Knee Problem

[tumbleweed606]

Hello All...I have been having some knee trouble. Recently I have been biking more than usual...I usually just ride around my home, ride on rail trails, and the occasional mountain bike ride. However recently I have been mountain biking more and just have been generally more active. A few weekends ago I was especially active...hiking, biking, etc...and I started to experience a weird knee feeling. When I was really putting a lot of pressure on my knees (riding up hill or hiking up hill) I started to feel something catch or move around in my kneecap area. I kept biking and it hasn't bothered me too much, but I still felt it. I just came back from my daily ride, and when I was almost back home I started to have some pain around the kneecap and now it is tingly. I have always been active and my knees have been good to me. I have been in taekwondo and have been biking lots. I am only 24 years old also. I have been taking some glucosamine to help with joints but it doesn't seem to be helping much. And no, I don't stretch before biking...I know I should. Anyone have some advice? Thanks so much!

 

[RickF]

It sounds like you could have chondromalacia patella or tendonitis. Chondromalacia patella is a degeneration of the cartilage on the under surface of the patella. Tendonitis is inflamation of the tendons. Both conditions are aggrivated when the hamstrings are much stronger than the quadriceps.

Stretching before excercise is overrated, but stretching after exercise is useful. If the hamstrings are too tight compared to the quadriceps, the knee is pulled out of its normal position, and there is not sufficient space between the patella and femur. Stretching the hamstrings while the muscles are cold can cause more injury, but stretching while the muscles are warm will help releave the pressure on the knee.

While there have been several on this board who claim that weight training will not improve cycling ability, this is one example of where they are wrong. For the elite cyclist who uses clipless pedals and has perfect pedalling technique and perfect balance between the down stroke and up stroke (not to mention professional massages after a hard ride), there is no benefit to weight training. For the rest of us, however, leg lifts and curls, followed by quad stretches and hamstring stretches would go a long way to reducing knee problems. Use the weight training to balance the quadriceps and hamstrings. Do not increase the weight on the stronger side until the weaker side catches up. In this case, the weight training might not make us any faster, but it will allow us to ride with less pain. Stretch after riding or weights, and ice the knees after stretching.

 

[tumbleweed606]

Thanks so much RickF! I really appreciate your advice. I am going to give that a try. Thanks again!

 

[Induray]

It sounds like you could have chondromalacia patella or tendonitis. Chondromalacia patella is a degeneration of the cartilage on the under surface of the patella. Tendonitis is inflamation of the tendons. Both conditions are aggrivated when the hamstrings are much stronger than the quadriceps.

Need more info. Is it lateral (outside the leg), or is it medial (inside the leg) above or under the kneecap. It is most likely patellar or patellar femoral tendinitis. You seem that you increased riding quite considerably and your legs were not accustomed to it. Climbing stresses a lot your knee joint.
Check your bike fit and clipless. If everything else fails , look for a good ortho that has riding experience. Therapy might be in order. DO it before it worsens. If the pain concentrates in the medial region, it might be Pes Anserins tendinitis, an often under-diagnose problem. If it is outside ITB syndrome might be the case. Need to stretch it AFTER cycling....religiously. Are you very flexible? average? or tight?

 

[tumbleweed606]

It is above the kneecap...I am about average when it comes to flexability. I am going to give stretching a try after my next ride, and take it easy for a few days and see how it goes. Thanks so much for your advice!

 

[Induray]

It is above the kneecap...I am about average when it comes to flexability. I am going to give stretching a try after my next ride, and take it easy for a few days and see how it goes. Thanks so much for your advice!

What worked for me. DO not rush through your stretching routine. Stretch AFTER cycling not before. Time your stretches, 30sec each side, no more, no less. Do three repetitions each side. Relax and feel the stretch. Start doing it while young and you will have a good chance you will prevent bad injuries (the persistent ones) as you age.

 

[Don Shipp]

Hello All...I have been having some knee trouble. Recently I have been biking more than usual...I usually just ride around my home, ride on rail trails, and the occasional mountain bike ride. However recently I have been mountain biking more and just have been generally more active. A few weekends ago I was especially active...hiking, biking, etc...and I started to experience a weird knee feeling. When I was really putting a lot of pressure on my knees (riding up hill or hiking up hill) I started to feel something catch or move around in my kneecap area. I kept biking and it hasn't bothered me too much, but I still felt it. I just came back from my daily ride, and when I was almost back home I started to have some pain around the kneecap and now it is tingly. I have always been active and my knees have been good to me. I have been in taekwondo and have been biking lots. I am only 24 years old also. I have been taking some glucosamine to help with joints but it doesn't seem to be helping much. And no, I don't stretch before biking...I know I should. Anyone have some advice? Thanks so much!

Something catching and moving around in kneecap area sounds like a torn semi-lunar cartilage.
TKD is very tough on knees, do you still do that?
Put less pressure on your knees by using lower gears when climbing. When hiking uphill with a heavy pack, just take smaller paces.

 

[jawnn]

TIPI-TOE MANEUVER

There is a zone in the crank circle where there is no power; because when your foot reaches the end of the push stroke the opposite foot is a quarter turn from the right place to push. To help your foot reach the right spot the foot at the end of the push must swipe threw and pull back, with recumbent cycles this is mostly just helping gravity. If you don’t wait until the foot is in the right space, you can push up your kneecap up, causing the infamous knee pain.

There are several mechanisms invented for stand up bikes to help your foot through this dead zone. Clipless pedals (cleats) or straps, and now a very expensive Rotor crank that eliminates the dead zone (rotorcranks.com).

Pedaling my 400lb sport utility vehicle (RCN #89 USX trike) gave me such pain in my knees that I had to back off from pedaling hard and try short cranks, which gave temporary relief, but soon led me to damaging my knee-caps again. As I was thinking about spending around $200 on clippless pedals and shoes, I reinvented a maneuver that places my foot at about 80 or 90 degrees to the crank arms at the beginning of the push stroke.

I push my toes forward as much as I can with out pain (it can’t be done with boots on) positioning my bones in such a way that keeps from pushing my kneecaps up. It’s amazing how much harder I can push now with out creating pain

At the end of the forward push I push down “swiping threw” and pulling back with my foot still on top of the pedal.

I don’t need clipless pedals with this maneuver but I do use BMX pedals and place the top of my foot arch on the pedal rather than the ball of my foot.

Short crank arms are not needed but they can help the foot reach the right position. One person told me that using this maneuver on his “stand on the pedals” mountain bike felt like running on his tippi toes.

Apparently some people can experience toe numbness from “anterior tunnel syndrome”. So don’t force your feet into this position.

I think the primary cause of knee pain is simply pushing before the right spot is reached. That’s why it is still possible for me to damage my knee with this maneuver.

I did move the seat closer to the crank to get more power to the pedals, but still there is a limit to how hard I can push with out lifting my kneecaps. And of course if I could lower the gear-inches below 10.5, I wouldn’t need to crank so hard, but it wouldn’t give me more power.

Then a faster cadence would be possible for most people. I can’t pedal as fast as some because of my large leg muscles. I believe that Power Saver pedal pendulums can help with cadence speed, but no one in America sells them.

I don’t think that the crank placement affects this maneuver but for comparison my crank is 4” lower than the seat.