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knee: the verdict(17 posts)

knee: the verdictJS Haiku Shop
Mar 22, 2002 8:32 AM

several xrays and refered to a sports med doctor/orthopedist, who relegated me to a minimum of 2 weeks physical therapy. the PTist is a triathlete/cyclist, and there are pics of Lance around the shop. not a bad sign.

doc says my kneecap is a little off-center in the "cup", and it can be caused by a muscle (quad? itb?) in the leg pulling it out of place, which is due to a "biomechanical" issue on the bike. this bike issue is supposedly pedaling "knee-in", or knee closer to the top tube, and mashing. after one session, the PTist says 99% likely it's ITBS, since there's no swelling, pain through normal movement, and no loss of motion.

they advised me to keep a light spin on the trainer every other day, no resistance for at least 2-3 weeks. PT consists of pushing and pulling on my knee and outer quad, some isolated message, and lots of stretching and some leg lifts without weights, and direct "ice therapy."

how long is this going to take? i've been off the bike for 3 weeks and in PT for one week and not seeing any change/difference. i did take a 20 minute spin around the block a couple days ago (low gears, zero resistance), and it felt pretty darned strange. of course, i have zero confidence in my leg/knee now, but it still felt pretty weird, that considered. is this all normal, and i'm just way impatient?

also, if this isn't a torn anything, and ITBS is simply a muscle rubbing over a bone in the wrong place, am i doing any harm when riding hard? hey--i'm a hypochondriac, and won't go out and hammer when i'm injured. in fact, i'm having to remind myself NOT to favor that leg, since it seems natural to lay off that side to speed recovery. but...i'm just wondering. what's really happening under the skin here?
Question on the knees in.LLSmith
Mar 22, 2002 8:46 AM
I had a fit/adjustment session last week. My seat was moved forword and up. It was also suggested I try to keep my back flat and knees in. After about 2 miles on my first ride my knee started to hurt.By the end of my third ride I had moved my seat back about 3/4". No real problems during ride 4 and 5. During yesterdays ride while trying to keep knees in and back flat my knee started hurting at about 1 mile. Did the Doc say part of your problem was because you were keeping your knees in?
yupJS Haiku Shop
Mar 22, 2002 8:49 AM
keeping the knees in as opposed to the natural line of my knee/leg in the revolution. in other words, my knees are "unnaturally" in. reason it happened on one leg and not the other was probably because that leg is either dominant, stronger, or both.
Pedal Float?Me Dot Org
Mar 22, 2002 9:00 AM
I have no idea whether this could be related to the problem, but do your pedals have enough float? If you're using Look or Shimano, you might consider Speedplays. They made a difference for me.
Pedal Float?netso
Mar 22, 2002 9:43 AM
Speedplay Pedals solved my problem also!
Pedal Float?JS Haiku Shop
Mar 22, 2002 12:01 PM
typically i ride look, most recently either with 9* float dialed-in on pp296, or with the red cleat that also gives 9* of float. however, over the last four months, i've been on mtb pedals with 4* float. so...guess i'll be looking for another system there. i'd be moving back to the geared bikes about this time in the season anyhow, and the 4* pedals are on the SS, so...So Be It.
Iliotibial band syndrome???Quack
Mar 22, 2002 9:13 AM
You didn't indicate whether you have been training through the winter but I once suffered from IBS as well. The physical therapist basically said that due to insufficient training, the inside of my thigh was now stronger than the outside and it was causing a ligament to snap across the outside of my knee. It can be verified by standing with a straight leg and flexing your quad. If your knee cap pulls to the inside or outside, that's a problem. It's supposed to go straight up and down when you flex.

Light weights, a knee brace, and religious stretching took care of mine in less than a month and I even lost the brace at that point.

Good luck!!
Do what the Dr. says.look271
Mar 22, 2002 10:41 AM
Take it easy. These kinds of things take time. Get it healed properly so that it doesn't lead to further problems. Good luck.
How long did the problem persist before you sought help?Slipstream
Mar 22, 2002 10:52 AM
A doctor once told me that there are two aggravating factors when it comes to tendons: uneven muscle development and too fast muscle development

Tendons take a lot longer to develop than muscles. Tendons can take 6 months longer than muscles. Because of this, most people think that just because they are feeling strong they should push it to the next level. Wrong. That is when you aggravate a tendon. The longer you push it the longer recovery takes.

So, follow your PTs advice; don't push it; take your time
How long did the problem persist before you sought help?JS Haiku Shop
Mar 22, 2002 11:44 AM
it hurt after two days of hard SS riding.

took five days off the bike in case it was an injury.

on the next ride, it felt funny, then started hurting again two hours into the ride. i one-legged it home.

took eight days off the, it still felt a bit funny, went to the doc, then the orthopedist, then it's history from there. long? about two weeks, with hardly any riding in there 'cuase i knew there was something amiss.
Keep the moral up. This is not so bad.tempeteKerouak
Mar 22, 2002 10:56 AM
Take this opportunity to work on something new.

-upper body strenght; much needed to move around on the bike. Work for resistance, not power.

-back and legs suppleness, stretching; do you have any idea how much you can improve overall performance, recovery, efficiency by being confortable at touching your toes???

-mental imagery (picturing you doing a perfect spin), keeping a tuck on the drops longer. It will help.
With this, try it on balancing exercises. You will find something new again. Improved balance and concentration.

Take some time to examine your diet. Instead of putting on weight, you might find a motivation in loosing some.

Lastely. Find a house chore you've been procrastinating around and about on. Do it. Don't feel down by doing nothing. That is something positive. Every achievement is positive. Improving your condition is an achievement only you can get. Not a doctor. They help and guide, you do the work.

Taking up swimming should not make you worse.
Remember it probably took time to hurt yourself like that,and it will take some to heal and change the habit that caused the trouble. Use that time.

You can come out of an injury stronger and better.

aha! good words...JS Haiku Shop
Mar 22, 2002 11:51 AM
oh, the things around the house to be done are endless. however, i'm parting the list like charlton heston did in that movie...what was that movie? anyway, it's either do whatever around the house, or pace a rut in the floor. i've also been concentrating on upper body strength work, but there's only so much you can do before you have to lay back and recover for a few days. it's not like i can work out for six hours on saturday. this is one of the things that are really getting to me...

i've considered swimming, but that would mean (1) getting a membership somewhere, and (2) learning to swim. not that i don't know, but it's rather like watching a cat cross a swimming pool. i'm not very good at it.

thanks for the thoughts. good advice! i'm really concentrating on what i can eliminate from my diet to accomodate for nine beers per night. i really need some sedative to keep me from breaking these "rusty chains."
Suffered ITB for a long time because...mlbd
Mar 22, 2002 11:27 AM
I never took care of it right. luckily, it barely affected me on the bike. my problem was running. instead of taking some time off from running AND biking, i just kept biking. every time i tried to run again it would come right back. i went on like that for 2 years. finally this winter i took 2.5 months off from both. i lifted, stretched and swam. it seems to have help though i haven't really tested the knee yet (in running that is).

unfortunately, my HMO was not interested in anything that wasn't life threatening so i had a hard time getting sound advice. sounds like you're getting good care. i'd follow there advice, take some time off and stretch, stretch,stretch.

good luck!
Advice on ITB stretchesmtber
Mar 22, 2002 12:14 PM
Could you pass along some of the ITB stretches that you do? I have a VERY tight ITB on my left knee, following an ACL reconstruction, and need to loosen it up. Tanks in advance.
Suffered ITB for a long time because...Far916
Mar 23, 2002 7:00 PM
Man this whole tpoic really hits home right now... About a month ago I pulled something in my left knee running (crosstraining). I had just started running/biking again in january trying to get ready for a couple duathons in april/may. Anyways I kept off everything for like 2 weeks, then I started back up with running and biking, at first everything was OK, then when I started running, there went my knee again, not as bad as it did the first time, but I felt like the top of my knee, just above the cap, was on fire, it feels like the muscle was just like 'floating' above my leg as if it were coming apart. Ive gone on a couple low intensity bike rides since then, but I can really tell somethings wrong. Anyways I have a docs apt for this on monday, and I hope everthng will work out, im going crazy on what to do/not do about it. Its very depressing anyways I hope the original poster lets me know how things work out...

re: how longcyclopathic
Mar 22, 2002 1:18 PM
I'd say 1.5-3mo, not ness off the bike. take it easy no force workouts spin don't mash and stretch stretch stretch.

Anytime you work out try to pay attention to the way your knee goes keep it straight. you need to learn to pedal correctly good luck.
re: knee: the verdictgtx
Mar 22, 2002 9:40 PM
I recently dealt with this exact same issue and was off the bike for several months. I think the ITBS diagnosis is the latest catch-all for knee problems. I was told the same thing by a doc, but frankly, it didn't make sense to me. What I personally felt was this: I'm really tight, and my knee cap is grinding/crunching, and my knee is starting to hurt. Well, then a friend who has been through several knee surgeries turned me onto this stretching book, which has been recommended by a PT. So I got the book. Hey, in the book it even says, "overly tight quadraceps can compress the kneecap against the joint." Well, that made sense to me. I started the stretch program--a fairly new method used a by a lot of elite atheletes--and bingo, I loosened up considerably and no more knee trouble. In fact, my knees feel the best they have in 17 years of fairly serious riding. Check it out. Good luck.