Author Topic: LEL borked my knee!  (Read 10991 times)

scottlington

  • It's short for, erm....Bob!
LEL borked my knee!
« on: 06 August, 2009, 08:46:05 am »
Hmm, I think riding LEL has finally borked my knee to a sufficient extent that I have made a doctors appointment.

I first noticed it around Longtownish Southbound as a dull pain on the front inside of my knee. This got steadily worse as I climbed towards Alston (at one point I had to get off the bike for a few minutes). I then spent until Thorne really struggling to keep up with my ride partner and the pain got steadily worse. I also noticed some tenderness of the area under touch (although no swelling).

At Thorne I had only 1 hours sleep and tried to steal a march in terms of time whilst being able to ride a little slower and mitigate the pain somewhat. However, until I got to Thurlby (where Tomsk suggested I raise my saddle a cm) it was painful enough that I thought about quitting. After I raised my saddle the pain got instantly better for the stage to Gamlinghay only to return again for the last satge (though not as bad as before).

I thought it was just a strain and that a couple of days off the bike would see it right (i've had other problems with my knees before - MSG this year springs to mind - but they always clear up after a few days), but not this time, almost a week after LEL has finished and with absolutely NO exercise it is still as painful.

Drugs do nothing (even a 600mg Ibuprofen taken at Gamlighay didn't touch it) and rest obviously hasn't made much impact.

Symptoms (as best as I can describe them)

Pain is reasonably localised to the front, left side of the knee around the kneecap area. It is worse when bending the leg, walking up or down stairs or any activity whcih cause the knee to bend more than, say 90 degrees. Also hurts when lifting my lower leg. Pain always 'there' but dull when walking or lying down. Slight tenderness to a seemingly random area of the front of the knee when touching.

I notice no swelling at all (never did) but knee sometimes feels, well, 'tight' is the only word that works I think. When bending the knee it's as if I'm pulling or pushing against something (almost as if there was a rubber band exerting just enough force to be noticeable). It also feels sometimes like there is some pressure build up (again, hard to be locale specific, but around the fornt left side of the knee).

Looking online it seems to be either chondromalacia or maybe prepatellar bursitis (which is what my riding partner suggested it was on LEL). I didn't fall or in any other way injure my knee in one go, so I don;t think it's a trauma style injury or torn muscle/ligament/cartilage.

I'm just desperate to get back on the bike or the gym and don't want to be laid up with this. My doctors appointment is not until next Tuesday.

Any advice in the meantime?

simonp

Re: LEL borked my knee!
« Reply #1 on: 06 August, 2009, 09:00:42 am »
Rice. Rest, ice, compression, elevation.  Wrap an ice pack around it for 15 minutes twice a day. I got mine from Boots. It has a Velcro strap to give extra compression.  

This will help with inflammation and swelling.

I would not get back on the bike just yet - cartilage and tendon problems are much slower to repair than muscle. If you want to stay active maybe try swimming.

GASGWS

vorsprung

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Re: LEL borked my knee!
« Reply #2 on: 06 August, 2009, 09:06:56 am »
I had this for after PBP.  It didn't affect me during PBP but happened a couple of days later

To start with I carried on riding but it wasn't getting better.  I went on a day ride with mrs vorsprung around Avesbury.  In the car driving back I had to apply a chemical cold pack

In the end I decided it was "spring knee" (i forget the science name).  To fix it I gave up cycling completely for 6 weeks and tried to avoid bending my knee at all
For exercise I got a month pass for the swimming pool and went there twice a week.  Swimming is the most boring form of exercise yet devised but it is kind to knees.

After 6 weeks it was fine.  I never want to go swimming in a pool again

Re: LEL borked my knee!
« Reply #3 on: 06 August, 2009, 09:15:05 am »
yeah. take great care of your knee. don't ride  if it will exasperate the problem, swim instead. it'll be worth it in the long run.

scottlington

  • It's short for, erm....Bob!
Re: LEL borked my knee!
« Reply #4 on: 06 August, 2009, 09:21:43 am »
I hate swimming....  >:(

vorsprung

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Re: LEL borked my knee!
« Reply #5 on: 06 August, 2009, 09:35:09 am »
I hate swimming....  >:(

Yes swimming sucks

Avoid walking up hills or cycling for six weeks and you will be sorted out.  Starting last week that's september the 10th, put it in your diary

scottlington

  • It's short for, erm....Bob!
Re: LEL borked my knee!
« Reply #6 on: 06 August, 2009, 09:39:24 am »
I hate swimming....  >:(

Yes swimming sucks

Avoid walking up hills or cycling for six weeks and you will be sorted out.  Starting last week that's september the 10th, put it in your diary

Can I quote you?  ;)

In any event, that stuffs up my RRTY.... again.  >:(

hellymedic

  • Just do it!
Re: LEL borked my knee!
« Reply #7 on: 06 August, 2009, 11:18:13 am »
Try to rebalance your quadriceps muscle by developing your vastus medialis.

Do not work your bent or straightening knee against resistance at all for the next few weeks. Let the handrail take most of your weight on the stairs (especially down).

Exercises
1) When you have an idle momement whilst sitting, straighten your knee and hold your leg out in front of you for as long as you can. Repeat.
2) Lie on floor. Lift leg up just 15-20 cm. Hold. Repeat.
Once you can do this for a long time, add a weight to your ankle, like a 2kg bag of rice or similar.

vorsprung

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Re: LEL borked my knee!
« Reply #8 on: 06 August, 2009, 11:40:26 am »
In any event, that stuffs up my RRTY.... again.  >:(

You could do a couple of laps of lincolnshire or the fens one legged if it is really important to you

simonp

Re: LEL borked my knee!
« Reply #9 on: 06 August, 2009, 12:07:34 pm »
Your knees are more important than RRTY.  Really.  I ditched RRTY at 11 months because physio said so.  Perhaps if I had ignored this advice, LEL would not have happened for me.

mattc

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Re: LEL borked my knee!
« Reply #10 on: 06 August, 2009, 12:24:18 pm »
May I share my knee problem? All advice appreciated (but may be ignored!).

The cause is similar - riding to Scotland in too short a time.

Mine was pretty much front of knee, bending caused the problem, and keeping it moving helped a LOT. (Even a short descent would cause pain when the next force was applied). It took a big jump in severity during a rainy pee stop on an exposed bit of Lincolnshire. I could barely get moving again.

Little visible swelling on the ride, but a fair bit came on when I stopped. Still some visible now (+5 days).

Raised the saddle considerably, and stuck to MUCH lower cadences, honking on every slight rise (I'm normally a spinner so this took constant mental effort to do!). Biggest improvement came from massaging the ITB* - got it from quite taut to about normal. From then the pain never got any worse.

Based on a similar ITB issue on my OTHER side (I am assymetric following distant car crash) I suspect the ITB was yanking my knee-cap over, causing the inflamation. But this is a guess.

So I'm resting it and taking max ibuprofen, icing every day. But it's very slow progress - I can bend further but not the full range before a tightness comes in.

How long do I rest it? How to reintroduce movement?
(I WILL see my physio, but they cost money, and not available at a moment's notice).

*Thanks Nic!
Has never ridden RAAM
---------
No.11  Because of the great host of those who dislike the least appearance of "swank " when they travel the roads and lanes. - From Kuklos' 39 Articles

scottlington

  • It's short for, erm....Bob!
Re: LEL borked my knee!
« Reply #11 on: 06 August, 2009, 12:32:14 pm »
May I share my knee problem? All advice appreciated (but may be ignored!).

The cause is similar - riding to Scotland in too short a time.

Mine was pretty much front of knee, bending caused the problem, and keeping it moving helped a LOT. (Even a short descent would cause pain when the next force was applied). It took a big jump in severity during a rainy pee stop on an exposed bit of Lincolnshire. I could barely get moving again.

Little visible swelling on the ride, but a fair bit came on when I stopped. Still some visible now (+5 days).

Raised the saddle considerably, and stuck to MUCH lower cadences, honking on every slight rise (I'm normally a spinner so this took constant mental effort to do!). Biggest improvement came from massaging the ITB* - got it from quite taut to about normal. From then the pain never got any worse.


I had exactly the same on my right knee during MSG this year. Even 30 secinds off the bike would result in huge pain when I got back on and started pedalling. Like you, I found less pain when out of the saddle honking. Mine cleared up after about a month (although recovery not helped by doing 450k DIY ride with Greenbank a few weeks afterwards).

I didn't do anything specific, I even carried on down the gym spinning. It just sort of - cleared up. On LEL I had no problems at all with it. Just the other knee....

Re: LEL borked my knee!
« Reply #12 on: 06 August, 2009, 12:52:51 pm »
(although recovery not helped by doing 450k DIY ride with Greenbank a few weeks afterwards)

And staying in the big ring for that entire ride...
"Yes please" said Squirrel "biscuits are our favourite things."

Re: LEL borked my knee!
« Reply #13 on: 06 August, 2009, 01:56:11 pm »
My symptoms 5 years ago sound similar to yours Scottlington, which of course is not to say that the problem nor solution are the same.  It happened during a CTC club 100-miler and was caused, I think, by overdoing it on the hills.  I stayed off the bike for a couple of weeks but that didn't seem to do the trick.  After about 6 weeks I had a very expensive (paid for through work) 20-minute consultation where I was told that if I were a runner I'd be told to get on a bike, but because I was a cyclist, I was not to cycle as far, or as fast or as hilly.  Not what I wanted to hear, and no good at all at that time because it hurt to cycle 2 miles on the flat slowly.  So I left it several months and eventually went to a sports physio who slowly got me sorted, with all the things I should have done earlier - ice/heat, gentle stretches, and then a careful build up to longer distances.

Good luck with the doctor, and get well soon.

 

scottlington

  • It's short for, erm....Bob!
Re: LEL borked my knee!
« Reply #14 on: 06 August, 2009, 02:39:54 pm »
(although recovery not helped by doing 450k DIY ride with Greenbank a few weeks afterwards)

And staying in the big ring for that entire ride...

No, and I'm well aware I've not been helping myself this season.  :-[ Done nothing shorter than a 300 since beginning of March, most of which have been of the hilly variety. So no 'normal' distance for quite some time just to build basic fitness and strength. Also, I first noticed this around 850K into LEL so that meant me cycling a further 550k on a rapidly worsening knee (when I probably should have just stopped).


Re: LEL borked my knee!
« Reply #15 on: 06 August, 2009, 02:42:03 pm »
you guys and you big rings, look after yourselves. Take it from an old timer like me.

mattc

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Re: LEL borked my knee!
« Reply #16 on: 06 August, 2009, 02:54:42 pm »
Woo-hoo! Got a physio slot tomorrow morning.

(advantages of a job in the Big City (Reading) )
Has never ridden RAAM
---------
No.11  Because of the great host of those who dislike the least appearance of "swank " when they travel the roads and lanes. - From Kuklos' 39 Articles

mattc

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Re: LEL borked my knee!
« Reply #17 on: 07 August, 2009, 10:45:42 am »
Update (to remind me what I was told this morning):

Tendonitis diagnosed in the tendon just below the knee cap. "Classic overuse cycling/running problem." There was some fluid behind the knee-cap.

Often caused by rotation of the knee, possibly due to tight ITB or fatigued glute. Triathletes suffer when they 'transition' from bike to run with tired glutes. I had great difficulty pedalling 1-legged on LEL, so that sort of fits (right side was fine).

Needs resting, massaging (i.e. kneading with thumb!), icing, ibuprofen. Must call back to find out if I can run or swim on it. Next* session hopefully look at the causes more i.e. as prevention.

I still feel this stuff is all a bit witchcraft; I don't fully understand the mechanics of the injury as explained; he reckons stretches are useless for ITBs, whereas the 2 physios that fixed my long-running right knee problems swear by various ITB stretches.

Perhaps the 12-hr in mid-September isn't on after all ...

*Why do they always say "Next time ..."? Can't they just take my £40 and fix me?!?
Has never ridden RAAM
---------
No.11  Because of the great host of those who dislike the least appearance of "swank " when they travel the roads and lanes. - From Kuklos' 39 Articles

scottlington

  • It's short for, erm....Bob!
Re: LEL borked my knee!
« Reply #18 on: 07 August, 2009, 12:16:47 pm »
Update (to remind me what I was told this morning):

Tendonitis diagnosed in the tendon just below the knee cap. "Classic overuse cycling/running problem." There was some fluid behind the knee-cap.

Often caused by rotation of the knee, possibly due to tight ITB or fatigued glute. Triathletes suffer when they 'transition' from bike to run with tired glutes. I had great difficulty pedalling 1-legged on LEL, so that sort of fits (right side was fine).

Needs resting, massaging (i.e. kneading with thumb!), icing, ibuprofen. Must call back to find out if I can run or swim on it. Next* session hopefully look at the causes more i.e. as prevention.

I still feel this stuff is all a bit witchcraft; I don't fully understand the mechanics of the injury as explained; he reckons stretches are useless for ITBs, whereas the 2 physios that fixed my long-running right knee problems swear by various ITB stretches.

Perhaps the 12-hr in mid-September isn't on after all ...

*Why do they always say "Next time ..."? Can't they just take my £40 and fix me?!?

At least it doesn't sounds too serious. Trouble is figuring out exactly when it is 'fixed'. I guess you'll no longer have any discomfort a long time before the injury itself is fully healed.

mattc

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Re: LEL borked my knee!
« Reply #19 on: 07 August, 2009, 12:27:06 pm »
At least it doesn't sounds too serious.
Yes, I almost forgot to be pleased about that :)

Quote
Trouble is figuring out exactly when it is 'fixed'. I guess you'll no longer have any discomfort a long time before the injury itself is fully healed.
Well the nice man will check for fixedness at £40 a time ... :-/

Also I can't fully bend it without tightness, so he said until that goes away, it DEFINITELY isn't healed. So that's a useful start.

(Apparently ignoring this injury, or not resting sufficiently, leads to scar tissue which is very visible as a tendon 2-4 times normal width! When he was saying what a good boy I was for coming in, I'm not sure he quite did the math that would have led to:
So you rode at least 500km with this problem?   )
Has never ridden RAAM
---------
No.11  Because of the great host of those who dislike the least appearance of "swank " when they travel the roads and lanes. - From Kuklos' 39 Articles

Re: LEL borked my knee!
« Reply #20 on: 07 August, 2009, 12:49:57 pm »
All these descriptions pretty much sound like what happened to me over PBP. I bailed as a result.
The aftermath was pretty much as described by others, rest and recuperation followed by a total rethink of my bike position, paying careful attention to cleats, saddle position handlebar position.
I also paid attention to warming up on my regular rides and also now treat my knees as "delicate" objects, so use knee warmers whenever the weather is cold or wet.

So far...so good.

I am tempted, now that all symptoms have gone, to croos train using Rollerblades, which strengthen up the whole area around the knees/hips and work the muscle groups in a very low impact way.

Re: LEL borked my knee!
« Reply #21 on: 07 August, 2009, 01:06:52 pm »
I am tempted, now that all symptoms have gone, to croos train using Rollerblades, which strengthen up the whole area around the knees/hips and work the muscle groups in a very low impact way.

Having suffered from various knee problems in the past, I've always understood that one of the most important things to do is build up the quadriceps, the theory being that the strain is taken by these rather than the knees.  

To that end I use the various fixed weight machines in the gym (especially the leg extension) and have suffered far fewer issues since.
The sound of one pannier flapping

simonp

Re: LEL borked my knee!
« Reply #22 on: 07 August, 2009, 01:15:38 pm »
Leg extension is generally not advised for people with knee problems (because of the strain it puts on the patellofemoral joint).

I have been doing single-legged squats/dips.  Not very deep; I can do those without discomfort.

Re: LEL borked my knee!
« Reply #23 on: 07 August, 2009, 01:41:09 pm »
Leg extensions borked my knees.  The made the big muscles in my quad strong, but the little teardrop one just above the kneecap did not benefit, and the alignment went to pot.  Single leg squats are the way forward from my experience (start with both legs if you can't do single legs comfortably).

Re: LEL borked my knee!
« Reply #24 on: 07 August, 2009, 01:47:57 pm »
Leg extension is generally not advised for people with knee problems (because of the strain it puts on the patellofemoral joint).

Well, this was done on the advice of a sports physiotherapist, but only once the original problems had been resolved.  I was led to believe that quad development was a recognised way of protecting knees in sportspeople - for me it has certainly worked wonders.  No more crippling ITB pain and only the occasional mild niggle which is relieved by rest.

As you say, leg extensions are probably best done under supervision if there are existing knee problems, but in the long term I think they are the way to go.
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