Very Persistent Knee Pain

Hi,

Been cycling at a moderate level for 5-10 years. But have had some serious knee problems over the last two years which I just can't shake off.
After tough climbs hills or longer rides ( 50 miles plus) I get knee pain just under the knee cap. It comes on fairly quickly, normally after a hard climb. For a few hours after the ride I find going up and down stairs to be very painful indeed- especially descending. Patellar Tendonitis?

Some things i've tried:

- Resting for 1-2 months then slowly buidling up.
- When that didn't work I tried stubbornly sticking at the cycling hoping my legs would get stronger and adapt- but stopping when the pain comes!
- Changing seat height.
- Changing shoes, though I always use SPDs.
- Doing excercises that strengthen the patellar tendon, as advised by a physio and doing a stretching routine nightly for ITB, calves, hamstrings.
- Had a MR scan which didn't show any problems.
-Tried giving up my other main sport which is circuit training. Circuits gives me tight calves and hamstrings I reckon.
- Spinning lower gears.

My Mountain Bike might be a little too big for me, and I am sometimes guilty of cycling with the seat too low as I need it low when doing descents.

Not a clue what to try next..Any one had this?

 

Mine comes and goes. I'm an old geezer (46), so I live with it. The pain seems to be worse when I try to mash up a hill in too high a gear. After a while it goes away. Then it comes back again.

 

A few days ago I did a 135km ride around the hills and being a masher it brought on the knee problem similar to what you have explained.

It only seems to happen when I riding around the hills whereas on the flatter roads I don't have any problems, a few weeks ago I did 220km and no knee problems.

I find a bit of massaging around the knee along with Glucosamine powder helps.

 

If its under the knee cap it might be a muscle imbalance/stretching problem. Have you had your X-rayed? A common problem with cyclist is that the outside of your leg(IT band/glutes) is stronger than the inside(VMO). This makes your patella to be tilted or even tracking to the outside.

To correct this you will need to stretch out the IT band and strenthen the VMO. Using a foam roller has really helped loosen up my IT band. I have tried many differnt VMO exercises but none seem to greatly strenthen it. What I found that works is electric muscle stimulation. You can get an EMS toy for about $150 and has greatly helped strenthen my VMO. Also on hills try to stand as much as possible since pedaling while standing works your VMO.

You need to go to a sports medicine doctor who specializes in cycling. I have had knee problems for the last 6 months and have been unable to ride until I went to a sports medicine doctor who deals with a lot of cyclists. He knew exactly what I had and am almost fully recovered now. You need to know what your fighting to win the battle IMO