Hi

After two long back to back rides last week I had to walk the final few miles due to severe pain on the inside of my right knee – its kind of around the inner side of my knee cap, and where my quad joins my knee. I rested it over night, tried to ride the following day but it was a complete non starter. The pain is only there when I pedal (walking running etc is fine) and is from mountain bike riding. I was using SPD’s, tried flats after day 2 but i think the damage was done.

I suspect I have picked up an overuse type injury of the medial cruciate ligament and am currently resting it. I am no expert, but wonder if the cause is down to a fit or cleat issue. Can anyone recommend someone to go to who would be able to assess my fit and see if there is a problem. I have noticed that when i pedal, my right knee tends to move outwards (away from top tube) at the top of the stroke and suspect this has caused it.

Rich at Pedal Precision is really good and he used to be a physical therapist for a pro rugby team as well so I’m sure he’ll be able to give your knee a good look at too.

Pedal Precision @ The National Cycling Centre

I did mine in 14 weeks ago, clipped in is best, for me, as I was told to keep knee straight, now at physio, now doing excercises to bend knee, sort of sideways. The 2nd doc I saw said “some” cycling was OK so did SSUK a few weekends ago(gently). Mine was caused when my cleat came loose and I compensated for it on a 3 hour MTB ride….
Go see somone. I wish I had much earlier………..

The OP’s problem sounds very similar to one I have sporadically. Mine personally is caused by overly tight IT bands, hamstrings and glutes, it masquerades as a knee problem but is almost always the former.

Very, very painful and I’ve rested it for weeks at a time before now to no avail. I’d try and find a good Sports and Remedial Masseuse to see if that will help, it does with mine.

Since making a mess of my knee last year I’ve had problems with tight ITB – get a foam roller – it’s great for working ITB, calves, quads, glutes etc etc

Do you not mean the Medial colateral ligament? A simple way to test if it’s that is get someone to hold your calf and push on the inner side of your knee. It shouldn’t move at all. And obviously there will be pain if it’s a Grade 1 sprain, Grade 2 partial tear and grade 3 rupture. When I did mine there was extensive bruising and swelling on the inner medial side.

Only way to treat it is RICE. And a knee brace won’t hurt either. Done my medial twice now. First time 10 years ago and it was one of three torn ligaments for current injury. Get to your gp for a Orthopaedic referral.

The medial ligament is regarded as a very serious injury involving the knee. The ligament’s purpose in the knee is to aid in sideways movement and balance.Damaging the medial ligament happens in a sudden jerky movement usually involving a twisting landing motion in which the knee will collapse inward

Do you not mean the Medial colateral ligament? A simple way to test if it’s that is get someone to hold your calf and push on the inner side of your knee. It shouldn’t move at all. And obviously there will be pain if it’s a Grade 1 sprain, Grade 2 partial tear and grade 3 rupture. When I did mine there was extensive bruising and swelling on the inner medial side.

So a grade 3 would be painful would it? It would surprise me – considering that most complete ruptures are pain free given the nerve damage asociated with a complete rupture.

You also dont want to go yanking on a grade 2 tear as you dont want to turn it into a grade 3.

Some people have lax ligaments anyway, so what may look like ligament damage is really just their normal.

If you are based near Edinburgh I will have a look.

Sometimes there can be initially. I know when I did mine for the first time that was a Grade 3 and that Hurt Initially for 24 hours. Then nothing but swelling and Bruising. Grade 1 and 2 cause pain.

Nobody said about yanking. I’ve had a Valgus stress test both times ive done my ligaments. Both by a GP and a Orthopaedic Consultant.

Yes there will always be a little movement but even to the untrained eye you can notice the difference in movement from a Ligament tear and the good leg.

According to my training book; medial pain.

possible causes (excluding trauma) – toes pointing outwards, too much pedal float, pedals to tight for easy exit or feet to wide apart.

solutions possible – adjust cleat so toes point in, use pedals with less float, adjust pedal tension, lastly for width ; adjust cleat, use shorter bb axle or use narrower cranks.

Fwiw a bit of a stretching program can sort a lot of this before it happens.

I would say that the same rules apply for most knee issues like this:

1) Go to the GP and beg for an MRI. If you suspect serious soft tissue damage do not get fobbed off with “rest for 6 weeks”
2) In the mean time while you wait for an MRI see a decent physio with cycling knowledge who can advise about managing the possible issues and advise about foam rolling/ stretching/ future exercises to address inherent imbalances (this might come further down the line if you remain in considerable pain and have a more severe tear)
3) When everything has settled down and you are cycling again get a decent bike fit.

As others have said any ligament injury is a serious issue and needs to be addressed ASAP if that is what it indeed is. It should at least be ruled out ASAP. I would not even consider further exercise and certainly not a bike fit until you get a diagnosis.

Nobody said about yanking. I’ve had a Valgus stress test both times ive done my ligaments. Both by a GP and a Orthopaedic Consultant.

Yes there will always be a little movement but even to the untrained eye you can notice the difference in movement from a Ligament tear and the good leg.

Point A – that’s where youre going wrong.

Point B – There isnt always movement – I have tight ligaments – no play in my joints.

@glupton1976 I’ll take that onboard. Orthopaedics is a whole new ball game to me. So I’m still learning.

Can I assume Orthopaedics is your field? If so may i ask, why after 12 weeks, and physio am i still feeling pain at the site of my fibula fracture? Proximal Fibula fracture just below the knee. When i first did it, even bending down to take socks off it was agony, this progressed to a dull ache over the weeks and this week i have severe pain that CO Codamol isn’t even easing.

Is it worth seeing the Consultant again?

why after 12 weeks, and physio am i still feeling pain at the site of my fibula fracture?

Different fractures heal differently in different people. Certainly do not be disheartened when you hear people suggest all fractures are equal and heal magically in 6 weeks. Bones take 6-7 years to completely remodel as a shocking bone fact but this has little/ no bearing on pain. To be more relevant- my tibia fracture took around a year before pain at the fracture site disappeared and I had full confidence in the leg again… As I say though, take this too with a pinch of salt as my fracture is undoubtably different to yours and there are numerous factors different between us