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Pain on inside of kneecap(20 posts)

Pain on inside of kneecapclimbo
Nov 9, 2001 5:53 AM
I just developed a pain on the inside of my right kneecap last night. I started to ride home and it was just there. Every pedal storke around it was a sharp pain in one small spot on the inside of my patella. Problem is I have two races this weekend. Is there any kind of brace or tape strapping I could use to help me through? It's cross so I need it to stay on very well but not hinder my movement too much.
re: Pain on inside of kneecapmorey
Nov 9, 2001 6:09 AM
sounds like Chondromalacia, which is very common to people who ride bicycles. It is an overuse syndrome, which I am sure you are doing or have done. Try ice and heat 20 minutes of each. I would be afraid of wraps etc. because of chafing.
re: Pain on inside of kneecapclimbo
Nov 9, 2001 8:43 AM
ok, somebody at work here (ex-fitness instructor) thought it could be a bone spur? It came on suddenly last night and I've never had anything like this in 4 years of riding. Maybe it is, maybe not. If it doesn't go away after treatment with ice etc. does this mean it's more serious?
Nov 9, 2001 9:10 AM
I'd second this theory, especially if it is right under the patella (knee cap). The unfortunate thing is that although the inflammation will subside with Ice, Ibuprofen, and Rest, it can return. This phenomenon occurs when the knee caps "tracks" slightly out of alignment and the head of the femur abrades the cartilage on the under side of the knee cap.

A minor 'scope can clean out the scuffed up cartilage and provide great relief, and certain exercises can then strengthen the muscles around the knee cap to help with recurrence. Also my partner wears a certain kind of strap under the knee that supposedly helps while riding.

I'd go ahead and visit the orthopod.
thanks for the advice (nm)climbo
Nov 9, 2001 9:48 AM
re: Pain on inside of kneecapBroom-Wagon
Nov 9, 2001 9:50 AM
I have the same exact problem--only in my left knee. I had it scoped in '95 to smooth out the surface to reduce the abrasion. That helped but after each ride, it would get sore and sometimes feel weak. Nonetheless, it was manageable as I would rather deal with a little rest and ice than have to endure the sharp stabbing pains.

Then just last Thanksgiving weekend, the sharp pains reoccured. It so painful that I was on crutches for day and could barely manage stairs. I saw orthopedist and said it was probably due to a flare up and a reoccurence of Chondromalacia. He prescribed some Vioxx and the pain went away just like that. Other than occaisional soreness where I may take some Ibuprofen, it's been fine.

Before you decide on arthroscopic surgery, have your doctor prescribe something like Vioxx or Relafen to see if that will relieve the pain. If it works, then concentrate on strengthening your quads to support the knee.

Resort to surgery as your last option. The other method may take longer but in the long run, I think that you'll be better off.

Good luck
re: Pain on inside of kneecapmorey
Nov 9, 2001 9:54 AM
One thing that has helped me is Speedplay Pedals. I also take Vioxx or Advil after a long ride. Surgery for Chondromalacia is effective for that occurrence, but it will reoccur. Surgery should be the last resort!
anti-inflammatory med cautionTig
Nov 9, 2001 10:26 AM
COX-2 inhibitor anti-inflammatory med's are great, but a word of warning is needed. Most require that you take them on a full stomach. I found out the hard way that a snack and a Coke are not enough to prevent stomach irritation problems caused by Celebrex. I had to stop taking them and use Axid (GREAT stomach med!) for a week. After the week, all symptoms of a stomach ulcer were gone. So, learn from my experiences and save your stomach...
anti-inflammatory med cautionmorey
Nov 9, 2001 10:32 AM
This is true, always have some food in your stomach!
Supplementary to Good AdviceJon
Nov 9, 2001 11:30 AM
All of the above advice is great. It also reminds me of a thread on the racing forum where we discussed
the merits of weight training. And this is one of the primary ones. For some, a lot of cycling with
no muscle-balancing weight training, can result in disproportionately strong vastus lateralis muscles.
This can result in the kneecap being pulled out of alignment with the above-noted consequences. I've
got an Ironman-type friend who also had this problem. Consequently, he is now a proponent of
weight training to maintain proper muscle balance.
Supplementary to Good Advicemorey
Nov 9, 2001 11:33 AM
Having owned a health club for almost 30 years, I second weight training. The Caveat is do not become a bodybuilder or weightlifter, tough on the joints!
Okay. So which strength exercises are good?harper
Nov 9, 2001 11:43 AM
I've been diagnosed with Chrondo, but was told by my orthopod to rest, take an anti-inflammatory and stretch, with the latter helping a lot. The muscle imbalance makes sense, so which lifts should I perform? Squats, extensions?

P.S: my knees feel better the day after a ride than they do the day after I have stayed off the bike. Can anyone tell my why that might be so?

Thanks ------- harp
Ask Morey and PeletonJon
Nov 9, 2001 12:08 PM
For expert advice, ask the experts. From my limited knowledge, I would say squats performed with reasonable
weight and perfect form, as this exercise will strengthen the medial quad as well as the rectus femoris.
I would also ask your orthopod or a physical therapist about when it's safe to commence weight
training. You could also benefit from some expert assistance in the design of your program.
Ask Morey and Peletonmorey
Nov 9, 2001 12:20 PM
Believe it or not Squats are better, the caveat if done correctly. Most orthopedic places have you do leg extensions, this is exactly the movement that caused the problem to begin with.
You should also do some leg bicep work (which exercises depend a lot on how you are built) in order to balance out the quads. You should also stretch. I wish I could get into more detail here, however I can't. You should ask someone who really knows kinesiology (Science of Muscle movement).
Ask Morey and Peletonmorey
Nov 9, 2001 12:21 PM
Also, try not to use a narrow stance on squats!
Please see a doctorpeloton
Nov 9, 2001 2:06 PM
The thing about describing your injury over the internet is that no one can see you, and even less are qualified to say anything. In the case you have having medial knee pain, you may have chondromalacia or it could be something else. It's hard to say without seeing you, and only a doctor can diagnose anyway so what I or anyone suspects is really of dubious value. See a doctor so that you know what is going on. Even giving weight training advice is difficult in this forum. I agree with morey on what he says about weight training, and his view on a wide stance squat being better than it's narrow alternative. Although, for some rehab patients who are trying to reduce PCL tensile forces a narrow stance squat may be better. That doens't at all contradict what morey says (he's right), it just goes to show that your individual needs can require different solutions that are impossible to see here. I would also agree that the leg extension can aggravate a number of knee conditions, and if you were to have chondromalacia that exercise could cause you pain. It's so hard to say without seeing an individual and knowing what their doctor thinks in an injury situation. I would add that in my work I have never worked with an injured athlete without speaking with their doctor first. You have to know exactly what is going on before anything else can happen. See a doc, and know for sure what your best plan of attack is.
Nov 9, 2001 2:12 PM
My above post was more aimed at the original poster. For harper, I would really encourage talking to you doc and seeing why rest and ice were prescribed for yourself before doing anything else. There may be a reason for it for now. If you don't like the answer you get, see another doc and maybe you will get a more progressive rehabilitation. Sometime though, rest and ice are great and can't be beat. After that though, you will want your PT to really show you how to do the exercises anyway to get the best results for yourself. Weight training is great, but it has to be done right for good results, so proper instruction on form is key.
don't worryclimbo
Nov 9, 2001 2:47 PM
I will. Not going to ruin for knee for anything. As soon as I get back home next week, I'll check out a doc. Hopefully it'll have subsided a bit by then. I had a roll around tonight and it felt much better than yesterday. Nothing strenuous, just a light, short ride. Ta.
I got through 2 races this weekendclimbo
Nov 13, 2001 10:34 AM
so it seems better. I did some icing treatment on and off on the Friday and it went through no problems the whole weekend. Hopefully this means it won't come back immediately but I'll know what it is if it does. Thanks.
Disclaimer: I'm no docter...Stampertje
Nov 9, 2001 12:11 PM
...but in general, free weights are better for developing balancing muscles than machines. When I sprained my ankle a few years ago, my fysio had me do lunges. Squats and step-ups should also be good. Then again, I hope someone more knowledgable can give me some hints, too.