Repetitive use injuries?

I'm so stinkin' frustrated...

Just when I think I know why my knee hurts and have it seem like it is getting better, it starts hurting again. Someone in the club mentioned it might be a repetitive use injury due to pedaling. I don't have health insurance, and can't afford to go to a doctor. Believe me, if I could I would go. In no way am I trying to get a diagnosis from the TE gals.

I've basically come to the conclusion that I should quit cycling for awhile. If the knee gets better, it was the riding... I could find a lot of info online about why one can get repetitive use injuries. But I couldn't find any info on recovering from the injuries. Anyone know?

Basically, do I quit cycling cold turkey for several months? Do I do easy spinning, slow rides one or two days a week? Forget hills? I'm intending on continuing other workouts (yoga, pilates, Tae Kwon Do). Can't stand the idea of having to rebuild the cycling muscles, but I will if I have to. My only other option is to sell the bike... :(

Maybe I just am looking for people to cry with me... :(

Hi Liberty! I can tell you're frustrated. Don't give up yet!

Tell us more. How long have you been riding? How many hours do you ride a week? What is the pain like? One knee or both? Does it only hurt on the bike or when you're off the bike as well?

Lorri

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Originally Posted by velogirl

Tell us more. How long have you been riding? How many hours do you ride a week? What is the pain like? One knee or both? Does it only hurt on the bike or when you're off the bike as well?

Lorri

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Thanks Lorri. I will have had my road bike two years in November. Have put on a little over 1450 miles since January, total odometer is 3000. I ride about 4 hours a week. It would be more except I am worried about the knee. Been to a chiropractor, and he says there is some tendonitis but that I could keep riding.

It is always the left knee. It is a fussy knee, no matter what the activity. Before I got clipless pedals I used toe clips, and my left knee would twist out if I tried to stand to go up hills. Maybe when I stand I twist that knee? Now that I use the clipless my knee feels more stable.

The sensation is a dull feeling in random areas. Normally it is on the inside of the knee, not behind the knee and not above or below, just on the inside. However, lately it is around the knee cap; various locations around the knee cap at times. I can say that if I sit with the left leg over the right, it sometimes causes my knee to ache. Many times I feel like my knee needs to pop or crack; all I have to do is bend the knee to get it to crack. My joints tend to pop a lot though.

Yesterday morning I went for a short, hilly 10 mile ride. My knee was fine afterwards. However, last night I also had Tae Kwon Do class. After that my knee was grumbling. Today it was fine. Slight discomfort, with periodic weakness.

I do not mash at all. I am a spinner; have had to be one because of the knee. My bike is a triple. I tend to stay in the middle ring on the flats, and the smallest ring on the hills. I tend to granny gear up all hills, though lately my fitness has been better and I could use a harder gear.

I use Look pedals, and have the float to the max allowance. Had two bike fittings. I am riding with a knee brace, which is helping a bit. Trying to do activities other than cycling too, so that the knee strengthens up a bit. All I can figure to do is stop riding for awhile and see if the cycling muscles are overdeveloped. Give the other muscles a chance to strengthen...

And, what have you done in the way of recovery so far? Have you taken a few weeks totally off the knee? (No Tae Kwon Do, no yoga, no bike...maybe just upper body pulling in the pool, etc). Have you done the RICE (rest, ice, elevation, compression) bit religiously for awhile combined with time off it? Keeping it wrapped, staying off it, icing, all that stuff?

My last serious time off was in May. Two separate times. First I was out of the country for two weeks. No exercise except for climbing several flights of stairs. Didn't do any ice, etc. Second time off was at the end of June. About a week and a half. Also no ice.

I took a lot of anti-inflammatories (for knees and lower back) over the summer. Iced the knee. But didn't elevate, compress or avoid all activities.

I agree with Starfish. I think that the best thing to do right now would be to take a couple of weeks totally off from any activity while doing RICE and possibly taking some anti-inflamitories. This will give the knee a chance to recover from whatever it bothering it. It is possible that you have tendonitis, but it can be really hard to know what caused it initially, and what just aggrevated it once it was started.

After your knee has calmed down and you start to slowly add activities back in, I would go back to the LBS and talk to them about your knee and have them look at your pedals. you may want to pay for a professional fit with someone who is experienced with these things. Tell them about how your knee felt when it hurt, how your knee used to turn out when you stood before getting clipless pedals and how it doesn't anymore. It seems possible that if your knee wants to rotate out and with the new pedals you don't let it do that, that could cause some stress to the knee. I am not a Doctor, but mechanically that makes sense. It might be that you have to switch to a different kind of pedals that allow your knee to do what it would like, maybe something with a lot of float like Speedplay zeros.

Good luck! I hope your knee feels better soon and you are back on the road!

See if your bike shop can put a forefoot medial wedge (like in Specialized BG shoes) into your current bike shoes.

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Originally Posted by KnottedYet

See if your bike shop can put a forefoot medial wedge (like in Specialized BG shoes) into your current bike shoes.

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Hey KnottedYet, my road shoes are Specialized BG Torch Women's... So do they already have the medial wedge in them?

When my dad found out about my knee, he told me about an old PT exercise his doctor gave him way back when. And no joke, as soon as I did the exercise, my knee felt better. Woke up the next day feeling great! I'm icing the knee too, and putting on arnica cream.

Basically the exercise is this: sit on the edge of a chair, extend your leg, and lift it higher than the height of a coffee table. Do 3 reps of 10. Once that is easy, add some weights. I obviously haven't added weights at this point, but I can do the 3 reps fine. Doing a 2 week rest period and then see how it is. Then some time afterwards, I will go pay the big bucks and get another bike fitting.

I will keep you ladies posted. Your responses really encouraged me. I seriously thought I'd have to sell my bike. Guess you don't realize how liberating biking is until you are faced with the possibility of not doing it any more. My life wouldn't end, and things would be fine. But still, I'd miss it terribly.

Liberty, another great exercise my pt's advised me to do was this:

Sit with your back to the wall.
Bend the right knee and bring it to the chest, clasping your knee with your hands. Keep the left knee straight.
Raise the left knee slowly off the floor about 8-10 inches. Hold for a couple of seconds. Release and slowly drop it back to the floor.
Do 25 reps, 3 sets.
Repeat with the other knee.

You might want to consider making some dietary changes as well. I noticed simple sugars will cause an inflammatory response in my joint so I stay away from processed foods and simple sugars.

Also, I drink Joint Juice which has glucosamine and vitamin c. It's endorsed by the Arthritis Foundation.

www.jointjuice.com

I hope this helps. It's no fun being sidelined due to a cranky knee. :(

there's also some data to support taking glucosimine and chondroitin in a certain dosage - this may help (I've heard it's good for things beyond arthritis, and joint therapy in general).

http://arthritis.about.com/od/glucos...lucosamine.htm

How do you feel about cross-training in the interim? Using something like the elliptical, or swimming?

dreadpirate (Princess Bride fan?? :) ) - I am taking glucosamine right now. It does help a lot. I was off it for about a month or so, and just started back up about a week ago... Maybe the absence is why things got rough all of a sudden. :) Gives me something other that overuse to blame the weakness. :)

I tried treating my knee for arthritis and other fun stuff. None of it worked. I finally talked to my chiropractor about it and he told me my IT bands were tight. They were pulling the patella out of alignment. So, he has me stretching.

A friend of mine is a massage therapist. She checked out my legs as well and noticed the same thing my chiro did. She also has me doing stuff. It's working. So, it may not be joint-related, but muscled-related.

Also, check that your seat is the right height. (You can have knee pain if it's too low.)