Show stopping knee pains
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Bobster



Joined: 25 Apr 2014
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PostPosted: Fri Apr 25, 2014 11:52 am    Post subject: Show stopping knee pains Reply with quote

Never had this before starting to get worried wondering if anyone has any experience on this and can hopefully tell me I will heal back 100% and can learn from it.

So i'm 24 and have been doing XC mountain biking for 3 years and loving it only doing 20ish miles once a weekend, but recently i'v upped my training and have been doing 30-40 mins turbo training twice (in top gear bad I now know) a week for the past 6 months.

My fitness and climbing is currently at a personal all time high so last week I had a week off work and accumulated up to 80 miles and done two 1 hour turbo sessions in the week, well over what i'm used to and I felt okay apart from some muscle aches and knee pains by the end of the week.

Its been 5 days of rest and the muscle aches have gone but my knees are trashed i'v had to go to work for 4 days but having today off to fully take the weight off my knees and will have the weekend to sit about and rest. After that If I still have the pains in my knees I was going to see the doc.

It's hard to tell where the pains are coming from but I would say its mainly around the knee caps and at the bottom of the cap, feels better if i'm walking slowly but stairs are a nightmare, Iv started taking ibuprofen and applying some gel since day 3 of the pains and its hardly had any effect. My knees don't look or feel swollen and don't particularly hurt on any area to touch.

So did I overdo it? my knees where very strong and had no twinges or pains during or after any rides before this high intensity week. Should I keep off the bike for another week? If the pains go I will ease back in and change the way I train (lower gears higher RPM)

Hope someone can give their opinion will be much appreciated, thanks

Bob
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olddude



Joined: 30 Mar 2014
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Location: Builth Wells, Powys

PostPosted: Sat Apr 26, 2014 8:20 am    Post subject: Re: Show stopping knee pains Reply with quote

Bobster wrote:
Never had this before starting to get worried wondering if anyone has any experience on this and can hopefully tell me I will heal back 100% and can learn from it.

So i'm 24 and have been doing XC mountain biking for 3 years and loving it only doing 20ish miles once a weekend, but recently i'v upped my training and have been doing 30-40 mins turbo training twice (in top gear bad I now know) a week for the past 6 months.

My fitness and climbing is currently at a personal all time high so last week I had a week off work and accumulated up to 80 miles and done two 1 hour turbo sessions in the week, well over what i'm used to and I felt okay apart from some muscle aches and knee pains by the end of the week.

Its been 5 days of rest and the muscle aches have gone but my knees are trashed i'v had to go to work for 4 days but having today off to fully take the weight off my knees and will have the weekend to sit about and rest. After that If I still have the pains in my knees I was going to see the doc.

It's hard to tell where the pains are coming from but I would say its mainly around the knee caps and at the bottom of the cap, feels better if i'm walking slowly but stairs are a nightmare, Iv started taking ibuprofen and applying some gel since day 3 of the pains and its hardly had any effect. My knees don't look or feel swollen and don't particularly hurt on any area to touch.

So did I overdo it? my knees where very strong and had no twinges or pains during or after any rides before this high intensity week. Should I keep off the bike for another week? If the pains go I will ease back in and change the way I train (lower gears higher RPM)

Hope someone can give their opinion will be much appreciated, thanks

Bob

Hi Bob,

I'm a Podiatrist, but I've done loads of sports injury work, including Premier Div football as a Consultant, so I know a bit about the lower limb.

You've overtrained.
Think of your body as a chain with different-sized links. Your heart is one link, muscles another, lungs another (etc). You have to train at a level which will stretch the chain, without straining or breaking a link.

Being young and fit you have found your weak link - your knees.
At my age it would be my heart if my legs weren't so puny Very Happy: .
The problem you describe is probably chondromalacia patella (Google for loads of info - most of it rubbish Very Happy ), and infra-patellar tendonitis (pain below the kneecap).

Overtraining is easy to do, and will ultimately slow you down because you'll injure yourself. Find something else to keep your fitness level high.
You can't run either, so it looks like a floatation vest may be the answer for you short-term. These work by keeping you floating and vertical in water so you can run without weightbearing. VERY, very hard work.
If you can canoe that would be good too.

Gel won't do anything. Antiinflamms may help a little, but rest is the cure.
If you have SPD pedals get rid of them. They can hold your knee in a poor position mechanically. Use good quality flats instead.

I hope this is useful.
One other thing - unless your GP is sports-savvy he\she will not be a great deal of help.

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AvalancheJon.



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PostPosted: Sat Apr 26, 2014 8:59 am    Post subject: Reply with quote

Yup,if it's the front of the knee it's probably over training. Rest and gentle stretching will help. If it lasts longer than a few weeks see a sports professional.
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Bobster



Joined: 25 Apr 2014
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PostPosted: Sat Apr 26, 2014 11:31 am    Post subject: Reply with quote

Thanks for the replies, i'v been using the downtime to research on whats going on with my legs and knees, i'm 80% sure its just a stain as olddude described.

It's day 6 of no training or bike rides but 4 days i'v had to go back to work with alot of stairs on my feet all day and manual labour (electrician) so only had 1 day of actual off my feet rest. Woke up this morning with the same pains I been experiencing all week just no end in sight had to miss my usual weekend ride today Sad

I have a 60 mile off road ride coming up in exactly 2 weeks would it be smart to cancel it even if the pain has subsided?

My muscles in my legs still feel tight especially around the knees, feels like I need to do some stretching, does anyone recommend a hot bath instead of warming muscles up on turbo training and doing some stretches then?
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olddude



Joined: 30 Mar 2014
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Location: Builth Wells, Powys

PostPosted: Sat Apr 26, 2014 4:44 pm    Post subject: Reply with quote

Bobster wrote:
Thanks for the replies, i'v been using the downtime to research on whats going on with my legs and knees, i'm 80% sure its just a stain as olddude described.

It's day 6 of no training or bike rides but 4 days i'v had to go back to work with alot of stairs on my feet all day and manual labour (electrician) so only had 1 day of actual off my feet rest. Woke up this morning with the same pains I been experiencing all week just no end in sight had to miss my usual weekend ride today Sad

I have a 60 mile off road ride coming up in exactly 2 weeks would it be smart to cancel it even if the pain has subsided?

My muscles in my legs still feel tight especially around the knees, feels like I need to do some stretching, does anyone recommend a hot bath instead of warming muscles up on turbo training and doing some stretches then?


The bad news is that you can't do the ride. Well, you can - and you'll probably complete it too, but you'll then take an age to recover properly.

Forget any exercise which involves putting power through your knees. At your age you'll recover quickly IF you rest. Thats rest, as in REST.
You also won't lose much fitness at 24. Trying having a layoff when you're 50 or 60 and you'll see what I meant Very Happy: .


A second opinion is available at your local physio's.

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Smurf



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PostPosted: Sat Apr 26, 2014 7:34 pm    Post subject: Re: Show stopping knee pains Reply with quote

olddude wrote:
I'm a Podiatrist, but I've done loads of sports injury work, including Premier Div football as a Consultant, so I know a bit about the lower limb.


Without wishing to hijack the thread, (sorry OP), maybe you can give me some advice OldDude.

Amongst many long term injuries to my knackered old body, I have bilateral, multiple anterior tibialis fascial herniations. Any tips for reducing the pain? (Don't tell me to cut my lower legs off and fit rigids Wink ).

It caused me to retire from playing football 18 years ago and has been a nuisance since. Cycling is fine but any impact exercise is a no-no. Had an MRI about 10 years ago and all they wanted to do was cut the fascia from knee to ankle on both legs to eliminate local protrusions. I said "no thanks". Laughing

Haven't been arsed to go back since.
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olddude



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PostPosted: Sat Apr 26, 2014 8:04 pm    Post subject: Re: Show stopping knee pains Reply with quote

Smurf wrote:
olddude wrote:
I'm a Podiatrist, but I've done loads of sports injury work, including Premier Div football as a Consultant, so I know a bit about the lower limb.


Without wishing to hijack the thread, (sorry OP), maybe you can give me some advice OldDude.

Amongst many long term injuries to my knackered old body, I have bilateral, multiple anterior tibialis fascial herniations. Any tips for reducing the pain? (Don't tell me to cut my lower legs off and fit rigids Wink ).

It caused me to retire from playing football 18 years ago and has been a nuisance since. Cycling is fine but any impact exercise is a no-no. Had an MRI about 10 years ago and all they wanted to do was cut the fascia from knee to ankle on both legs to eliminate local protrusions. I said "no thanks". Laughing

Haven't been arsed to go back since.

Happy to help if I can.

Also known as "shinsplints". A real problem and there is no easy answer.
Caused by the fascia (envelope around the muscle) becoming fibrous so that it does not allow the muscle to expand when it's worked.

The fascial split you describe seems an easy cure, but it isn't for many, and can (like any surgery) lead to further problems. And of course the diagnosis must be right for it to work. Yours may simply be multiple tears at the muscle/bone attachment. An MRI won't diagnose it - really you need to have a catheter inserted between the fascia dnthe muscle - highly unpleasant - to measure pressure.

I'm guessing you are in your 40's, so there is hope Very Happy .
Cross-frictional massage can work well in reducing the symptoms, and, I believe, can make the fascia itself more flexible (although there is no hard evidence for this).
Look them up if you want to have a go yourself. Find a sore spot by running your fingers up the shinbone crest (front of leg). Rub lightly for a couple of minutes - it will numb down. Then rub hard up and down the shin, then across.
5/10 minutes should do to begin with. Find all the sore parts you can and repeat.

If you don't fancy faffing around yourself a good physio will be able to do it for you.

Yes, it can be helped without surgery - is the message.

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Bobster



Joined: 25 Apr 2014
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PostPosted: Sat Apr 26, 2014 10:19 pm    Post subject: Reply with quote

Quote:
The bad news is that you can't do the ride. Well, you can - and you'll probably complete it too, but you'll then take an age to recover properly.

Forget any exercise which involves putting power through your knees. At your age you'll recover quickly IF you rest. Thats rest, as in REST.
You also won't lose much fitness at 24. Trying having a layoff when you're 50 or 60 and you'll see what I meant Very Happy: .


A second opinion is available at your local physio's.


Wise words thanks, it's a real shame I done this to myself 2 weeks before the big event I had been training for the last few months but there's always next year. I have been resting off my feet for the most part of today had to walk around shopping for an hour with the missus though Rolling Eyes. Think I can detect some healing the shooting knee pains are happening less frequently but the dull ache at the bottom of my knee caps are still there, also still feel weak on the knees especially if I stand still too long.

Instead of creating a new thread I wonder if anyone can answer this for me as i'm building a small gym with room for a turbo trainer and one other exercise machine. What's a good machine to use after turbo training sessions to compliment cycling fitness and wont put strain or fatigue on the same muscles I had just been using on the trainer?

I was thinking of getting a rowing machine to build core strength but worried about over using the knee joints and leg muscles again.
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Smurf



Joined: 19 Jun 2013
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Location: Norfolk CMHT

PostPosted: Sat Apr 26, 2014 11:24 pm    Post subject: Re: Show stopping knee pains Reply with quote

olddude wrote:
Smurf wrote:
olddude wrote:
I'm a Podiatrist, but I've done loads of sports injury work, including Premier Div football as a Consultant, so I know a bit about the lower limb.


Without wishing to hijack the thread, (sorry OP), maybe you can give me some advice OldDude.

Amongst many long term injuries to my knackered old body, I have bilateral, multiple anterior tibialis fascial herniations. Any tips for reducing the pain? (Don't tell me to cut my lower legs off and fit rigids Wink ).

It caused me to retire from playing football 18 years ago and has been a nuisance since. Cycling is fine but any impact exercise is a no-no. Had an MRI about 10 years ago and all they wanted to do was cut the fascia from knee to ankle on both legs to eliminate local protrusions. I said "no thanks". Laughing

Haven't been arsed to go back since.

Happy to help if I can.

Also known as "shinsplints". A real problem and there is no easy answer.
Caused by the fascia (envelope around the muscle) becoming fibrous so that it does not allow the muscle to expand when it's worked.

The fascial split you describe seems an easy cure, but it isn't for many, and can (like any surgery) lead to further problems. And of course the diagnosis must be right for it to work. Yours may simply be multiple tears at the muscle/bone attachment. An MRI won't diagnose it - really you need to have a catheter inserted between the fascia dnthe muscle - highly unpleasant - to measure pressure.

I'm guessing you are in your 40's, so there is hope Very Happy .
Cross-frictional massage can work well in reducing the symptoms, and, I believe, can make the fascia itself more flexible (although there is no hard evidence for this).
Look them up if you want to have a go yourself. Find a sore spot by running your fingers up the shinbone crest (front of leg). Rub lightly for a couple of minutes - it will numb down. Then rub hard up and down the shin, then across.
5/10 minutes should do to begin with. Find all the sore parts you can and repeat.

If you don't fancy faffing around yourself a good physio will be able to do it for you.

Yes, it can be helped without surgery - is the message.


Sorry, should have explained the positioning of the hernias. It's not shin splints, it's further round towards the outside of the gastrocnemius. I've just had a look online, and there's a muscle called the peroneus that I wasn't aware of. Going by the anatomical drawings, that's where the pain is. (My physio said tibialis anterior for some reason Rolling Eyes ).

Cheers for the info, would the methods for pain relief you described above still be relevant? And you're correct, I'm in my 40s. Just.
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olddude



Joined: 30 Mar 2014
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PostPosted: Sun Apr 27, 2014 6:42 am    Post subject: Re: Show stopping knee pains Reply with quote

Smurf wrote:
olddude wrote:
Smurf wrote:
olddude wrote:
I'm a Podiatrist, but I've done loads of sports injury work, including Premier Div football as a Consultant, so I know a bit about the lower limb.


Without wishing to hijack the thread, (sorry OP), maybe you can give me some advice OldDude.

Amongst many long term injuries to my knackered old body, I have bilateral, multiple anterior tibialis fascial herniations. Any tips for reducing the pain? (Don't tell me to cut my lower legs off and fit rigids Wink ).

It caused me to retire from playing football 18 years ago and has been a nuisance since. Cycling is fine but any impact exercise is a no-no. Had an MRI about 10 years ago and all they wanted to do was cut the fascia from knee to ankle on both legs to eliminate local protrusions. I said "no thanks". Laughing

Haven't been arsed to go back since.

Happy to help if I can.

Also known as "shinsplints". A real problem and there is no easy answer.
Caused by the fascia (envelope around the muscle) becoming fibrous so that it does not allow the muscle to expand when it's worked.

The fascial split you describe seems an easy cure, but it isn't for many, and can (like any surgery) lead to further problems. And of course the diagnosis must be right for it to work. Yours may simply be multiple tears at the muscle/bone attachment. An MRI won't diagnose it - really you need to have a catheter inserted between the fascia dnthe muscle - highly unpleasant - to measure pressure.

I'm guessing you are in your 40's, so there is hope Very Happy .
Cross-frictional massage can work well in reducing the symptoms, and, I believe, can make the fascia itself more flexible (although there is no hard evidence for this).
Look them up if you want to have a go yourself. Find a sore spot by running your fingers up the shinbone crest (front of leg). Rub lightly for a couple of minutes - it will numb down. Then rub hard up and down the shin, then across.
5/10 minutes should do to begin with. Find all the sore parts you can and repeat.

If you don't fancy faffing around yourself a good physio will be able to do it for you.

Yes, it can be helped without surgery - is the message.


Sorry, should have explained the positioning of the hernias. It's not shin splints, it's further round towards the outside of the gastrocnemius. I've just had a look online, and there's a muscle called the peroneus that I wasn't aware of. Going by the anatomical drawings, that's where the pain is. (My physio said tibialis anterior for some reason Rolling Eyes ).

Cheers for the info, would the methods for pain relief you described above still be relevant? And you're correct, I'm in my 40s. Just.

You're welcome.
There are several Peroneals, but they are in the same place, just one is longer than the other (hence it's called Peroneus Longus Very Happy ).

The same treatment will work. Find a diffent physio perhaps?

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olddude



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PostPosted: Sun Apr 27, 2014 6:47 am    Post subject: Reply with quote

Bobster wrote:
Quote:
The bad news is that you can't do the ride. Well, you can - and you'll probably complete it too, but you'll then take an age to recover properly.

Forget any exercise which involves putting power through your knees. At your age you'll recover quickly IF you rest. Thats rest, as in REST.
You also won't lose much fitness at 24. Trying having a layoff when you're 50 or 60 and you'll see what I meant Very Happy: .


A second opinion is available at your local physio's.


Wise words thanks, it's a real shame I done this to myself 2 weeks before the big event I had been training for the last few months but there's always next year. I have been resting off my feet for the most part of today had to walk around shopping for an hour with the missus though Rolling Eyes. Think I can detect some healing the shooting knee pains are happening less frequently but the dull ache at the bottom of my knee caps are still there, also still feel weak on the knees especially if I stand still too long.

Instead of creating a new thread I wonder if anyone can answer this for me as i'm building a small gym with room for a turbo trainer and one other exercise machine. What's a good machine to use after turbo training sessions to compliment cycling fitness and wont put strain or fatigue on the same muscles I had just been using on the trainer?

I was thinking of getting a rowing machine to build core strength but worried about over using the knee joints and leg muscles again.

I would say doing trunk and upper body circuit training (you can use dumbells for that), but I'm sure there will be other advice along in a bit.

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Bobster



Joined: 25 Apr 2014
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PostPosted: Sun Apr 27, 2014 9:25 pm    Post subject: Reply with quote

Well its Sunday (day 7 off the bike since the pains) and I I still have the same shooting pains at the front top bottom and sides... all over in other words of my knees. Time to see the doc, never experienced this before I done too much last week with only 1 day rest and i'm absolutely kicking myself for doing this damage I was fine before that bloody week argh! Evil or Very Mad
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Nant



Joined: 16 Oct 2012
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PostPosted: Wed May 21, 2014 1:51 pm    Post subject: Reply with quote

Yeh massively rest and get it sorted and seen to. Don't even touch the bike till you know whats wrong

I made the mistake of spraining my ligaments in my left knee and not really resting it. A few months year later, completely snapped my ACL and PCL and broke off half my meniscus which then got lodged in between my femur and tibia in an inverted position.

Had surgery, to repair ligaments, couldn't repair meniscus though and that was removed. Impact sports are a big no go. Gave up football, squash and running. Gutting!Cycling is good for me as long as i don't crash...

Massively regret not resting and getting it seen to.

EDIT: seen its been a month, how is the knee?

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Bobster



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PostPosted: Sun Nov 02, 2014 12:42 am    Post subject: Reply with quote

Just a update for anyone who might be interested, Been 7 months since I strained my knees, I'm 90% sure it was IT band strains which tugged on my knee muscles this was confirmed by a physio session. Took me 10 weeks completely off the bike and 3 weeks to walk normally again.

after 8 weeks I could train again only 2 hours a week at no resistance and high RPM, I did this for a month then started riding out on trails again and I now am back to training and riding 5 days a week on high power intervals and have made a full recovery 7 months later.

Just be sure to keep stretching and foam roll/massage stick and avoid high gears especially on hills.
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Gunner



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PostPosted: Sun Nov 02, 2014 3:04 pm    Post subject: Reply with quote

Bobster wrote:
.............and have made a full recovery 7 months later.


Good news, though it sounds like it has been a long hard journey for you.


Bobster wrote:
.......Just be sure to keep stretching and foam roll/massage stick and avoid high gears especially on hills.


Sound advice.

I've recently started stretching again after a back injury and am really enjoying regaining my flexibility, but find avoiding the high gears, especially on hills quite hard work.

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