Knee problems

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I've been working out an hr a day or more on my stationary bike for 3 years now (after a two decade lapse in being active.) Didnt have any problems physically until I went back to regular cycling a few months ago.

Now I have ongoing knee pains...first it was ilio-tibial band syndrome (which went away after a short rest period), then it was a seriously pulled calf muscle (which is almost gone now), and yesterday my right knee felt swollen and tight all the way around (not pain, really, just tightness and discomfort.) What does this last one sound like, anyone know? My legs have also started swelling up by the days' end, only to go away by morning.

I'm 43 years old, female, I dont know if that has any bearing onit. None of this was happening until I went back to regular cycling. Any ideas for relieving these symptoms, esp. the swollen/tight knee (its the knee and the back of it too...like a band around my knee that gets tight.)

I have been suffering ITB for 8 months now and I am pleased to say that I am now finally recovering. It started when I gave up ridding for a while and started running seriously in the winter. I have seen 4 physio therapists and I have done extensive research as nothing seemed to be working.

What I have have discovered is that it is a problem that women are more likely to suffer from then men. It is because of the way we are built, wider hips less inside leg muscle and bum muscles which puts more load on our knees. I started suffering other pain in my knees as well, similar to what you are describing and I really started to feel like I was crumbling or that I was just built wrong! Particularly standing in a group of physion therapists in my underwear!

Firstly I had to ditch running because it was the thing that caused it. Initially I had to ditch everything until the major pain went away. In physio they worked on reducing the scar tissue and different kinds of stretching. Once the acute pain went, it was up to me to start doing some serious work on building muscle that support my knees. These are the inside muscles in your legs particularly the big muscle on the inside of the knee. There are good machines in the gym for that. I also had to do some serious work on my bum! But focussing on the muscles just above the big glute muscles. Then I had someone look at my cycling technique.

Now I feel stronger and more powerful then I did before and I definitely feel like I put less load on my knees both running and cycling. Stretching and electrotherapy work to sort out the pain initially, but you need to look at building the supporting muscles for your knees for a long term solution!

Good Luck!

Originally posted by HellonWheels
I've been working out an hr a day or more on my stationary bike for 3 years now (after a two decade lapse in being active.) Didnt have any problems physically until I went back to regular cycling a few months ago.

Now I have ongoing knee pains...first it was ilio-tibial band syndrome (which went away after a short rest period), then it was a seriously pulled calf muscle (which is almost gone now), and yesterday my right knee felt swollen and tight all the way around (not pain, really, just tightness and discomfort.) What does this last one sound like, anyone know? My legs have also started swelling up by the days' end, only to go away by morning.

I'm 43 years old, female, I dont know if that has any bearing onit. None of this was happening until I went back to regular cycling. Any ideas for relieving these symptoms, esp. the swollen/tight knee (its the knee and the back of it too...like a band around my knee that gets tight.)

Iwas just scanning through knee injuries and noticed that you have a bit of tightness in your knee. Can you tell me nore about your injury? Does it lock up? pinch a nerve. swelling in the knee? let me know other symptoms, hopfully I can give you an answer.
I have a knee injury and hpfully you do not have what I have. Happy cycling Darren Alberta Canada

Iwas just scanning through knee injuries and noticed that you have a bit of tightness in your knee. Can you tell me nore about your injury? Does it lock up? pinch a nerve. swelling in the knee? let me know other symptoms, hopfully I can give you an answer.
I have a knee injury and hpfully you do not have what I have. Happy cycling Darren Alberta Canada

Originally posted by michele
I have been suffering ITB for 8 months now and I am pleased to say that I am now finally recovering. It started when I gave up ridding for a while and started running seriously in the winter. I have seen 4 physio therapists and I have done extensive research as nothing seemed to be working.

What I have have discovered is that it is a problem that women are more likely to suffer from then men. It is because of the way we are built, wider hips less inside leg muscle and bum muscles which puts more load on our knees. I started suffering other pain in my knees as well, similar to what you are describing and I really started to feel like I was crumbling or that I was just built wrong! Particularly standing in a group of physion therapists in my underwear!

Firstly I had to ditch running because it was the thing that caused it. Initially I had to ditch everything until the major pain went away. In physio they worked on reducing the scar tissue and different kinds of stretching. Once the acute pain went, it was up to me to start doing some serious work on building muscle that support my knees. These are the inside muscles in your legs particularly the big muscle on the inside of the knee. There are good machines in the gym for that. I also had to do some serious work on my bum! But focussing on the muscles just above the big glute muscles. Then I had someone look at my cycling technique.

Now I feel stronger and more powerful then I did before and I definitely feel like I put less load on my knees both running and cycling. Stretching and electrotherapy work to sort out the pain initially, but you need to look at building the supporting muscles for your knees for a long term solution!

Good Luck!

Hi Michele.

If you don't mind, I have a few questions for you.

1) How long did you ditch everything (exercise)?
2) You said you waited until the acute pain went away. Did you have much pain when you started working on the problem or did you wait until everything felt great?
3) What did you do to work on your cycling technique?
4) How did they try to get rid of scare tissue? Was it just ultra-sound?
5) Do you feel you have the problem beat now?
6) Was your therapy to work on the inner quad supposed to help with your ITB issue?
7) What exercises did you find most effective for you bum?
8) Do your knees make a grinding sound when you climb stairs or straighten your legs?

I thought I'd post these questions to you because people that get through these things can have a lot to share with people that are currently experiencing them.

i have been having a related knee problem the last 2 years myself. it started when i was at a team camp doing lots of sprints in the cold air, followed by a long climb home. after about 15 sprints, i got a sharp pain in my left knee after about 2 pedal strokes into a sprint. i was stupid and finished the sprint. when i got back to my room my left knee was tight and it hurt when i bent it. couldnt ride the next day. i had swelling, tightness and pretty bad pain when i put weight on my left knee when sitting down/standing up. i took the next 4 weeks off from riding. i was able to ride after what seemed to be a recovery, but ever since i have had occasional less painful tightness and swelling in the knee, when riding. i went to a couple doctors but i nothing worked. i have been riding since and my knee hasnt given me much problems untill the past month, when i started riding indoors. i think doing sprints on the trainer has bought back the problem worse. i havnt done any sprints the past 2 weeks. 2 weeks ago i got fitted for my bike and made some adjustments with saddle position and cleat changes. i found out that my left femur is longer than my right, which i think is the original problem. i am still getting a tightness and swelling when i ride. this week is a rest week for me so it has been easy riding, with some days off.
i get the pain/tightness below my kneecap in the front of my left knee. both knees seem to swell from riding. i can climb stairs no problem, but i occasionally get the symtoms when walking. i started taking a shark cartilage supplement last week, which i read might help with cartilage/joint injuries. last year i did weight training in the off season. this year i am only doing set-ups, nothing else. i am thinking about going back to the gym so i can do knee extensions, which i heard help strengthen the muscles that support the knee.
about me. i am almost 19yrs old, male, and i am very much into road racing and very dedicated to my training. i have been riding for 4 years. arthiritus is in my family.

any advice or suggestions, or diagnosis to what i have would be greatly appreciated.
my email is velomanct@yahoo.com

I've found this site really helpful for me and my bum knee.

http://www.kneeguru.co.uk/index.html

Lots of stuff there and check out their forum with your questions. Some really knowledgable people there.

Hope this helps,
Tim

Originally posted by velomanct
i have been having a related knee problem the last 2 years myself. it started when i was at a team camp doing lots of sprints in the cold air, followed by a long climb home. after about 15 sprints, i got a sharp pain in my left knee after about 2 pedal strokes into a sprint. i was stupid and finished the sprint. when i got back to my room my left knee was tight and it hurt when i bent it. couldnt ride the next day. i had swelling, tightness and pretty bad pain when i put weight on my left knee when sitting down/standing up. i took the next 4 weeks off from riding. i was able to ride after what seemed to be a recovery, but ever since i have had occasional less painful tightness and swelling in the knee, when riding. i went to a couple doctors but i nothing worked. i have been riding since and my knee hasnt given me much problems untill the past month, when i started riding indoors. i think doing sprints on the trainer has bought back the problem worse. i havnt done any sprints the past 2 weeks. 2 weeks ago i got fitted for my bike and made some adjustments with saddle position and cleat changes. i found out that my left femur is longer than my right, which i think is the original problem. i am still getting a tightness and swelling when i ride. this week is a rest week for me so it has been easy riding, with some days off.
i get the pain/tightness below my kneecap in the front of my left knee. both knees seem to swell from riding. i can climb stairs no problem, but i occasionally get the symtoms when walking. i started taking a shark cartilage supplement last week, which i read might help with cartilage/joint injuries. last year i did weight training in the off season. this year i am only doing set-ups, nothing else. i am thinking about going back to the gym so i can do knee extensions, which i heard help strengthen the muscles that support the knee.
about me. i am almost 19yrs old, male, and i am very much into road racing and very dedicated to my training. i have been riding for 4 years. arthiritus is in my family.

any advice or suggestions, or diagnosis to what i have would be greatly appreciated.
my email is velomanct@yahoo.com

Hi velomanct.

You probably should have started a new thread for this one.

I hate to tell you this, but you may have some serious problems. One thing I'm going to dwell on here is how, when I read your post, I couldn't help feel that you are a very motivated athlete. Depending on the medical advice you get, some doctors may be very encouraging, and some very discouraging. The fact of the matter is that many people get injured for many reasons. However one thing that is usually true is that, "given the activity the people are doing, their bodies can not take the stresses they put on them".

I realize that statement is a no-brainer.

However, some people are lucky in that their problems occur because they were doing something that was very wrong for their body and they stopped it fast enough to turn it around. For example, bike setup was completely wrong; Training methods were MUCH too aggressive; Sport chosen did not agree with their body's makeup.

Others, however, are motivated and dedicated athletes and their training errors are less severe. Their very ability to "take the pain" is what wears them down over time and causes them long lasting problems.

From what you've said I think you're in a good situation. You had a problem two years ago. It happened while working extremely hard. Now, you're finding the problem returning again while trying extremely hard. You may not be screwed long term. ...yet...

It's very possible that the answer is that "you try too hard". If you can't make a million dollars through your athletics, you have to ask yourself, "Am I really accomplishing what I need to accomplish in life by doing this?" You're probably telling yourself right now that the answer is clearly "yes". However the answer may be "no". You may also find that slowing things down, so that you are cross training (maybe with swimming) to make VO2 gains and using cycling for longer easier rides, improves endurance and makes you a better cyclist. You also might find that pre-made athletic programs might be MUCH too aggressive for you to stay injury free.

What you've described may be a combination of Chondromalacia and Tendentious. It could also involve scare tissue from damage you've done in these great efforts. Of course, it could be just one of what I mentioned. There is a good chance that trying to push through this will cause irreversible damage.

The point I'm trying to make is, what you're describing is a big deal. I promise that no supplement will be a magic problem solver. You'll have trouble getting an entire diagnosis on any news group forum and you will likely need to talk to someone that knows a lot about knees and sports training. If you do not, you may not have an athletic future. If you're talking about taking it easy for this week because you're on an "off week", the sooner you realize that one "off week" is not enough, the better off you are.

There is a thing called "diminishing returns" where, for example, 5x the effort in training only amounts to 1% better performance (sometimes performance goes down with increased effort). Learning that point can make a person a much more injury free athlete. From what you've described you are a very capable cyclist. Asking for too much may be a problem.

...I apologize for the length of that advice but I'm trying to make it sincere.

In terms of more technical advice:

1) Take a break of 2 to 4 weeks with NO riding. You won't lose as much ability as you think.
2) Ice your knees regularly (gel packs that go into the freezer are much better then ice because you won't freeze your skin but anything cold works)
3) Do not put excessive pressure on your knees (ie, with tights)
4) Ensure your bike fit is similar (not WAY out) to guideline fit standards. However do not make major changes at a time. Rather play with no more then 2 or 3 millimeters at a time within every 7 hours in the saddle.
5) Ensure cleat position is exact for your physical geometry.
6) Do not try to JUMP into strengthening exercises at the gym. Do these only while you feel great.
7) Allow yourself the freedom to re-evaluate your athletic goals (this is by far the hardest one and the bulk of what I was first focusing on).

Good luck in finding the right help.

Thanks for the insight Postie.
it's hard not being able to ride for 2 weeks or however long it is going to take for my knees to heal. for once, my training had gone exceptional well and i was on track for my season goals, until this whole knee thing came up. but i realize i have no choice.
i know the reason why i am getting this problem. spending 9hrs a week on the trainer is the reason. the restricted movement has aggravated my knees. i am now selling my trainer which was such a good training tool, but at the same time, the worst thing for me.

You're welcome. For what it's worth, I understand how hard it is to stop. I also know what it's like to be on track and find that your body isn't ready for your pace. If we could all play this game off effort alone I'd be ready to challenge Lance.

However, in the case that you're less injury prone then me, I have a couple ideas for you to consider if you really want to keep your trainer.

1) Maybe speedplay pedals would help you find your most knee friendly foot position and, in turn, put less torque on your knees?

2) If you're using a magnetic trainer, you might find that the roller stops within a second after you stop pedaling. One that can keep momentum when you stop pedaling could put less torque on your knee for the down stroke. The faster your trainer roller slows down after pedaling the more you're simulating a steeper incline. And hill training is something that anyone without perfect knees should do with some caution.

actually, i already have the speedplay zero pedals, with the float adjusted in the middle range. also, i have the kurt kinetic road machine trainer, which is probally the best trainer to simulate outside riding. coast down from 10mph is 9 seconds. its a combination fluid mag resistence unit, i think. it does such a good job at simulating real riding.
i can ride rollers if i cant get outside, and since i can move around on them, there isnt that problem with the bike being fixed like on the trainer.
i am going back to get my position checked again, maybe make some changes.
my guess is that i need to let my knee heal completely, and hopefully the problem doesnt come back.

The problems are your IT-Band and Quadriceps.

Try:
http://www.cyclingforums.com/t86579.html

Update:

today i went back to the bike fit specialist and made a few more adjustments with cleat fore/aft and added some shims. after some massage and stretching(that i never did before) there was significantly less pain in my knee. when i got home i did an hour on my rollers and my knee felt the best it has in a month. although not completely back to normal, it is about 80% right now. the massage and stretching helped loosen up tight quad and hip flexor muscles in my left side, which was part of my problem. i am going to continue doing lots of stretching and self massage.
so things are finally looking good. :)