Why would a knee suddenly start to hurt?

[snail]

I am annoyed.

I was on the 100km Breeze Challenge Event today. I did a club run on Thursday night, at my usual pace and usual distance. Last week I did a longer sportive. Basically nothing is any different to any other time. I haven't changed my bike or my set-up. I had a bike fit over a year ago and my spds were sorted out and I've had no issues.

At 10km in, I got some twinges in my right knee when pushing down. Such is life so I pressed on.
By 15km I was unable to push with any force - I was effectively pedalling with my left leg.
Not being silly, I knew I would have to swap onto the 50km course - a flat option, so I took my time and grumbled along.
At the feedstop I found that walking was not a problem but sitting down and getting up caused a flare of pain.

I've got home - driving was fine - had a bath - and now it hurts to walk.

Specifics: it feels hot to the touch so something is inflamed. It's the inner side of the knee. Walking up and down stairs makes me whimper. It is not noticeably swollen.

Questions:
1. How on earth can something just start to hurt if I haven't changed or done anything?
2. Do I bother to see a doctor, or instead see a specialist sports physio, or just put my feet in the air and ice it for a few days?

Really rather peeved about this!

[Ian H]

It happens more as you get older (believe me!). I have a physio in much the same way I'd have a trusted, skilled mechanic for a classic car.

[Dibdib]

I have a physio in much the same way I'd have a trusted, skilled mechanic for a classic car.

Because funding your own pension isn't expensive enough? 

Dragging myself back on topic, if it persists I'd definitely get it checked. Life's too short for knackered knees.

[Ian H]

I have a physio in much the same way I'd have a trusted, skilled mechanic for a classic car.

Because funding your own pension isn't expensive enough? 

Okay, perhaps I exaggerate a little; it's more like breakdown maintenance. But I have very little faith in NHS physios dealing with sports injuries. In my experience they're far more likely to say it's beyond repair, best stop what you're doing. My sports physio regards it as his job to get me back on the bike.

[mattc]

^Agreed.

Also -  depending on which end of the time-poor cash-poor spectrum you are, I'd consider seeing GP / Physio immediately. (Seeing the knee when still inflamed can be very useful).

10km is rather quick, otherwise I'd certainly just say "wait and see".

[campagman]

Most injuries are caused by overuse. You've done more than you're used to.

[Wowbagger]

The location and description sound like ligament damage.

Warning: I am not a doctor but I did tear a knee ligament falling down some stairs a few years ago.

[snail]

Overuse seems unlikely as I maintain a fairly consistent amount, and in fact this event was flatter than I am used to. I just assumed that if it were ligaments I'd notice a "ouch I've torn that" moment.

Age. Old age. This sucks. 38 and already my knees hate me.

I might wander into my local walk-in health hub thingy tomorrow. Or, hobble in. I now cannot bend my leg.

I would be perfectly prepared to lay out some cold, hard cash to ensure this does not become a persistent problem; I'll ask locally for recommendations.

[mattc]

running clubs seem to be a good source of pointers to serious physios!

[teethgrinder]

Wonky pedal?
Have you bashed your pedal recently?

Shoes? Are the shoe plates loose? Are the shoes wearing out?

Loose BB?

Bent crank arm?

[snail]

Perhaps it is just a general wearing-out of things - could that be it?

After all I bought this bike 3 years ago, laid out for spds and shoes two years ago, and being very tight with cash, I've never changed or upgraded. I worked out that I had cycled from London to Moscow so far this year (1700 miles). When the bike mechanic checked my chain today the tool thingy fell right through and I got a lecture about chains and now my possible need for a new cassette. I had no idea and feel somewhat foolish.

So maybe the shoes, cleats, pedals are indeed worn out - could that be enough to cause a sudden horrible pain? On the plus side my garmin tells me I managed to cycle at an average of 10-11mph with one leg for 40km. I will have a thigh the size of Chris Hoy at this rate. But just one thigh.

[Biggsy]

A reduction in pedal float can be bad for your knees, but wear doesn't necessarily mean reduced float.  Actually it's the opposite, in my experience with SPDs and Looks.

[Kim]

Perhaps you've done something seemingly innocuous to your knee off the bike, that's been exacerbated by cycling?

[Polar Bear]

Don't beat yourself up about chain wear.   It happens to the best of us from time to time.   Riding a bike is far more enjoyable than maintaining it!   

Injuries happen.   Usually day-to-day life doesn't put much stress on the body but a seemingly innocuous thing like a slip in the shower or a sharp turn when somebody called your name could just have put some extra load on there.    Whack on a few hundred kilometres on the bike and your body just got to tipping point.     

I turned my head once and got a shooting pain right up my right side.   The pain and discomfort lasted about a fortnight.   I worked out from further incidents that it was my sleeping position.   Change of pillow and all is now well.   

I advise that you get it seen to and hope that recovery is quick and permanent.

[Bledlow]

Overuse seems unlikely as I maintain a fairly consistent amount, and in fact this event was flatter than I am used to. I just assumed that if it were ligaments I'd notice a "ouch I've torn that" moment.

Age. Old age. This sucks. 38 and already my knees hate me.

My first episode of ultrasound on my left knee was a couple of months after my 36th birthday, IIRC. It turned purple & swelled up one day, when I was doing an audax. I became intimately familiar with the anti-inflammatory effectiveness of various NSAIDs, & the degree to which they irritate my stomach, in the years after that.

I have absolutely no regrets about paying to see a physiotherapist. I've consistently been told "the sooner the better" by everyone who I think is qualified. My GP was oddly reluctant to refer me, as he was when I needed physio for an injured shoulder - & I probably paid for that in worse healing than prompt treatment would have resulted in. If yours will refer you quickly, go for that.

[snail]

Thanks for all the advice!

I examined my knee and there is a tiny bruise where it hurts. So the simple explanation must be that I've clobbered it - and not noticed, as Kim and Polar Bear suggest. And then the cycling has aggravated it.

Still sore today, so I may go to the hobble-in centre once the striking is over.

[giropaul]

All good advice above, but maybe a couple of other things to consider:

As has been said, worn pedals, cleats etc. Also worn shoes, especially the insole. These tend to flatten out over time. If you keep on having a problem then consider custom insoles.

Do you do anything else other than road cycling - for instance spinning (many spin bikes have bent pedal spindles in my experience), or weights work in the gym?

More generally (and this may not apply to you), with the great upsurge in "new" cyclists I observe a tendency to ride in shorts in colder conditions. The rule of thumb (in my circles anyway) is 20 degrees - below that knee warmers, and if colder fill tights or leg warmers.

The bruise could be  a sign of damage, but might be coming to the surface from deeper trauma. A GOOD sports Physio/therapist would be useful.

Just my thoughts without knowing your riding style etc.

[snail]

I loathe sport and exercise of all kinds, which is why cycling appeals to me as it's a stealth way of staying fit So, no spinning classes or so on.

My last few rides have been in my winter tights because I do feel the cold quite quickly. I am cautious of my knees and try to look after them.

I haven't gone to the walk-in place. I went around Tesco for an hour and can walk without problem, and it's not too bad moving it now. I am going to take it easy and put my feet up as much as possible. I have a club ride to lead on Thursday night so want to be rested for then...

[Kim]

More generally (and this may not apply to you), with the great upsurge in "new" cyclists I observe a tendency to ride in shorts in colder conditions. The rule of thumb (in my circles anyway) is 20 degrees - below that knee warmers, and if colder fill tights or leg warmers.

My rule of thumb is that the advantages of shorts over 3/4s are largely non-existent (at least, in British weather), while 3/4s will keep knees warm down to the point where winter tights are justified.

My last few rides have been in my winter tights because I do feel the cold quite quickly. I am cautious of my knees and try to look after them.

...though I have found that the compression effect of winter tights can affect knees, so consider this if knee problems coincide with the onset of tights weather.

I loathe sport and exercise of all kinds, which is why cycling appeals to me

+1   

[Peter]

A, it's good to hear from you again - especially at this time of year!  What kind of club rides are you leading?  Haslingden's a bit far for a ride out for me on an evening but I might see you on the road somewhere.

All the best

Peter

[snail]

Hi Peter! I kept moaning at Rossendale Road Club members that their rides were too far/fast/intimidating for new people. Or slow people like me on mammothly heavy tourers.

Which meant that I ended up sort-of volunteering to run exactly the sort of rides I'd been asking for. They've only just started. Now, on Thursday, there will be two rides leaving - one is the regular run of 30 miles or so, and the other is mine. My "introductory" ride at a "steady pace" of about 20 miles, over 2 hours. It is hilly. I hope to encourage new folks to come and have a go. I've been doing Breeze rides but I have spoken to lots of men who are also intimidated by the idea of club runs so I wanted to broaden the access a little.

Kim, I was mortified when I dragged my winter tights on last week - to discover that the two-year-old fleece-lined wonders are horrifically baggy around the knees. They are the Nora Batty of cycling gear. But so so so so comfy I cannot part with them.

[snail]

Well. You all asked about shoes and pedals and set up and so on.

No one asked if I'd recently bought a new car!

I've gone from driving a Landrover Defender 110, to a Ford KA. And doing long (200+ mile drives) in the new one. It appears to have *possibly* contributed to a muscle strain (as hastily diagnosed by ex-physio mother in law) but I will see how it goes and maybe get a second opinion from local sports physio if it doesn't clear up.

[Aunt Maud]

There you go, that's probably it, as you sit very differently in a Ka than you do in a Land Rover. How tall are you ?

I was going to ask if you've changed anything when I got to the bottom of the thread and you've answered it yourself.

[mrcharly-YHT]

Aha

Defender pedals take quite a lot of force to move. So much so that you can 'rest' the weight of your leg on them. Weirdly they are very comfortable vehicles to drive for long journeys.

Modern small cars are light to operate, so for long journeys you are pretty much suspending your right foot in the air. No wonder you are getting knee pain.

[snail]

I'm five foot four if I breathe in and stretch.

I tried a test-ride up a hill just now. It twinges.

The Defender is hell to drive for a long time, the pedal is totally wrong for me (it's the husband's pet vehicle) but I'm used to it. The KA felt comfy right from the start but obviously something is pinging away. I have booked to see the physio next week because I want to know exactly what the issue is, and what I can do about it.

I do prefer razzing around in the Defender! I feel like a farmer and I like the way we all wave to each other. Like cyclists. It's fun. But totally impractical for nipping to the shops.