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A Pain in the Knee

If you hang out with me on the reg,  you know that I’ve been lucky enough to “never” been injured (and then always say *knock on wood* right afterward). Well besides that time I sprained my ankle in a high school field hockey game two days before Homecoming and proceeded to attend Homecoming anyway and dance on my bruised and swollen foot all night. The good news is, I can still say I’ve never been injured, but this recurring pain in my knee is probably the closest I’ve come since my endurance sports career started just three short years ago.

About two weeks ago during a 88 mile bike ride with about 4,000 feet of climbing, I began to have some pain in my left knee – right on the top, like on the knee cap. It was more of a discomfort and popped up about halfway through the ride. It was more pronounced during hills and got slightly worse as the ride went on and was located on the top of my knee – like on top of the knee cap. After the ride, we ran just over 4 miles and my knee felt fine, not aggravated by running on it so I took that as a good sign.  The next day, I ran just over 20 miles and I could feel a slight amount of discomfort but not a lot. It seemed to be affected mostly by riding.

The next week was the weird week where I took a lot of time off of working out due to the knee, schedule conflicts and overall lethargy. We took Wednesday off of work and rode 40 miles on the coast and my knee felt fine. I didn’t ride again until the Monday of Memorial Day weekend and was sad that not only did my left knee start hurting earlier on in our ride (70 miles of hills) but BOTH knees started to hurt. By the end of the ride, the dull pain turned into sharp pains at times. Not good. I took the ride easy but the end was painful.

I iced the knees but still ran last week (without pain) and then attempted 1.5 hours of spinning on the trainer mid-week but stopped it at 1 hour due to my knees still feeling a bit of pain. Thursday I bit the bullet and paid a pretty penny for a professional bike fitting using RETUL technology to get the exact right fit. I talked to the fitter about my pain and he felt that the new bike fit would definitely help. I was hopeful that the solution would be immediate, but was disappointed when I went out for my ride on Sunday (hoping for 90 miles) and my left knee was still acting up. About 10 miles into the ride, I knew I wasn’t going to make the 90 miles I was hoping for. Luckily, my right knee was 100% fine and the pain was not sharp and less intense than previously. I could tell that my new fit was putting less pressure on my knees, but I didn’t want to test it out by climbing 70 more miles of hills, so at mile 20, I headed back to the coast (via 20 more miles of hills) and added on about 17 miles of flat coast riding, for a total of 57 miles.

So where am I now? I iced my knee last night and I plan to rest it until at least Thursday. I plan to attempt to spin for an hour on Thursday and see how it feels – if it immediately is still sore, I will skip the workout. I am going to focus on quality sleep and quality food for the entire taper to ensure my  body is primed and ready to heal. I know that the bike fitting won’t miraculously heal me – I need to treat my knee right and get it there on it’s own. I’m glad I got the fitting done because now I am assured that the bike fit is not going to aggravate the problem. I know that all the hard work for the race is behind me but there is a big part of me that is VERY worried that the pain will come back on race day. The good news is that running doesn’t seem to aggravate my knee so hopefully even if my knee acts up during the 112 mile  bike portion, I can at least attempt to run the marathon. I have three weeks to get to the start line healthy and healed and I intend to take every measure to get myself there.

Do you have any tips for heeling a bum knee? Have you ever had similar pain? How long did it take to go away!?

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June 4, 2012 By fitnessfatale 13 Comments

Filed Under: Triathlons, Uncategorized Tagged With: ironman CDA, knee cap pain while riding, knee pain during cycling

Reader Interactions

Comments

  1. Shelly Satizabal

    June 4, 2012 at 8:39 pm

    Bummer!!! Ok, a few questions:
    1. Where exactly the pain in your knee?
    2. When you’re cycling, is there a specific position during your pedal where the pain occurs? If so, what position, where in your knee, and is it sharp?
    3. Do you feel this pain when stretching? Try a figure 4 stretch. It stretches your piriformis. Any pain?
    4. When you felt it pop, was the pain in the same locati

    Reply
    • FitnessFatale

      June 4, 2012 at 9:20 pm

      Hi Shelly! Thanks for the help.

      1. My knee pain is on the top of my knee- almost like on top of the knee cap. The pain is fairly dull most of the time – however at the end of a 70 mile ride on very hilly terrain it did start to get sharp. This last ride however it was just dull.
      2. I’m not sure about a particular position – it did hurt more when NOT in aero than while in aero after I got my professional fit (not sure if there was a different before the fitting when the pain originally occured) and it is more tender while climbing.
      3. No pain during figure 4 stretch.
      4. I never felt anything pop.
      5. No pain while swimming or running (although during running I can tell that it’s not 100% right, it doesn’t aggravate it).

      Reply
  2. Shelly Satizabal

    June 4, 2012 at 8:42 pm

    Oops… Sorry about that.
    (continuing) was the pop in the same location as your current source of pain?
    5. Anything happening in your knee while swimming?
    I’ll ask some of my PT friends and so some research. Keep icing!!

    Reply
  3. Ben

    June 4, 2012 at 9:04 pm

    Sounds like a patella strain (google it). I’ve been there, very common in those new to cycling. Likely causes are seat too low (not enough leg extension) and grinding too high of gear on the climbs. Pedal stroke could be uneven (too much force on the down stroke which puts pressure on the patella and not enough pull on the up stroke). Rest, go light on your taper and spin high cadence (focus on the pull) on the climbs and you’ll be fine for CDA.

    Reply
  4. Page

    June 5, 2012 at 1:03 am

    Three weeks of rest, taper and listening to your body will surely help. I would recommend going to a chiro for ART.

    Reply
  5. Hilary

    June 5, 2012 at 4:53 am

    Hello!
    Any problems going up/down stairs? If so might be runners knee/patella femoral syndrome. Or….ITB
    I recently just had an injury which caused me to sit out this past weekends marathon in SD. It turned out being IT band. Started out as knee pain then eventually worked its way up to my hip. However running aggravated and sometimes high resistance spinning did too. Might be something to consider. I had to force myself to take six weeks off ( can start up again tomorrow). In the beginning I saw a sport md and got steroid shot which alleviated temporarily ( a week). He did say at the time if I really needed to get though my race I would continuously needed to get the shot.
    Tips:
    Ice twice a day including after workout.
    Ibuprofen (I did twice a day at my MD recommendation )
    Rest when you can

    Getting back on my feet,
    Hilary
    Las Vegas, NV

    Reply
    • FitnessFatale

      June 5, 2012 at 7:53 pm

      thanks for the tips and help! Luckily no problems going up or down stairs …it seems to be getting better! I ran this morning on it and didn’t feel a thing! I guess it’s a good thing I’m in taper mode now so I can afford to take a little time off of cycling while I heal. I’ve been icing and taking ibuprofen so hopefully it will work itself out ASAP!

      Reply
      • Shelly Satizabal

        June 5, 2012 at 9:18 pm

        So I did a little bit of research and based in the info I received, it may be your quadriceps tendon at its insertion point. This tendon connects the quadriceps muscle group to the patellae and continues into the patellar tendon, which inserts onto the tibial tuberosity (that annoying bump at the top of your shin that always gets nicked during shaving…maybe that’s just me…). Here’s a link to a forum that I find helpful: http://forums.roadbikereview.com/racing-training-nutrition-triathlons/quadriceps-tendon-pain-advice-please-90544.html. It also provides an icing schedule that’s been pretty effective for me, but then again everyone’s bodies are different and respond differently to modalities and treatment. My recommendation–note that I’m biased because I’m in the field–is to seek a physical therapist that specializes in endurance athletics and sports performance. Though s/he may tell you to rest or something you’d rather not hear, they may also be able to help you finish your iron(wo)man (sorry, I couldn’t help myself) with reduced pain or causing any serious long term damage. I’m not licensed, I’m still in school, but based on my experience and the recommendations of those I’ve spoken with, making an appt with a PT should definitely happen, whether it be before or immediately following your race. I hope this helps!

        Best,
        Shelly

        Reply
        • FitnessFatale

          June 5, 2012 at 9:55 pm

          Thank you! Although it has been feeling better I want to do as many preventative measures as possible so a specialist is probably a great idea. My boss recommended an Active Release Therapy provider – he also works on pro triathletes here in San Diego. Do you think that would be a good person to see or should I just see a general physical therapist?

          Reply
      • Shelly Satizabal

        June 7, 2012 at 7:58 am

        ART is an excellent choice, should the source of your pain be soft-tissue damage/inflammation alone. Since training in ART earns continuing education credits for chiropractors, physical therapists, massage therapists, certified athletic trainers, medical doctors, and others who are licensed to work on soft-tissue conditions/injuries (as well students in those fields), there are many practitioners that utilize ART without seeking the source/reason for pain. Example: several years ago I had sciatica pain that caused my back to spasm, so I sought relief from a chiropractor. Though I felt instant relief after each appointment, my pain would always return and worsened. It was only after I saw a PT for a different running injury (plantar fasciitis & dropped cuboid [note that the dropped cuboid dx was missed by my podiatrist]) that the source of my back pain/spasms was identified and treated: I had a weak gluteus medius that caused me to overcompensate everywhere else, and because only the pain had been originally treated, my source of pain still created issues. Hence, my recommendation would be to investigate the source: oftentimes patients have their symptoms treated only to have reoccurring issues and pain that was once acute and may turn chronic. Such incidences are all too common and may be prevented had the source of pain been treated rather than the symptom alone. Though an ART certified specialist may resolve your pain, it may be only temporary relief and could cause long-term damage should something else be happening. My rec: see a PT that is ART certified and go from there. Again, note that I am biased, yet I pull from my experience and what I have seen in the clinics–most of our patients that were seen/treated by other specialists prior to coming to PT wished they would have come to us first to not only save time and money but to be pain-free sooner than later. Sorry this is long-winded! Hope this helps!

        Reply
      • Shelly Satizabal

        June 7, 2012 at 8:02 am

        Btw: my back pain was related to my knee pain that caused my plantar fasciitis. I’m happy to report that I no longer back, knee, or foot pain. Additionally, my PT changed my running form to alleviate the compensations I was making, and not only am I pain-free while running, I’m a faster and more efficient runner!

        Reply
  6. Change of Pace

    June 7, 2012 at 6:51 am

    Sorry to read about this. I think you’re being super smart about it though. You’ve put in the work; just rest it and do as much as you can on it.

    Reply
  7. Malisa Salvadge

    August 9, 2012 at 1:36 pm

    Knee pain is quite easy to treat with modern anti-inflammatories and also food supplements that can reduce swelling like Chondroitin. :;`;.

    Regards http://healthmedicinelab.com/cat-bite/

    Reply

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