[Closed] MRI scan on knee shows nothing - but I can’t cycle. Opinions?

Listen to specialists

Sorry should have added some more info as the editing function doesn’t appear to save.

- bike configuration and clothing has not changed in 2 years of pain-free riding
- I ride flat pedals and do XC rides
- I’m reasonably healthy and fit enough to do 40 mile rides without issue
- 16 week wait for NHS osteopath appointment (paid for MRI myself to save time)

Just as the weather is getting better too! All that mud through the winter for nothing! Bats.

Did youget an opinion from a orthopeadic bod? If not you need one.

My other half had a strange knee pain that seemed very like footballers cartilage. Here anyone being referred for orthopaedic appoints is screened fist by a very senior physio. tight ITB band diagnosed ( pulling the kneecap to the side and causing the pain) couple of weeks with the foam roller and the pain is gone

MRI scans do not show everything so really it could be a multitude of things

Skiing/early season biking and not stretching shortens/tightens my hamstrings, causes knee misalignment and pain. Stretching resolves it quite quickly.
Hopefully your pain is your body giving you a heads up and not a sign of irreversible joint damage like my wife has.
Discuss issues with your physio as they may need to reassess the cause and treatment plan.

7 weeks? Think yourself lucky.
Mine went 'bad' after a quick walk in May last year, I'm having an arthroscopy next Saturday.
I can cycle all day but can't walk far.

Hmm... can't say for sure that we're suffering the same issues, but a winter on the singlespeed has unfortunately just highlighted an underlying weakness in my quads and left me with possible patello-femoral syndrome on the inside of my right knee. Basically gets sore and stays sore if riding hard.

The only similarity we might have is that some physio exercises seem to aggravate it (difficult to be scientific about which ones, but I suspect weighted lunges and or single leg dips, am returning to dips slowly with less 'dip') and also that a month of the bike achieved very little.

My physio is sympathetic but did suggest 6-8 months to notice an improvement, not sure if that's the time it takes for damaged cartilage to heal, or for the muscular imbalance to resolve itself.

Happily as I'm mostly road biking I have adapted my style to suit (higher cadence, on the cusp of feeling silly but still in control). Doesn't seem to slow me down much (would be hard to notice...) but feels OK, aggravates the knee less. Think it's just patience after that.

Edit:

MTB definitely didn't help, just too difficult to maintain a smooth high cadence, and also all the moving about on the bike.

Also tried lowering my saddle a smidgen, think I read that the VMO (muscle on the inside of the knee/quad) activates most at full extension, and since mine are apparently pulling too much to the inside I wanted to engage them less. Noticed my saddle had crept up about 15mm from where I was recommended at my last bike fit!

Paying for the MRI was a waste of time. You need to see an orthapod first or a top level physio if they have them in your area.

Thanks for the responses - @monk, the single leg dips are the ones that give me trouble.
@tj, MRI appears to be a stab in the dark, but wanted to rule out anything serious (mission accomplished), Orthodox is the next step I guess, i’m In London at the moment and appear to have plenty of choice should my pockets go deep enough.

Completely understand it’s a bit of a 1st world problem, and have the utmost sympathy for others who have been ‘grounded’ for far worse and not hit the bottle as a result!

It appears to be so trial-and-error though, not like dentistry!

This all sounds a little vague and the key is finding a decent specialist as others have said. Knee problems are tough and you really do rely on finding a decent person/ people to help.

The MRI was a good idea as the wait for one on the NHS can be massive and you've gone past the point of optimal treatment in many cases... however the are many different types of scan and you really need to know what you are looking for before the scan. You've also got to bear in mind the context someone reading them may have- ie unless there's something catastrophic on the scan you are "normal". My other favourite is seeing a mangled joint and can be told "you are completely normal for your age".

Keep trying to find someone with the knowledge and time and I'm sure you'll get there!

See a specialist consultant, privately if needs be.

I'm in a similar situation. Had knee pain for around 8 months now and had an MRI scan on the NHS, which came back completely negative and was misdiagnosed by their top tier physio and given a bunch of exercises that significantly worsened the knee.

Saw a consultant privately, who within 10 minutes knew exactly what was wrong with the knee and put me forward for surgery to remove an inflamed Plica. This was clear as day on the MRI scan when you knew what to look for but was previously missed.

Mrs Dubs can recommend Mr Johnathon Bell at the Wimbledon Parkside for all knee surgeries 🙂 He's a sportsman and is more interested in getting you back playing / riding again.

Mrs Dubs has had an ACL repair, two meniscus tidy ups (one of which included a free tidy up of a previous NHS ACL repair) from him. We didn't pay the bill, but he isn't actually that expensive (private medical has covered us each time).

That said, sounds like you don't have a diagnosis yet - I hear good things about Six Physio, but I haven't used them personally.

Anyone else had this?

Yes!

I had gotton fit for a torq-in-your-sleep event and was hit by fairly intense pain in my right knee during the race.

Didn't cycle or run much afterwards other than some trainer work, but was getting pains and aches at different locations around the knee, different each day even. Sometimes it seemed it was ITB related, then the pain shifts to the other side or the ache is across the top or bottom.

Had an MRI to basically check that nothing was fundamentally wrong - minimal wear found.

Been seeing a muscloskeletal therapist locally and previously a local physio.

The physio had given me the one-legged squats to do and this seemed to help but it is very important to keep your hips level when you do these :

(I don't use a ball just concentrate on level hips)

I thought this was working well recently as a long climbing hike had the suspect knee aching less than the good knee, however the next day it was painful.

However I seem to be coming out of it now as have been for some runs recently without issue.

It seems to be a combination of :

- some muscles being in a poor state around the top of the knee, and sometimes causing some grainy calcification (or something) around the top of the knee - I bash these out with a massaging device
- bloody tight calves - I bought a tilted platform to help stretch these
- too much reliance on quads - so I have managed to get my hams working more - given me a lot more power cycling as well
- tight hams - again stretching
- ITB problems - often have to roll or use a massage machine to hammer out the sore bits
- tight quads - in particular I hook my right foot up on the bannister at home then do a lunging stretch and I can feel this pulling across the inside front of my knee. Has to be extreme to trigger this.

So I have a more regular stretching regime now in the mornings which doesn't take too long - 20 seconds stretch position, then relax and then straight back into the stretch for 20 seconds - seems to work best.

And now I have started running, or sessioning the stairs again - my knee is starting to feel OK.

So my advice is to go to a physio or similar and get him/her to watch your form when you move and massage around looking for tight or unbalanced muscles, or over-reliance on certain muscles, and then work on them.

I've been experiencing knee pain too. But as a break with STW convention, I'm not going to tell you I know what your problem is and how to fix it.

However, what I did do was get a physio to refer me to X-ray and MRI. Both of these turned out inconclusive. So I asked my physio for a referral to a knee surgeon for a private consultation. This cost £220, but as the physio carefully chose the surgeon on the basis he also does NHS work in my "funding area" it seems that I've got an NHS arthroscopy booked in 4 weeks time.

It probably helps that I live in Stafford, where all that hoo-haa was about our local hospital (they've now changed its name, so that's all fixed), but my first physio was late January this year and my surgeon appointment was last Thursday.

Several phone calls and drop-ins and nicely worded begging letters helped me to understand how the system works here, so I was able to ask the right questions to get fast tracked.

I'm not sure if I should take a box of doughuts along to the operating theatre though.

Knee paid years ago, basically related to doing too much cycling and not enough muscle building.

Switched some of my workouts to resistance work (squats, banded exercises etc), and haven't suffered since.

I had some physio sessions to sort out knee pain which flared up half way round a 100 mile ride last year.
Stretches sorted my knee out after 6 weeks or so but it does return from time to time.
My Physio recommended that I also look at Bike Fit to try and see if it's the position / setup of the bike which is causing the knee pain.

Get MRI (3T rave machine type), results say nothing is wrong.

How do you know that if you haven’t seen the doc? Did your GO refer you for the MRI?

Do not compared yourself to others or do exercises others do, it could make things worse

You're not in this category yet, but 10% or so of msk pain is medically unexplained. They might find something fixable, but they might not. In which latter case best thing is if the orthopods can tell you to feel confident exercise won't make it worse and just press on, fiddling with seat height, whatever...

I had an MRI on a damaged knee - it will only really show up structural issues, not soft tissue ones.

In the end a physio found that a tendon in the back of my knee had got damaged and then healed with a small lump on it that was 'catching' as the knee moved. Essentially she had to 'redamage' it and then manipulate the tendon to remove the lump and then keep workign on it each week to make it heal smoothly. Proper laying on the couch, teeth clenched, sweating in pain for the 8 visits it took to sort out. No problems since.

I also had knee pain doctor sent me for a MRI nothing showed up on it so I tried riding with flat pedals again not had a problem since

I've had several MRI's and each one needed the specialist consultant to analyse the image after the event. The MRI machine operator couldn't tell me much. When it was my knee , the consultant did some crazy voodoo sh%t*, told me what was wrong(acl) and the mri confirmed it!
* all he did was hold my knee and wobble it,very gently. Made my eyes water though!
🙂
See the consultant and do the physio they recommend.
Get well soon.