How long does it take to build up?

[ozstriker]

Im having trouble with my left knee.

I get pain right across the top of the knee cap, and also sometimes dead center of my knee cap where it feels like its bruised when i push on it.
Its only really painful if i leave my leg bent for a while then go to extend it.

Then after about 24 or so hours, its about 90% gone with only a slight niggle left, then the day after that it is as if it was never there.

I have only started to get back into cycling after 2 years off, i have been going for about 2 months now.

Does this sound like im building too quick?
Muscle Imbalance?

I like to hammer myself on hills, which probably isnt helping.
But how long should it take to build enough that you can hammer yourself without the pain.

[trailgumby]

Sounds like you need a trip to see a cycling-specific physio.

As a layman, I'd suspect patellar tracking problems, which can be caused by muscle imbalances pulling it to one side. Normally it is the patella being pulled slightly to the outside that is the issue, and seated leg extensions (weights machine) where most of the effort is expended in resisting the release of the weight (I thnk it's called "eccentic contraction") are usually the recommended rehab exercise.

[RonK]

What makes you think that you can ever hammer yourself without pain?

[ColinOldnCranky]

What makes you think that you can ever hammer yourself without pain?

Which may be true. Do not hammer yourself. The "No gain without pain" is an outdated and dangerous slogan of the seventies.

Step off the pedal for a while while you recover. I am an old man and things take longer to correct themselves every year. But I have found that I have been able to continue riding each day and still recover. But I DO pay close attention to what my body is telling me at those times and ride accordingly.

I also had a knee problem years ago when I started using cleats - correct alignment fixed that.

btw I used to get a sharp but not extreme pain in my right hip on the first downhill every morning (unicycles are fixed wheel). It worried me that eventually it would stop me riding as it was persistent over a long time. But a physiotherapist noted something when I could not balance on my right leg - my adductors were not pulling the right leg inwards as they should. A simple exercise (balancing on the right leg with a bent knee) and the problem has gone. Perhaps you could benefit from some specialist advice.

[AndrewBurns]

I had knee pain when I first started riding in decent volumes, ended up so bad that I could hardly walk and went to the physio. I got some exercises and stretches to do which helped a lot and then I went to get a proper bike fit.Turns out my seat was significantly too high and a few other changes needed to be made, now I can cycle pain-free as much and as hard as I want so for me it was worth it.

[trailgumby]

ozstriker, where do you live/work?

It might be possible that a forumite can recommend someone local. Not all physios are equal.

[ozstriker]

Im in toowoomba so im guessing cycling specific physios will be few and far between.

I dont really see it as too much of a problem only because it fixes itself pretty quick, or is most cycling knee pain like that?

[ozstriker]

The only reason why i think its from building too quick is because if i go for an hour and a half easy spin (which is very hard for me) i dont have any dramas with my knee

[foo on patrol]

an hour and a half easy spin / i dont have any dramas with my knee

This statement here, tells me, you're pushing to hard to soon!

Foo

[trailgumby]

Im in toowoomba so im guessing cycling specific physios will be few and far between.

May be, but if you don't ask you don't get.

WRT to your second comment, that's how long term over use injuries usually start. At the very least, listen to your body.

[Addictr3]

are your cleats on the left foot to far forward? or are the aligned the same with your right shoe? Do you have a longer left leg? I'd drop your left cleat back a touch and also observe yourself pedaling in a mirror, see if you left foot is toe down while looking at how your right foot sits?

Also how is your power balance from left to right (leg) do you push more with your left?

[wombatK]

The only reason why i think its from building too quick is because if i go for an hour and a half easy spin (which is very hard for me) i dont have any dramas with my knee

Cycling is one of the most knee-friendly exercises you can come up with - that's why the saw-bones recommend it, or rather demand it, for knee replacement patients. If you're getting knee pain, something is wrong. Assuming you don't have a prior injury from another sport/exercise you do, have you thought about bike fit issues ? Have you ever had a professional bike fit done ? Would expect that toowoomba would have an LBS with the capability.

[ozstriker]

Ive started to stretch daily to try and combat this, but when i do my itb stretch i get a pain on the inside of my knee is that a normal part of that stretch?

[PawPaw]

Oz, you don't have the vocab to explain your symptoms clearly enough for a medical professional, let alone anyone else, to give you specific advice here.
If you want a diagnosis, go and see a GP, physio, chiro, osteo, crystal therapist.
Knee pain is hard enough to pin down accurately with a dozen orthopedic tests, let alone on an internet forum with fuzzy descriptions.

What you have mentioned so far could be quadriceps tendonitis, a cyst, bursitis, patellofemoral pain syndrome, osteochondroma, medial collateral ligament sprain, medial meniscus acute trauma or degenerative change, loose body in the pf or knee jt, etc, etc.

I think you get it that you've ramped up climbing volume and intensity too quickly.

As for how long it takes to build up, depends on age, skeletal alignment, previous trauma, lifestyle (diet, stress, sleep, knee use for other than training).

[misterhorsey]

I had knee pain when I first started riding in decent volumes, ended up so bad that I could hardly walk and went to the physio. I got some exercises and stretches to do which helped a lot and then I went to get a proper bike fit.Turns out my seat was significantly too high and a few other changes needed to be made, now I can cycle pain-free as much and as hard as I want so for me it was worth it.

This was/is my situation - seat too high, cycled through the pain, injured and off the bike for six months. Got a bike fit, and only just getting back onto it.

If you feel pain, you're doing something wrong. Quads get overworked, hamstrings and glutes underworked = patella gets misaligned = pain and inflamation. At least, that's one scenario.

[ozstriker]

Its definitely training volume/intensity.

Even last week i noticed, i was doing light spinning on the wind trainer monday tuesday thursday concentrating on maintaining 130 BPM, and after those workouts completely pain free, i thought great must be getting better.

Then saturday i went for a group ride and after 10k's i could already feel it, not so much pain as a tightness that i know its coming.
Its definitely hard to keep intensity down in Toowoomba considering everytime i hop out the front door im starting at a hill.

So after that ride, the pain was back, took yesterday off, then went for a ride this morning and stupid me went too hard again.

Checked my strava after the ride and i averaged 160 BPM over the hour .

The problem is i feel strong powering up hills its just the after effects.
How can it be that your muscles/joints feel capable but then whinge at you after.

[dyson.ross]

many fixie hipsters in the hilly suburbs of sydney face the same problem as yourself. stomping big gears all day is bad for you. you're putting too much pressure on your knees to without warming their tiny muscles up.

use lower gears or try to start your rides on a flat for for 5-10 minutes. i personally always start my rides going downwind, even if it makes my course longer. just to start from a relaxed position.

[tralph7]

I had something similar at the start of the year. Do something about it ASAP or it gets worse... maybe even where the fat pad under your knee gets pinched between the two bones and you'll be off the bike for a few months! Not fun.

I'm not a medical professional so you might want to get expert advice, but main thing I did was to check the bike set up. Firstly and foremost, my saddle was way to low... therefore you don't use the inside muscle of the quad at all as it only comes into play the last 15% of leg extension or something... then the other muscles build up and pull the patella sideways. I think I ended up raising my about two inches. Your leg knee is supposed to be on a 30 degree angle or something. A quick (body geometry) check is to put your armpit on the saddle and then your index finger should touch the top of the crank.

Another thing is to have your knees going as straight as possible. Check the cleat positions.. If you have a high arch you may need to get some inserts into your shoes too. As you push down without the support the arch flatters and turns your knee inwards from its natural movement. I ended up getting pretty high arch supports and some toe pieces (can't remember their real name) too as the ball of my foot isn't really flat... as most peoples aren't.
Something i did was to set the bike up on a trainer and have a camera in front and on the side just to see how everything moves and then make adjustments to make them move properly i.e. knees at about 30degrees, over the top of the pedal when at the top of the stroke, knees going straight up and down no weird angles!

My tip would be to check the set up of everything... if you can get a bike shop guy to do a proper fit. Maybe tone down your training a bit and nip it in the bud. Ease of your riding a bit and work your way back into smashing those hills! But you shouldn’t be getting that pain. You should only be getting that good old pain of score muscles.

Another thing... if the pain keeps coming back you’ll need to stay off for a while. Because of poor blood supply to the affected area it takes ages to come good.

Good luck

[wurtulla wabbit]

Since this is a relevant thread, can I ask a question ?
I get a burn in my upper thigh tendon area (don't know tech term) when pushing into wind or climbing etc.
No pain or drama anywhere else at all.
90 mins of footy last night , 60klms of mixed hills and flats today in windy conditions and could have went on all day if it weren't for this burn.
Is it a "ride fitness" thing or adjustment ?
Ps, only done 2 real rides recently after getting into road riding.

[ozstriker]

Well ive given myself a week off

I thought i would give myself a week of light pedalling to see whether it would actually be therapeutic, as it turns out it is not, it only compounds.

So hopefully the inflammation will disappear over a week.
I just wanna ride for gods sake, i dont get it though, looking back 18 months ago i could go out all day every day if i wanted and it wouldnt bother my leg.

How long has it taken other people to get over Pattellofemoral pain syndrome?

[tralph7]

I had it about Easter time.... i took a week of then a light ride no differnce. another week. same. two weeks. Still got some pain. then i took 6 weeks off (it was too bloody cold and wet anyway) and have been on the trainer for about 4 weeks starting to get out on the road now.

Its a royal prick.

How'd you go with the bike set up?

[ozstriker]

Its funny because when i first got this bike i set it up with the same measurements of my last bike that i was measured for, and when i started getting the knee pain, i slowly started moving the seat up little bits at a time.

The knee pain seemed to be getting less and less each time although i think that was just because my body was starting to get used to it.
Until the sunday just gone when i moved my seat up once again, which is when my knee hit the wall and became REAL sore.

So i just went back and checked my seat and set it back to what it was on my old bike and i ended up lowering my seat 25mm

So i guess what this guy says is pretty spot on. I was actually raising my seat more and more expecting the pain to eventually move to the back of the knee, which didnt work at all it just made the front pain worse.
http://www.stevehoggbikefitting.com/blo ... can-it-be/
Steve eludes to the fact that at the bottom of your pedal stroke, if your seat is too high your knee will accelerate rearwards, which adds stress to the knee.

He says that most people have there seat set too high, which causes knee pain not just in the back but in the front.

So i guess ill just leave my seat where i know it has worked and be patient.

[waramatt]

an hour and a half easy spin / i dont have any dramas with my knee

This statement here, tells me, you're pushing to hard to soon!

Foo

1

About a year ago I got hooked on hills, and especially took a liking to tackling them on single speed. Anyway, I developed a very sharp pain in the centre of my left knee. Not when walking, but when kneeling. It was sharp, localised, and felt like a burning sensation. And it hurt like all hell. What did I do? Backed off the hills, started using gears for the climbs, learned to love the smaller chain ring and checked my bike fit. A few minor adjustments and the pain went away. I'm not anti getting medical help, I just don't think it should be the first thing one does.

Reading what you've written Oz, I think you've answered your own question. Try backing off a little

[ozstriker]

I should have taken my own advice, instead I was adamant it was a bike fit issue even though I set it up exactly as my last bike was where i had no dramas, so instead of it being a simple overuse injury it turned into tendonitis in my vmo from moving my cleats out and aft, then itbs from moving my cleats forward and inboard.

So my dimensions are now reset and I will just be patient.
Sometimes you just have to accept your no as strong as you think you are.

[waramatt]

That's all good Oz, but beware the grinding up those hills even with a perfect setup/fit.