you can only get ahold of otc products. If you can buy prescription medications I suggest meloxicam 15 mg a day. You can look up med info on merck manual online or pdr online to see the dosages. I have a considerably damaged shoulder which I decided not to have operated and occasionally use these medicines to reduce swelling. It usu. takes 2 weeks to see improvement. good luck

 

Mike,
Back in November 2005 you stated that your knees were getting better after addressing the ITB and VMO issues. Has the progress stopped??? I've been dealing with patellar tendinitis / PFS since the end of January and sometimes wonder if I will ever get back to normal. How has your recovery been?
John

 

It sounds like you're at a stage that you can control your problem pretty good by strengthening your legs and ensuring you don't overdue it.

However, when that condition gets significant, it's possible to be in a situation where exercise will never leave a person "pain free". Hence, it's often possible that people have to put up with some pain all their life. The trick then is to get to a point that the pain is minimized without making the condition worse.

 

Yep, this is exactly where I'm at. Its a very difficult condition to overcome entirely, mainly because you're predisposed to it.
I will say though that gluteal strengthening is very important for PFS as they can take some of the load off the VL in tracking your knee; there are dozens of exercises that help strengthen every part of this muscle group, which a good PT should be able to show you

 

it is difficult to say...you are in trouble

 

Yes I have still been having problems. I'm 17. My knee pain started around Febuary 2005. I was diagnosed that I most likely had PFS. The pain was sharp and even walking for short distances aggrevated it. November 2005 I started using a foam roller and leg lifts with electronic muslce stimulation. I believed that has helped. My left knee has pretty much cleared up and am not really experiencing problems from it. Since Nov. my right knee pain pretty much gone up and down. My knee starts to feel pretty good and I try to get back into cycling and running but my knee gets aggrevated again. My pain is always on the outside of my knee. I also experience occassional popping in the knee which suggests mal tracking. Most of the time the pain is fairly minimal but it's always there. To keep the inflammation down I was taking NSAIDS. I have switched to Asprin since taking NSAIDS long term isn't great on your body. I am also taking Glucosamine supplement.

Has anyone else experienced persistant outer knee pain? Another cyclist I know is having the same problem with outer knee pain and cycling. I am going to see my sports medicine doctor again and see what he thinks. It is soo frustraiting not being able to exercise. I miss cycling so much. I would do anything to be able to ride again.

 

I've been struggling with my knees. I went to a knee surgeon, and did xrays and an mri. I was told that the tests show no indication of damage to my knee. I'm typically not one to complain about pain. I've got a very high threshold, but im finding this intolerable. in both knees, the pain is on the medial side and upper portion of the patella. I don't typically feel the pain while im riding, but after i get off the bike, my knees become very uncomfortable. I did 6 wks physical therapy. i find that i make slight improvements in the condition if I get off the bike for a week or so, but one i get back on, the pain returns. i'm the type of person who turns into a ball of goo if i dont exercise regularly, so i'm incredibly frustrated. recommend some good glute exercises.

Here are the stretches / exercises i'm already doing

prone quad stretch
hip medley ( lifts, kicks, circles, knee kicks)
hamstring stretch w foot extension
foam roll the IT + Interior quad
TP quadballer on the same spots

what others should i be doing?

 

Did your orthopod say anything about tendonitis? Do you ice your knees after a ride? Are you taking any anti-inflammatories.....ibuprofen, aspirin, naproxen, and etc?

 

i have been icing. i'm not taking any anti-inflamitories. i'd rather take 6-8 weeks longer off the bike than start using drugs regularly. I put up with the pain riding for about a month, until i felt it was beyond typical soreness. that was in august. i cut my cycling back to recreational flat rides during my PT, now i'm wondering if i should take 2 months off just to be safe.

 

Did the doc say anything about the problem possibly being tendonitis?

 

nothing. he gave me the attitude that because nothing appeared on the mri, that i should quit being such a pussy. the guy has pictures of he and Kobe, Michael Jordan post op hanging in his office. felt like he didn't really pay attention once he learned he wasn't operating. I proposed tendonitis when I got to pt, but unfortunately i feel like the therapists in my town are hired more for their looks than their expertise. of 15 exercises recommended only 3-4 of them really seemed to help.

 

It sounds like the doc is an ass. I'd consider getting a second opinion or at least seeing someone that is actually good at working with patients. Physical therapists can be great, but unfortunately they can't diagnose what's wrong. They should talk to you, too, about the exercises you're given and what they target. Until you can see someone to get a better idea of what's going on, you should consider taking an anti-inflammatory (ibuprofen, naproxen, aspirin). Controlling inflammation is quite often key to managing pain relief as inflammation is a major cause of pain.

 

i picked up a pair of k2 skates over the weekend. i found lying in bed doing hip lifts way too boring, so i decided to get outside. skated around for an hour at lunch, and 90 mins after work. some mild inner patella pain, but nothing overwhelming. just wondering how long it will take with moderate exercise for my glutes to balance my quads. I was biking this route about 2-5 times a week for 2 years. great exercise, but rough on the knees.

http://goo.gl/maps/4m1n7

hopefully not 2+ years