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Knee pain questions (big surprise there)(4 posts)

Knee pain questions (big surprise there)Rob March
Jul 24, 2003 8:58 AM
Hi all,

Some months back, I wrote on the board about some issues with my knees. After badgering my general practitioner, and finally getting MRI's and a visit to an orthopedic specialist, I was told that my kneecaps are tilted.

My friend who is a physical therapist also told me that it was likely due to the pronation of my feet (they are super flat). Even though I use Specialized bike shoes (built in orthodics), she said she could still see the pronation in my knees. I inserted additional orthodics, and she was much happier with the result. In addition, she gave me all of these exercises for strengthening my VMO muscles (which she showed me were very weak).

So, I'm doing my exercises every other day, and riding twice a week. I commute for one ride (15.5 miles RT), and generally take a longish ride of 30 miles over the weekend.

My questions are:

1. What is a good cadence if I want to heal faster? I've been trying to keep it at 100+, but sometimes my butt bounces on the saddle.

2. Should I get a HRM immediately, so that I can tailor my rides a little better? I've just been spinning like mad, and it seems like I may be working too hard on my knees anyway.

3. Anyone have any experience with this and the potential recovery time?

Thanks for the help.

I have some bad news for you....funknuggets
Jul 24, 2003 9:33 AM
There is no definitive answer for any of your questions, unfortunately. Your physiological differences are largely unique to you, as is your propensity for healing and increased stress on this area.

1. For healing purposes, I would have to suggest you not force a high cadence until you are sure you knee is healed and your muscles are adequately strong. A different angle and forced motion (orthotics) will likely either exacerbate the current problem, or create another one if you immediately start spinning like crazy before your muscles are ready. I think using a light gear is wise, but I would just try and cycle without pain and use proper technique before worrying about cadence which should be viewed more as a training and cycling style and method, rather than a recovery tool.

2. HRM will do nothing for your knee recovery. When training regularly, and especially recovering, the HRM is an invaluable tool. It all depends on your training school of thought, however. HRM will have little to do with cadence and how hard you are working your knee. Heal your knee and get to riding without pain, then focus your training using the HRM when you have recovered. Getting it now will provide you little benefit as it pertains to your knee.

3. Knee problems are one of the most elusive and extremely individualistic structural injuries that a person can have. It all depends on the individual, but if you rest and recover correctly, and properly strenghten the supporting muscles and tendons first... your recovery time will be much less than someone who jumps back into things too early. Work with your ortho and your friend to develop specific objective methods of measuring your recovery and when you can start to train again. My best advice, do not do too much to soon, It could be catastrophic.

Best of luck.

So sayeth the funk,
As painful as it might seemJervis
Jul 24, 2003 12:51 PM
(the lack of riding, not your knee) I'd stay off it for a couple of weeks. Being 20 and in college I can't really afford an orthopedic checkup for my knee, so I've just lay off the bike totally. It's been two weeks now, and I think I've ridden my single speed beater bike with platforms probably 10 or so miles over these two weeks, and my knee still hurts a bit when I try and push. I always heal pretty fast so this is rather odd, and I assume a somewhat serious injury that could hurt me in the long run if I don't take care of it. I'd stay off the bike for a while with maybe a very very light ride a couple of times per week to strengthen/test the muscle. Make sure you consult with the doctor you've been seeing periodically to make sure things are improving and take it really easy. It really sucks (for me anyway) being off the bike for this long, but here's the way I figure it: You might be off the bike for a couple of weeks, or even a couple of months, but if it heals your knee and provides you with many more painless years of riding to come, I say it's worth it. But that's just me, you could be one of those die-hard-will-ride-unless-it's-over-a-class-5-tornado kind of guys (in which case you need to calm down). I also agree with funk, leave your cadence alone and simply pedal at what's comfortable. Leave the training for later. Good luck and take it easy.

As painful as it might seemRob March
Jul 24, 2003 1:07 PM
I'm not a ride or die kind of person. That said, my diagnosis is that I haven't actually injured myself. The tilted kneecaps result in irritated cartilage, which is the source of my soreness. My orthopedist and my physical therapist both want me to continue to ride, but just to not overdo it. I just need to figure out what that means. I think I need to strengthen my legs to the point where everything is back in proper alignment, and then I will heal at a faster rate than I'm currently seeing.

Another thing about the pain is that I rarely feel anything during the activity. It is the next day that I tend to be sore. Thus, I've also been using alot of ibuprofen (Vitamin I) and ice following my rides/workouts.