Pain behind knee - any more answers

[adrian knight]

Hi

I've already pretty much explained my problem in a previous mail but I'm hoping some new insights might lead to discovering my problem.

The pain is deep in the top of the left calf. There is an exercise that aggravates the problem even though it is very subtle movement.
If I lie on my back with my leg straight and repeatedly drag my heel so that my knee raises off the floor a couple of inches (heel doesn't move), while not having any inidcation of a problem whilst doing it, my upper calf will ache deep (almost feels like the bone aching) within a couple of hours after the exercise and for a long time after. This is the same sort of movement as pulling on the pedals (which I am now unable to do). Is this chronic tendinosis. It started years ago as an injury caused (I think) by overtraining and has never gone away. Massage seems to alleviate the pain briefly.

Has anyone got any ideas what it is or how to fix it ???

 

[Skoorb]

Are you sure it's not your lower hamstring where it wraps around the inside of the knee and connects to the top of the tibia? In any case, have you seen a highly competent physical therapist about it? He may have an idea of flexibility or strength issues that could be aggrivating it.

 

[pistole]

- hi , sorry to hear about your pain.

- I developed some pain behind my right knee as well. Boiled down to my having my saddle too high.

- hope this helps.
.

 

[adrian knight]

Thanks, sounds sensible. Do you know of anyone else who has had a similar problem?

Are you sure it's not your lower hamstring where it wraps around the inside of the knee and connects to the top of the tibia? In any case, have you seen a highly competent physical therapist about it? He may have an idea of flexibility or strength issues that could be aggrivating it.

 

[adrian knight]

Thanks, sounds sensible. Do you know of anyone else who has had a similar problem?

Self diagnosed semitendinosis tendon tear brought about by muscle strength increasing more rapidly than tendon strength after returning back to training after 18mth lay off. Don't think there's much I can do to fix this....any one wanna buy a bike, boohoo!!

 

[Skoorb]

Self diagnosed semitendinosis tendon tear brought about by muscle strength increasing more rapidly than tendon strength after returning back to training after 18mth lay off. Don't think there's much I can do to fix this....any one wanna buy a bike, boohoo!!

You are quitting cycling? Cannot your tendon recover and catch up?

 

[benkoostra]

Lower your seat.

 

[Devinci75]

Hey everyone, I too just started road biking again (for about 2 weeks now) and had my Devinci Silverstone fit and set up to my body. I am finding that the following day after a 50+km ride the tendons on the left and right side at the back of the knee are sore or inflamed. This last for only a day to 2 days and isn't painful but I notice it though. I told the people who set my bike up and they thought my seat was up too high as well. So they asked me to get on the bike so they could see my leg and it was right where it should be. There was no over extension so my question would be.... could this be like when you go work out at a gym after a long layaway from lifting weights and all your tendons get stretched from not being used in that way for so long? Would it be only a matter of time until your body "should" adjust to the mechanical movements? Or maybe when I am climbing hills off my seat I am hyper-extending my leg and that could be causeing the pain afterwards. Any thoughts from the grizzled veterans and know-it-all. This humble Canadian would like to hear what you have to say. Thanks.

 

[Skoorb]

Hey everyone, I too just started road biking again (for about 2 weeks now) and had my Devinci Silverstone fit and set up to my body. I am finding that the following day after a 50+km ride the tendons on the left and right side at the back of the knee are sore or inflamed. This last for only a day to 2 days and isn't painful but I notice it though. I told the people who set my bike up and they thought my seat was up too high as well. So they asked me to get on the bike so they could see my leg and it was right where it should be. There was no over extension so my question would be.... could this be like when you go work out at a gym after a long layaway from lifting weights and all your tendons get stretched from not being used in that way for so long? Would it be only a matter of time until your body "should" adjust to the mechanical movements? Or maybe when I am climbing hills off my seat I am hyper-extending my leg and that could be causeing the pain afterwards. Any thoughts from the grizzled veterans and know-it-all. This humble Canadian would like to hear what you have to say. Thanks.

I am sure it could definitely be that. Many new activites will have with them a pain that just has to work itself out. I've had these from running (more) and also from cycling. It could be encouraged (the pain) by hill climbing, but I doubt you're overextending too much. If it is hamstring pain, then they simply have to catch up, but I wouldn't press the matter too much; if the pain gets more than mild, then lay back and consider seeing somebody, but almost anybody who starts an endurance sport after some time off is going to have acclimation pains, from muscles to joints and everywhere in between to some varying degree!

 

[robertjtaylor]

I certainly consider the possibility of hamstring tedonosis, I am not a medical professional, but it appears that this could be a contributing factor to your problem.

I found a webpage that seems to describe your condition. It is found at http://www.aidyourhamstring.com/hamstring-tendonitis.php

hamstring tendonosis refers to the inflammation in one or more hamstring tendons located around the ischial tuberosity, just below the knee. You state you are suffering the discomfort in your upper calf, so this theory may correspond.

It is worth further investigation.

 

[adrian knight]

Hey everyone, I too just started road biking again (for about 2 weeks now) and had my Devinci Silverstone fit and set up to my body. I am finding that the following day after a 50+km ride the tendons on the left and right side at the back of the knee are sore or inflamed. This last for only a day to 2 days and isn't painful but I notice it though. I told the people who set my bike up and they thought my seat was up too high as well. So they asked me to get on the bike so they could see my leg and it was right where it should be. There was no over extension so my question would be.... could this be like when you go work out at a gym after a long layaway from lifting weights and all your tendons get stretched from not being used in that way for so long? Would it be only a matter of time until your body "should" adjust to the mechanical movements? Or maybe when I am climbing hills off my seat I am hyper-extending my leg and that could be causeing the pain afterwards. Any thoughts from the grizzled veterans and know-it-all. This humble Canadian would like to hear what you have to say. Thanks.

My advice is only do mild stretches before your ride and only after doing something to warm up first - 10 mins walking for example. It sounds like you're overdoing it (I know all about this!!!). Take it easy and monitor the situation.

Ade

 

[adrian knight]

You are quitting cycling? Cannot your tendon recover and catch up?

Been trying for years. Pretty much convinced nothing will fix it now.

 

[adrian knight]

I certainly consider the possibility of hamstring tedonosis, I am not a medical professional, but it appears that this could be a contributing factor to your problem.

I found a webpage that seems to describe your condition. It is found at http://www.aidyourhamstring.com/hamstring-tendonitis.php

hamstring tendonosis refers to the inflammation in one or more hamstring tendons located around the ischial tuberosity, just below the knee. You state you are suffering the discomfort in your upper calf, so this theory may correspond.

It is worth further investigation.

I have actually bought one of these devices. Unfortunately, it just made my leg ache even more. I have put this down to it increasing blood flow to the area but don't want to make things any worse so have stopped.

 

[robertjtaylor]

I have actually bought one of these devices. Unfortunately, it just made my leg ache even more. I have put this down to it increasing blood flow to the area but don't want to make things any worse so have stopped.

If one is experiencing inflammation at a particular time, then utilzing any treatment method that increases blood flow would not be recommended, generally speaking. This is possibly what happened in your case. Heat therapies, such as ultrasound, are usually effective, but only after swelling has subsided and the recovery process is underway.

Robert

 

[adrian knight]

Lower your seat.

Hey Ben. If it were that simple....

 

[Skoorb]

Hey Ben. If it were that simple....

It sucks. I've been battling runner's knee for two years. I'm glad I've not given up yet. I am currently on a program given to me by a competent physical therapist which includes a ton of work on hip flexors, abductors, etc. as well as flexiblity and strength training. I don't want to jinx it by saying anything, but I'm glad I've not given up yet. If you have no suffered a trauma, like an impact, and simply have a chronic overuse injury that you cannot seem to solve, I do believe that shows optimism that it SHOULD be solvable. In my case, I'm quite positive my problem is because of muscular weakness and imbalance in hips, plus a mild functional leg length discrepancy. There's so much to look at when treating these, but I've also heard of people who really benefit from graston technique (done by a chiropractor). I guess in my case it's just so important to me to be competitive in triathlon that I'm not willing to quit this yet, but I"m also being reasonable about it and adjust training based on my knee.

Preaching to the choir on how frustrating it is, though. Rarely a month goes by when at least once I don't think that I'm just continually hitting myself against a wall and that I should give up already, but then I have that one killer bike ride or killer run and it gives me hope again.

Goodluck!

 

[adrian knight]

It sucks. I've been battling runner's knee for two years. I'm glad I've not given up yet. I am currently on a program given to me by a competent physical therapist which includes a ton of work on hip flexors, abductors, etc. as well as flexiblity and strength training. I don't want to jinx it by saying anything, but I'm glad I've not given up yet. If you have no suffered a trauma, like an impact, and simply have a chronic overuse injury that you cannot seem to solve, I do believe that shows optimism that it SHOULD be solvable. In my case, I'm quite positive my problem is because of muscular weakness and imbalance in hips, plus a mild functional leg length discrepancy. There's so much to look at when treating these, but I've also heard of people who really benefit from graston technique (done by a chiropractor). I guess in my case it's just so important to me to be competitive in triathlon that I'm not willing to quit this yet, but I"m also being reasonable about it and adjust training based on my knee.

Preaching to the choir on how frustrating it is, though. Rarely a month goes by when at least once I don't think that I'm just continually hitting myself against a wall and that I should give up already, but then I have that one killer bike ride or killer run and it gives me hope again.

Goodluck!

Cheers. I hope you can fix your problem. I haven't totally given up. There doesn't appear to be much scientific knowledge regarding the best way to treat tendinosis but one suggestion is Eccentric Exercises so I'll go down this avenue. Again, not a lot of info regarding the exercises to do for this problem so I'll still be 'running blind'. I just need to convince a physio that I am right regarding the prognosis so I can get some expert advice. I wonder if surgery would be the answer???

I hope it works out for you and good luck with your next comp.

 

[adrian knight]

Cheers. I hope you can fix your problem. I haven't totally given up. There doesn't appear to be much scientific knowledge regarding the best way to treat tendinosis but one suggestion is Eccentric Exercises so I'll go down this avenue. Again, not a lot of info regarding the exercises to do for this problem so I'll still be 'running blind'. I just need to convince a physio that I am right regarding the prognosis so I can get some expert advice. I wonder if surgery would be the answer???

I hope it works out for you and good luck with your next comp.

For those who are suffering with similar problem, I had ultrasound scan recently and chronic scarring in semintendinosis and calf was found. Getting injections to break up the scar tissue and extensive physio to reduce the reformation of scar tissue. May be riding again after all.

 

[Skoorb]

Adrian, glad to hear there is some optimism.

Interesting you say eccentrics. I came upon that stuff recently. I'm now 2.5 weeks into doing twice daily eccentric one-legged squats on a 25 degree incline with 12 lbs in each hand, 15 reps (3 seconds down, 1 up) and using both legs for the recovery.

There was a study done that showed similar results between surgery and these eccentric exercises on a 25 degree platform for those with patella tendinosis/tendinopathy, which I think is what I have.

So far it's going decently but I know it's supposed to be a long term thing (the studies were 12 weeks and I have heard of 4-6 months for proper tendinosis recovery). I have been battling it for a long time but I have found that when I take time off, the knee gets VERY SLOWLY better, but then upon return to activity it quickly gets worse and plateaus to a point where I can train quite hard and it doesn't get worse, but tapering back training doesn't make it better (until I taper to nothing).

I may also need surgery at some point or something else to break up scar tissue on the tendon, but that is premature at the moment. I've been with this 2+ years but I am still able to race a little and my symptoms just are not intense enough that a surgeon can say "get this done".

I put a good bit of leg training in this year and got some size and strength into my knee and I have to say I have reasonable confidence it was a reason why this season I was less symptomatic than the last, though part of that may be my much decreased run miles as well.

So, beyond the eccentrics, I'm also stretching a lot (hips down to the calves) and doing hip strengthening as well and balance excercises.

 

[adrian knight]

Adrian, glad to hear there is some optimism.

Interesting you say eccentrics. I came upon that stuff recently. I'm now 2.5 weeks into doing twice daily eccentric one-legged squats on a 25 degree incline with 12 lbs in each hand, 15 reps (3 seconds down, 1 up) and using both legs for the recovery.

There was a study done that showed similar results between surgery and these eccentric exercises on a 25 degree platform for those with patella tendinosis/tendinopathy, which I think is what I have.

So far it's going decently but I know it's supposed to be a long term thing (the studies were 12 weeks and I have heard of 4-6 months for proper tendinosis recovery). I have been battling it for a long time but I have found that when I take time off, the knee gets VERY SLOWLY better, but then upon return to activity it quickly gets worse and plateaus to a point where I can train quite hard and it doesn't get worse, but tapering back training doesn't make it better (until I taper to nothing).

I may also need surgery at some point or something else to break up scar tissue on the tendon, but that is premature at the moment. I've been with this 2+ years but I am still able to race a little and my symptoms just are not intense enough that a surgeon can say "get this done".

I put a good bit of leg training in this year and got some size and strength into my knee and I have to say I have reasonable confidence it was a reason why this season I was less symptomatic than the last, though part of that may be my much decreased run miles as well.

So, beyond the eccentrics, I'm also stretching a lot (hips down to the calves) and doing hip strengthening as well and balance excercises.

Well, from all the resrearch I have done to help my injuries, you certainly seem to be ticking all the boxes. I'd keep an eye on that tendinosis though, there's a fine line between healing and injuring - I know from experience ! Good luck, let me know how it is in a few months.