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I need a reality check(16 posts)

I need a reality checkKristin
Sep 29, 2001 1:06 PM
In 26 days I've riden: 25 miles, 22 miles, 65 miles, 18 miles, 16 miles. Total 146 miles. After today's ride (16 miles) my knee was hurting. I actually walked a couple inclines to avoid hurting my knee further. Is there any hope that I'll be healed and ready for the Hilly Hundred? Its two 50 mile days back to back on Oct. 20-21. There are shorter options on the ride too. *Sigh* Is it all over for the year?
re: I need a reality check6fhscjess
Sep 29, 2001 1:37 PM
HI KRISTEN, Try RICE. It stands for rest,ice,compression and elevation. Also you could take an NSAID thats a non steroidal anti-inflamatory drug such as asprin or ibuprofen. Also you should check your cleats to make sure that they are in the right position. You may even want to have your cleats adjusted using the fit kit. I noticed in another post that your seat is loose this could have caused a problem with your knee also. If no bolts or screws are stripped on your seat but are just loose you may want to use some loctite on them. Not the permanent type though.
Another Bike just for these emergenciesStickers
Sep 29, 2001 3:47 PM
I placed my cleats myself, and paid big time for it. Was a long, climbing day trip. Knee pain after going over the mountain range. Bought Advil when I reached a town. Hurt the entire ride. Climbed back up the mountain range, then got lost, walked, but that hurt too. A guardian angle in a station wagon told me how to get back. Rode with my bad knee out of the pedal, one foot drive. Thought my riding days were over. Could it have been me, and my cleat angle? Paid $25 dollars for a fit, I learned my lesson. I pay for shoes, then I pay for cleat fitting. My knees be fine! Good luck.
Another Bike just for these emergenciesStickers
Sep 29, 2001 3:52 PM
Oh, I meant to say, that if you have another bike to ride, one with platform pedals, You may be able to ride while the physical problem gets better. Just fit yourself with court tennis shoes and just the right size bike. Get well.
re: I need a reality checkflying
Sep 29, 2001 4:16 PM
I agree with 6fhscjess
RICE is the best for knee problems.
As for the cleats... Do you have any play at all?
I really like & have always used 3* of play.
Lots of pedals like the Look PP296 & 396 allow you to set
3,6,or 9 degrees of arc. Im not a fan of a total lock on the cleat position. I could see a 200+ lb sprinter needing the extra lock but most folks riding varied terrain can use a bit of arc.
Good Luck & I hope you heal up. If not pass on the ride there will be more. But your knees have to last your whole life. You will miss them when they are gone ;-)
CleatsKristin
Sep 29, 2001 5:30 PM
Even if my cleat position is tragically off, will adjusting them magically cure my pain? I'm wondering if the Hilly Hundred is too soon to get ready for...considering how long I've been out of commision. I'm trying to decide whether to sell my space in the event?

Pedals: I have '99 Ultegra SPD pedals and a loose pair of Look MS shoes. The pedals have plenty of side to side play, but no float. I've put almost 2000 miles on like this and had no problems until the 14th. Thats when I mashed 30 miles during the metric century. Additionally, I had only ridden 20 miles during the 10 days before the metric due to illness. So basically, this wasn't a slow building problem, but rather an injury. A stupid one at that.

I've been doing RICE and even avoided stairs for 7 days. But everytime I ride, it comes back. Will riding a different bike be better? I could always borrow something. I'm getting fit at the Bike Rack within two weeks.
Yeah, I think you need a reality check too.nee Spoke Wrench
Sep 29, 2001 6:52 PM
It sounds to me like you are seeing problems where none really exist.

Back when I lived in Northwest Indiana, I used to ride the Hilly every year. I trained in an area where the biggest hill was where the road passed over a railroad track. Even then, I felt there were only two "monster" hills, one each day. Besides, the Hilly's not a serious ride, there's too many riders for that. It's a rolling party. People ride it (OK, maybe they walk parts of it) with no training at all. You are not only going to be all right, you are going to have a ball.

For now, take the rest part of RICE seriously. Your knee will only heal so fast so let it. The base miles you have ridden all summer long will carry you through the Hilly Hundred - IF you have the patience to let your knee heal.

You are going to get a professional bike fit. I think that's a good idea. Any issues with bike fit that may be contributing to your trouble will be resolved. Don't forget to tell them about bouncing on your seat when you get cranking.

You have already ridden more that the required mileage each day so you know that you can do it.

The reality is: You have nothing at all to worry about -unless you think its a sin to have too much fun.

Cheers,
re: I need a reality checknothatgullible
Sep 29, 2001 9:56 PM
Ok Kristin here's the thing. I believe you said you are suffering from IT band syndrome. Guess what? That's one of the worst knee injuries you can have. You really need to give it a rest or it won't go away. I had it in '87 and had to quit cycling. It happened because of overtraining, too much, too soon. At the time I went to the doctor and had some therapy but as soon as I would ride the bike, the pain would come right back. After trying to get rid of it for a long time I just sold my bike and everything else. I simply quit. I started riding again in 1998. '99 was fine but developed some chondromalacia on the left knee. Went to the orthopedist and spent quite a while in physical therapy. Didn't help. Lost all of 2000 due to the injury, no structured riding for the year. After resting most of the year, I started traing for 2001. Guess what? Did too much too soon and in about mid January developed the old pain on the side of my knee, ITBS. I tried doing interval type traingin with a new set of pedals and that set off the ball rolling. At the very beginning, I cut back my training and went back to the original pedals and everything was fine. Then when things got better I put the different pedals and went for a hard 3 hour ride. The knee was sore but I figured It would go away. After 2 weeks of riding with this pain, I went back to the old pedals but there was no coming back, the damage was done. I haven't done any structured riding since the beginning of the year. I have tried everything. Ice, heat, stretching, resting for up to a month at a time, anti-inflammatories, DMSO, Active Release Technique, all kinds of changes to my riding position, about 3 different types of pedal systems, I have read all I can about the problem on the Internet and on the library and right now I'm having massage therapy once a week. It is still bothering me. Mostly now is more of a tightness so I'm hoping that more strethching and the massage will help. If you read page 243-244 in Davis Phinney's book "Training for Cycling" you'll realize how serious this injury is. It used to be thought of as a career ending injury. The best advice I can give you is to be patient with this. I would rest that knee for at least a month and a half maybe two. I know how hard that is, trust me. One thing that seemed to help a little bit was installing speedplay pedals. It's not a cure but when it comes to IT band they seemed to help, not a cure though, remember that. Maybe try a sports orthopedist. But the one thing above everything is to stop riding. Forget that ride you want to do. You'll hurt your knee even more and you might loose all of next year. It can be that bad. One thing I also tried was the Patt-Strap which I think was invented for runners but it didn't help. I have a friend that is a runner that got this injury. He lost a whole year of running. He basically rested, stretched and took it easy until the injury was healed. I don't come to this site very often because it takes so long to load so if you have any more questions or want to discuss anything about it you can e-mail me at mrodri4795@earthlink.net I am going through the exact same thing you are going through and I know how hard this is. Please take the advice, you can't ride through this injury and read that portion of the Phinney book and you'll get a better understanding of the need to care of this before it gets out of control. By the way I think you mentioned that you ramped up your trainging and that's when you got hurt. I hope you learned something from that. You have to ease into cycling programs or you will get hurt. I wish you the best and let me know if you have any questions.
re: I need a reality checkLLSmith
Sep 30, 2001 2:41 AM
Reality is you are going to have to take it easy for awhile.At what point in your 16 mile ride did your knee start to hurt?Did it hurt at all before the 16 mile ride? Does it hurt today?I would think you should not get back on the bike until you can go for 4-6 days with no pain at all.You might even wait until you get your fitting.As you know a little seat and cleat adjustment here and there can make a big difference.I know 16 miles is not alot with the training you have put in this year, but you might do well to start with 3-5 miles and slowly build your knee up.When the pain is gone try stretching just like before a ride and go for a walk...just to keep moving.
re: I need a reality checkKristin
Sep 30, 2001 9:28 AM
Yesterday, the pain began at around 9 miles. I had been off the bike for 13 days. The pain goes away within a few hours, so I feel fine right now. Just frustrated and depressed. You are probably right...I should have started off with an shorter ride. I intended to do only 8 miles, but once I hit the road, I wanted to keep going. I'm the queen of pushing myself to far. I am gonna get fit before I ride again.
re: I need a reality checkDuh
Sep 30, 2001 3:05 AM
Five rides in 26 days. The last one only 16 miles and you had to walk up a few hills or inclines. Sorry, time to stop asking people you don't know and see a sports specific expert. If you are in such pain your body is trying to tell you something you you can't get here. Duh
Duh, did you read my message?Kristin
Sep 30, 2001 8:54 AM
I am under the care of a sports doctor. My regular sports doctor is a cyclist too. The guy I saw on Friday is a collegue of his. I start physical therapy on Monday. So, no sweetheart...I'm not relying on you for medical advice. Just looking for opinions from people who have experienced this.
re: I need a reality checkMothhunter
Sep 30, 2001 8:17 AM
This is an excerpt from Andy Pruitt's book, available on-line at www.roadbikerider.com

Ilio-tibial Band Friction Syndrome

DESCRIPTION

The ilio-tibial (IT) band is a wide
sheath of fibrous connective tissue
that extends from the crest of the
hipbone to slightly below the knee
along the outer side of the thigh.
The IT band's lower end crosses the bony protuberance
on the outer side of the knee. There is a bursa
(fluid-filled sack) located between the bone and the IT
band for protection and lubrication. In some situations,
this area can be irritated. IT band syndrome is not only
an inflammation of the tissue, its also bursitis.

SYMPTOMS

A sharp, stabbing pain on the outside, middle of
the knee. It usually begins as a mild twinge, then
increases until it feels like someone is tightening
a hose clamp or stabbing you with a screwdriver.
The pain is usually worse during the power portion
of the pedal stroke. Maximum friction occurs
between the stroke's midpoint and bottom dead
center.

CAUSES

A stance on the bike that's too narrow.
Badly positioned cleats. Usually they're too toedin,
but this isn't always the case.
Biomechanical factors like bowlegs.
A saddle that's too high.
Too much riding too soon. IT problems rarely
happen after a period of base mileage.
Flat feet and non-floating pedals are two other
contributors.

TREATMENT

Apply ice as many as three times a day for 10-
15 minutes each time
Take a non-steroidal anti-inflammatory drug
(NSAID) with food.
Widen your stance on the bike by moving your
cleats as far to the inside of the shoe sole as
possible. Or, put a washer on the pedal axle so
the pedal doesn't thread as far into the crankarm.
Limit washer thickness to 2 mm so enough
pedal screws in for safety. Some road riders install
a triple crankset on their bike to take
advantage of the longer bottom bracket axle.
If your pedals don't have float, it may help to
position your cleats so your feet angle out more
than normal.
Lower your saddle about 6 mm. (IT band friction
syndrome is one of the few knee problems
where the saddle should be lowered rather than
raised.)
Over-the-counter arch supports or custom orthotics
are often helpful because controlling the
arch controls excessive tibial (lower leg) rotation.
For this reason, anatomic shoes, such as the
Body Geometry models by Specialized, are effective.

CAUTION! If these treatments don't relieve the
pain in one day, stop riding but continue icing and
NSAIDs. Once IT band friction syndrome gets established,
it's hard to correct.

IF THESE REMEDIES DON'T WORK

You need to do specific stretches, such as the
OBER stretch, on a regular basis. Learn them
from a qualified physical therapist.
Another possibility, localized cortisone injections
for temporary relief. However, cortisone is
indicated only when the tendons to be injected
aren't under a constant load. Cortisone tends to
dry out the tissue, causing necrosis (tissue
damage). This can lead to a ruptured tendon.
In persistent cases, a relatively simple surgical
procedure can save the day. The surgeon removes
a small section of the offending IT band,
eliminating the pain.
Sucks, Doesn't it........Len J
Sep 30, 2001 4:34 PM
I can feel your frustration, even thru this electronic medium.

The only experience I have with your injury is second hand from friends & what I've read. That being said, when I combine what I know about it with your comments about your leg alignment and your propensity to push yourself and it's not surprising that you are continuing to have problems. It sounds like the root cause of your problem is the way your legs fit the bike. (I think you said you were bowlegged & had one leg shorter than the other). This is then compounded (I would guess) by your resting and then overdoing it in an attempt to get yourself ready for the hilly hundred. Since this condition is aggrevated by hard work without the benefit of a large foundation of base miles, every time you go into (panic) hard training (trying to make up for lost time)without building up easy base miles, you are reinjuring yourself.

If you truly want to heal, it sounds to me like the following is probably in order:

1.) Get your bike fit properly, especisally to your legs. (It sounds like this is your plan, Congrats)

2.) Once you get your bike fit properly, begin by building slow base miles, but only after the M.D's OK. RICE until then.

3.) If (& only if) you can build up easy milage, where you can do 30+ miles easy with no pain, consider doing the Hilly hundred.

Since you only have 3 weeks, I would say that you will not be ready. I know this sucks, but at this point, its more important for you and your health to get better. Continuing to aggrevate a painful injury in order to have fun doesn't sound like fun. The good news is that you may be getting to the heart of the problem. With your tenacity, this will make you a more knowledgable & healthier (in the future) cyclist. Use the winter to heal, learn to spin and work on flexibility & aerobic capacity. You will be glad for it in the spring.

Sorry for the reality mirror, but if your friends can't be straight with you, who can.

Len
Anyone need a ticket for the HILLY HUNDRED?Kristin
Oct 2, 2001 8:47 AM
I'm torn between Dougs message about pushing past the pain (read: don't be a wimp and quit) and not being stupid. I hate wasting money and quitting, but if I hurt myself worse, my strength training goals will be shot. So, it sucks, but I'm gonna cancel. If anyone hasn't registered yet who wants to go, I'll sell my spot for $20.
Sounds right to me! Tough but good for you. (nm)Len J
Oct 2, 2001 9:07 AM