Pain Behind Knee (back of leg)

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Pain Behind Knee (back of leg)

Postby foo on patrol » Wed Dec 26, 2012 6:59 pm

Ok, really cheesed off at the moment.

Yesterday when I took off for my ride I had a clicking in my knee for around 5mins and then went away (25Ks) on my ride. Then did 8klm on the MTB and around 2/3Klm of walking.
The pain is or feel like it's behind the I don't know what it is but a ligament or tendon that runs from the low to the upper part of your leg. When I start to crouch down my leg wants to give way on me. Any ideas of what this maybe? :? :evil:

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by BNA » Thu Dec 27, 2012 6:40 pm

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Re: Pain Behind Knee (back of leg)

Postby Snicks » Thu Dec 27, 2012 6:40 pm

First question would, I suppose, to be to ask whether or not you've changed anything thing with your riding position/load recently?
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Re: Pain Behind Knee (back of leg)

Postby foo on patrol » Thu Dec 27, 2012 7:44 pm

Yeah I moved my cleats back about 3mm and dropped my seat around the same but that was three or four rides ago. Not knowing the correct terms for these part of the anatomy, it makes it sound a bit vague when I describe it. :oops:

Think where your lower and top leg bones come together and you have the knee cap over the front and the back there is a tendon or ligament runs between the two. the pain feels like it is in behind this tendon/ligament but the cracking was on the inside just below the knee cap. This morning I went for a easy 10klm and it cracked away merrily for about half a klm and then stopped but you could tell there was something still not right. :evil:

I'm joining a group on Bribie tomorrow for a 30/35klm ride so I will see how things go. Really is anoying because I have this opportunity to do some Ks and drop some weight and then this happens. :roll:

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Re: Pain Behind Knee (back of leg)

Postby twizzle » Thu Dec 27, 2012 8:59 pm

Go and see a doctor! Clicking could be something simple like a tendon catching (still bad) or cartilage damage. Knee collapsing under you suggests something isn't working properly at all. ACL tear?

Chick at work had a bone spur in her shoulder that wore through a tendon, had to have surgery to correct, six weeks before she could even start physio.


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Re: Pain Behind Knee (back of leg)

Postby Snicks » Fri Dec 28, 2012 12:19 am

By rule of thumb I would agree with twizzle, a doctor is probably your best bet.


Excuse the continual questions but is there any major reason why you moved your cleats back 3mm and your seat down 3mm?
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Re: Pain Behind Knee (back of leg)

Postby toolonglegs » Fri Dec 28, 2012 12:21 am

Are we talking back of knee cap or back of the knee?
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Re: Pain Behind Knee (back of leg)

Postby foo on patrol » Fri Dec 28, 2012 5:11 am

Pain is at the back of leg and to the inner side of where the two bones meet TLL.

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Re: Pain Behind Knee (back of leg)

Postby toolonglegs » Fri Dec 28, 2012 6:07 am

Bit different to mine... I get a bit of pain behind the knee in the tendons, hamstring... especially when they are tighter than mormal, also when on the TT bike it is lore noticeable.
But crouching is becoming a problem, when I crouch it become really painful to straighten my leg out again ... luckily I don't crouch too much!.
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Re: Pain Behind Knee (back of leg)

Postby winstonw » Fri Dec 28, 2012 8:52 am

Unlikely a rear tendon would cause your knee to collapse when squatting...that's more a symptom of a medial meniscus tear. Some slips from the hamstrings attach to the rear horn of this menisus. When you lowered the saddle, you might be bending your knee more and engaging the hammies more, which could be irritating a pre-existing compromised mm. If you press around on the tendons and cannot reproduce the pain, then it is most likely coming from inside the joint.

OTOH, repetitive clicking could be caused by tendon, joint capsule, inflammed bursa, or mm.

If you see a GP, better to see a sports physician. Some GPs don't do comprehensive orthopedic examinations.
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Re: Pain Behind Knee (back of leg)

Postby foo on patrol » Sat Dec 29, 2012 5:38 am

I will have to give this some thought Winstonw. The ride Did yesterday it didn't bother me and the pace.....when I was able to stay on the bunch was ummmm a lot quicker that I was used to doing by my loansome. :oops: (see QLD section Bribie ride)

Going out for another now and see how it is. :)

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Re: Pain Behind Knee (back of leg)

Postby foo on patrol » Tue Jan 01, 2013 4:15 pm

Well I gave it a break for two days to see if things would settle and the ride was between 30-35Ks and it cracked for the first 300mtrs and stopped. During the ride I never noticed any discomfort. :D I put my seat back up by 3mm and took out one of the headset spacers, this with having moved my cleats back around 3mm, sees' me a bit more comfortable on the bike. :)

But the area is very iffy when moving around normally ie; standing to sitting and back up, twisting like when you turn to look around and pushing back the office chair whilst on the pooter.

If you took a string line and went from the crease at the back of your leg and went the knee cap on the front. Then taking that line you go from the crease are to the inside of the leg and up to like the knob on the side of the knee, this where the pain area is. I don't know if this has anything to do with my current problem but I have been extremely tight up through the back of the leg for quite some time, like the hamy back down to the top calf. I think I just need shooting. :mrgreen:

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Re: Pain Behind Knee (back of leg)

Postby Dr_Mutley » Tue Jan 01, 2013 10:43 pm

If u moved your cleats back 3mm, then u need to, as u did, drop your saddle height accordingly. Sounds like u need to drop the height more than 3mm... U may also want to think about moving the saddle forward a few mm, as by moving your cleats back your effectively placing yourself further behind the BB. All the above means your riding with a straighter (more extended) knee, and reaching forward a little more with your stroke. All of which places more strain on your posterior (behind the) knee structures.

If u want to run a more rearward cleat position, try dropping your saddle height a little more, and sliding your saddle forwards a smidge too..,
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Re: Pain Behind Knee (back of leg)

Postby twizzle » Wed Jan 02, 2013 10:26 am

My mother really enjoyed getting her partial knee replacement. (Not!) If she'd had the cleanup of the damaged cartilage a few years earlier than she did, she might not have needed to have the kneecap and groove replaced.

Take this as a cautionary tale.


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Re: Pain Behind Knee (back of leg)

Postby Dr_Mutley » Wed Jan 02, 2013 10:47 am

twizzle wrote:My mother really enjoyed getting her partial knee replacement. (Not!) If she'd had the cleanup of the damaged cartilage a few years earlier than she did, she might not have needed to have the kneecap and groove replaced.

Take this as a cautionary tale.


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Did she move her cleats on her shoes too?
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Re: Pain Behind Knee (back of leg)

Postby twizzle » Wed Jan 02, 2013 10:57 am

Dr_Mutley wrote:
twizzle wrote:My mother really enjoyed getting her partial knee replacement. (Not!) If she'd had the cleanup of the damaged cartilage a few years earlier than she did, she might not have needed to have the kneecap and groove replaced.

Take this as a cautionary tale.


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Did she move her cleats on her shoes too?


No, but her knee wasn't giving way under her either.

Pussy-footing around the real issue with BS about 3mm changes in position being the cause isn't helping. 3mm in a seasoned cyclist might result in tendonitis or similar, it doesn't cause your knee to click and give way.


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Re: Pain Behind Knee (back of leg)

Postby Dr_Mutley » Wed Jan 02, 2013 11:08 am

twizzle wrote:
Dr_Mutley wrote:
twizzle wrote:My mother really enjoyed getting her partial knee replacement. (Not!) If she'd had the cleanup of the damaged cartilage a few years earlier than she did, she might not have needed to have the kneecap and groove replaced.

Take this as a cautionary tale.


Sent from my iThingy...


Did she move her cleats on her shoes too?


No, but her knee wasn't giving way under her either.

Pussy-footing around the real issue with BS about 3mm changes in position being the cause isn't helping. 3mm in a seasoned cyclist might result in tendonitis or similar, it doesn't cause your knee to click and give way.


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Quoting BS anecdotes from your journey through isn't either doc... ACL tear? Give us a spell...
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Re: Pain Behind Knee (back of leg)

Postby winstonw » Wed Jan 02, 2013 3:11 pm

foo on patrol wrote:If you took a string line and went from the crease at the back of your leg and went the knee cap on the front. Then taking that line you go from the crease are to the inside of the leg and up to like the knob on the side of the knee, this where the pain area is. I don't know if this has anything to do with my current problem but I have been extremely tight up through the back of the leg for quite some time, like the hamy back down to the top calf. I think I just need shooting. :mrgreen:

Foo


Foo, if I follow you correctly, the knob you are referring to is the medial epicondyle of the femur (google it to confirm).
Pain with pressure applied to this indicates the proximal part of the medial collateral ligament is involved. There might also be a small friction preventing fat pad (bursa) that is irritated as well.

However, at your age :), it is common for this ligament AND the medial meniscus to be simultaneously compromised.
The ligament is often a less troublesome and secondary injury to damage to the meniscus. The ligament has a better blood supply and heals better than the meniscus. And as I alluded earlier, giving way of the knee is more a symptom of compromised menisci.
I can't be bothered reading back over what you said earlier, but I am unclear if your main pain is the side or rear of the knee.
You can reduce irritation of the medial collateral ligament during pedaling, by not straightening your knee as much, AND ensuring your knee is not moving excessively towards the top tube when you push down. This latter point is often achieved by using medial cleat wedges to elevate the ball of the foot.

Anyway, pointless of me to say more without clinical examination.
A GP, sports physician, or sports physio, all with a seasoned interest in cycling would clarify.
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Re: Pain Behind Knee (back of leg)

Postby Dr_Mutley » Wed Jan 02, 2013 4:57 pm

foo on patrol wrote:The pain is or feel like it's behind the I don't know what it is but a ligament or tendon that runs from the low to the upper part of your leg.


I just assumed from the description here, and the title, he was prob referring to his medial hamstring insertion... Now reading the later posts more carefully it sound like his medial epicondyle foo's describing? Where's the little confused icon thingy?! ;-)
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Re: Pain Behind Knee (back of leg)

Postby foo on patrol » Wed Jan 02, 2013 7:13 pm

Dr_Mutley wrote:
foo on patrol wrote:The pain is or feel like it's behind the I don't know what it is but a ligament or tendon that runs from the low to the upper part of your leg.


I just assumed from the description here, and the title, he was prob referring to his medial hamstring insertion... Now reading the later posts more carefully it sound like his medial epicondyle foo's describing? Where's the little confused icon thingy?! ;-)


:? Here it is.

I don't know any of the techo terms but like I say, over I'm guessing now, it would be a couple of years, I would have this real tightness up the back of my right leg. I have felt it was the hammy or sciatica nerve all along but when I started to get this clicking (like when you crack your fingers) in my knee cap and then the pain around the back of the leg, when trying to crouch or kick something away, I sort of lost any hope of figuring it out.

I will see how it all goes after the end of this week and see if it settles, then decide if I should see a Dr. :wink:

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Re: Pain Behind Knee (back of leg)

Postby winstonw » Thu Jan 03, 2013 10:46 am

Foo, keep in mind you may have several things going on simultaneously.
The loud crack "in my knee cap" might just be arthritic degeneration of the cartilage between knee cap and thigh bone, combined with compromised knee extensor action. The pain with crouching may be any of the things mentioned above.
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Re: Pain Behind Knee (back of leg)

Postby foo on patrol » Thu Jan 03, 2013 5:45 pm

Yeah now worries Winstow, I think I have some nerve issues going on as well as I had plenty of pain stemming from my lower back through the groin and down the back of my right leg this morning. The bit that branches out from the spine each side on top of you hips, if that makes sense. :oops:

The only way i could get relief was to lay on the floor for half an hour and do some stretching and that seem to have eased it off a bit. Anyway I think I will try and get into the Drs next week.

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Re: Pain Behind Knee (back of leg)

Postby twizzle » Thu Jan 03, 2013 10:30 pm

Dr_Mutley wrote:
twizzle wrote:No, but her knee wasn't giving way under her either.

Pussy-footing around the real issue with BS about 3mm changes in position being the cause isn't helping. 3mm in a seasoned cyclist might result in tendonitis or similar, it doesn't cause your knee to click and give way.


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Quoting BS anecdotes from your journey through isn't either doc... ACL tear? Give us a spell...


Simply trying to point out that he's much better off getting it looked at properly instead of trying to ride through it and work it out through trial and error, potentially suffering avoidable consequences.

Apologies for the BS comment - but I am incredulous that someone would suggest that 3mm changes in positioning would make it O.K. to just keep on going with changes instead of finding out exactly what had gone wrong. Having built a model in excel previously for calculating effects of changing saddle position, I am also very aware that 3mm in cleat position would result in a lesser change in saddle height, not greater, and that there are so many variables related to ankle angles during the pedal stroke that make it impossible to make assumptions about how it affects knee angles. The 3mm change in saddle height is a more significant change (compared to cleat), but it's "princess and pea" territory at 3mm.

At the end of the day he has knee pain and stability issues that could be completely unrelated to the changes he made to the bike, and IMHO it's not worth waiting to see what happens by riding through it.

Then again, it's not my knee, so I'll just refrain from commenting at all.


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Re: Pain Behind Knee (back of leg)

Postby Dr_Mutley » Thu Jan 03, 2013 11:14 pm

Keep on being incredulous, and playing with excel :-)
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