[Closed] knee pain - what can I do

I was expecting some sort of actual treatment to reduce the pain, rather than just exercises....

Why? And what would you expect that treatment to be?

m8 was given treatment, an operation... he's never ridden since, do not allow them to operate on your knee if at all possible

I went to the physio yesterday for a similar issue. I've got exercises (these are treatment) to do and a 6 inch bruise from the massage. Feel far worse today than before I went.

I agree with z1ppy, knee operations are the last thing you should be doing once every other avenue of treatment has been exhausted.

They have given me some exercises to strengthen the muscles that support the knee. Im pretty flat-footed and used orthotics for running and cycling

That is your treatment. Knee problems like that are very likely caused by misalignment or muscle imbalance. Do the exercises, there's no magic bullet! 🙂

Exercises from a 'good' physio are better than any medical treatments.
If your kneecap isn't tracking properly, how do you hope to eliminate the pain without addressing your muscle imbalance?

If you can get a copy pf Andy Prewitts Medical Guide for Cyclists, he notes a fair few bike and positioning tweeks to try and alleviate knee pain...

As others suggest, surgery should be the final option really IMHO

HTH

To add - my Mrs is a senior NHS physio & her biggest gripe is people coming to see them, being given a set of exercises to do (that the physios know will help), the patients don't do them then complain there's been no improvement 🙄

to echo the above re physio: if you haven't given the exercises a PROPER go, you shouldn't really be talking about trying anything else - assuming it's a physio who knows their stuff.
a good physio is worth their weight in gold, and then some...

I had been getting pain on the outside of my right knee for a while, and the hamstring/top of the calf behind it was all sore.

Then my left thigh developed a sore point which required rolling out.

Then I got the symptoms of quadriceps tendonitus above the right knee, and when walking I could feel the vibration in the muscle, sort of like disconnected.

So I went to see an osteo near work and he straightened up my hips and advised a few stretches.

I haven't had any knee pain since the visit.

So worth getting your 'alignment' checked out.

I choose this osteo as he runs at a high level in the masters category, and so I guessed would have a lot of experience of all the different injuries.

http://www.ec4osteopath.co.uk/therapists.php

All sounds like you're doing the right thing.
If it were me a physio would be the first port of call.

If the physio can detect a muscle imbalance and says exercises will fix it then I would do exactly as they say.

I'd be considering a bike fit to ensure my position is right on the bike so it doesn't re-occur.

Did the physio say to not ride ? I'd be tempted to have a gentle ride to see how it feels

Plus the exercises might have little value if you are 'crooked'.

I had stopped running and was walking a couple of hours a day and climbing the 9 flights of stairs at work several times a day to strength up my legs without the shock of running, but they were just feeling worse with that shocky/disconnected feeling.

That feeling went the day after to adjustment and the legs feel fine.

A mate a work has a similar issue - he has a goal of running a certain speed at 400m by the time he is 50, but keeps getting injured and has a distinct bias of strength on one side.

He went to another osteo who treats some big name athletes, and his pelvis was also crooked.

He came back straight after the manipulation saying how he could push much beter with one side - although I did tell him he might be falling for that trick that the balance band people do at places like the ideal home exhibition, to fool them into thinking that the balance bracelet is doing something.

I am waiting for an op on a medial meniscus tear .My knee has been buggered since July and causes a limp there is no alternative

The thing with physios is that it does take time and commitment.

You wouldn't hire a sports coach, and then complain they hadn't made you into the next Wiggo after only one session, yet I hear it time and time again with regards to physio treatments!!

DrP

If it hurts, take ibuprofen which will help, but suggest you follow the Physio's advice for a while....whats the alternative?

You gotta take care of your knees, problems are difficult to resolve.

I've had bother with pain around / under my knee cap once with running and twice with cycling. No quick / easy fixes:

1. Running - saw a good sports physio who quickly diagnosed muscle imbalance in quads. Prescribed some weight training to help it. Problem got better as soon as I started the exercises and was totally sorted in 6 weeks of doing the exercises. Went from unable to run 5 mins due to pain to running better than before.
2. Cycling 1 - had a lot of pain around knee cap from riding, got worse to the point I couldn't ride at all. Saw a very good sports physio who worked out the imbalances that were casing the knee pain and got me back into a better exercise regime. Problem sorted after 3 months of totally changing my exercise routine and introducing a lot more cross training and weights. Took 3 months but was stronger / fitter afterwards.
3. Cycling 2 - niggling pain around knee cap, just manage it by reducing volume. Gradually got worse. Cut a long story short it seemed to be caused by a) saddle height due to slipping seat post b) riding in crap shoes causing my foot to roll out. Fixed by changing shoes, pedals, seat height and more stretching / massage.

So a good physio can help but you need to put in the effort and apply yourself.

You've probably got chondromalacia patellae, which is irritation of the sliding surface behind the kneecap caused by sitting back while skiing or by bad saddle setup or just wear. I had it for a few months after a ski holiday when I sat back fearfully in deep powder but it went away of its own accord once I returned to normal life. Medicine is about keeping the patient amused while Nature does the curing, according to Voltaire.

i am doing the exercises they suggest, and i realise there is no quick fix as such. When I had private health care with an old job, I had some sort of infra red light/heat treatment thing for another knee ailment. I guess i thought there would be more of that. Yes globalti, it sounds very much like you describe. without orthotics my knee moves inwards by a fair degree rather than over the toe. Im getting new orthotics made up as mine are getting on a bit, so hopefully this will help.

doctor said heat pad, to aid it, physio said ice?

There is no evidence to say that infra red works.

As for the heat versus ice thing- Ice takes away pain, heat does the same in low back pain - stick with the ice.

Loads of great advice here

The physio will know what needs to happen muscle wise

But you might want to get your seat height checked and if you use cleats get your cleat alignment checked

"Treatment" could well mean numbing the pain until you've ground away all the cartlidg

http://blog.walkjogrun.net/2012/11/29/treating-it-band-syndrome-in-runners/

Scroll down to the picture, pretzel stretch.

Do it 3 times a day, also standing leaning over a table. Saved my kness!

Try different shoes and move cleat position. For years I was getting a pain after 2/3 hour rides. Changed to older shoes- noted how odd the cleat position felt and pain dissapeared. "odd position" now replicated on all shoes and pain yet to reappear.

There is a 4 page article in Cycling Weekly this week about knee pain, may be of interest.

I had to order some new cleats last week and noticed this:

[url= http://www.wiggle.co.uk/ergon-pedal-cleat-tool ]link[/url]

I fitted the cleats using the tool and went for my first ride Tuesday night. The position was quite a bit different to normal and felt odd at first but felt good as the ride went on. Time will tell...!

M6

In addition to correct bike size, riding position, seatpost height etc

A lot of knee pain can be attributed to tight ITB's and glutes. I'm back to square one after neglecting to continue the exercises my physio prescribed.

Physio normally works. I also found icing the area after a ride and regularly during the week helps with recovery.

anyone mention a proper bike fit? doesn't work as well on full suspension bikes but anything else it may help realign your position. do the physic thing too (that is what you said right?) ask elvis for his advise 😆

Lots of good advice here, mainly look at what your shoes and bike fit are doing, go to a physio and do what they say. Can't fail.
Have to point out though, and apologies to TurnerGuy, osteopathy is ineffectual nonsense. I doubt TurnerGuy had anything wrong that some rest wouldn't have sorted, osteopaths usually claim things like imbalances, crooked pelvis, muscle knots, these are all false, all to justify their bill. The manipulations they do are the equivalent of cracking your knuckles, just a bit of theatre, however they are potentially dangerous so please avoid.
Top athletes are always looking for crutches to help them, belief in magical thinking like osteopathy, acupuncture and all sorts of assorted quackery are always a problem. Endorsement doesn't mean it works.

I was expecting some sort of actual treatment to reduce the pain, rather than just exercises.... so do i pay to see a physic and get some other treatment or is their anything else i can do

Do the exercises you have been given and see if you improve.

The system these days is set up to send people through the MSK route before they get any where near seeing an orthopaedic surgeon. Do the exercises and if still no improvement, your GP will eventually refer you to clinic.

2nd the avoiding going to see quacks who will take your money, but medically dont do anything, apart from potentially make you worse.

osteopathy is ineffectual nonsense

believe that if you want, but you are wrong.

Seen too many instances of people being straightened - a guy a worked with used to wear cheap suits to work. One day he seemed to look smarter than usual - turned out he had been to an osteo who had straightened up his hips and now the suit looked better as he was standing straight.

Another girl couldn't win any medals at Dressage - her horse kept wandering to one side. After straightening' the horse went straight and she got a bronze in the next comp.

The guy I normally go to has a picture of someone with scoliosis on his web page, both before and after he managed to straighten him from that - which is quite something.

I effectively had been resting - only walking, hadn't run for ages, only a couple of recent rides that weren't very taxing, and my knee was worse than it had been when running. Day after treatment and pain gone and hasn't come back, and the hamstring seems to be returning to normal - all with no more than the same stretches I was doing before the manipulation.

Obviously if you look after yourself and don't have any bad habits then an osteo probably couldn't do anything beneficial. But not many people fall into that category.

I was expecting some sort of actual treatment to reduce the pain, rather than just exercises

hello nan. It's a shame they couldn't just give you a pill to fix it.

osteopathy is ineffectual nonsense

the osteopath i saw gave me stretches and strengthening exercise to do. I no longer have the back pain i once had. it was very effective.

As with most professions, I suspect there are good, bad and indifferent physios.

When I had neck issues, the physio just looked at me and said "do you carry a bag over one shoulder". A few sessions later, and with doing the exercises, I was cured.

With my recent knee issues, one physio was a bit ineffectual, but the most recent one knew exactly what he was doing, told me what exercises to do, and after three sessions I was back running. He was recommended by the knee doctor I saw after the MRI scan.

I had a spate of knee pain last year early in the fair weather riding season, reckon I did too much distance before I was conditioned for it 😆

[b]Things I noticed made it worse
[/b]
1. wearing shorts in cold weather

2. wearing sticky flat trainers with nanotech pedals giving no natural foot movement when riding

3,longer rides

[b]Thing I did to improve it
[/b]
1. stretched pre ride, mid ride and post ride

2. lycra with shorts over the top to keep knees toasty until summer arrives (also supports knee area and offers increased stability)

3. layback seatpost, looked at a few angles of knee when sat on bike and layback helped put less torque on the joint (the T40 gives an impressive 25mm of additional layback and has sexy height markings http://www.chainreactioncycles.com/truvativ-stylo-t40-layback-seatpost/rp-prod123029?gs=1&gclid=CIazo6ycusQCFaQIwwodeDwAJA&gclsrc=aw.ds )

4. moved back to my rubbish nike running trainers, meant less grippy on pedals, giving more natural foot movement on tap, less angular forces through kneecap from foot stuck solid to pedal.

5. Along with touching toes with straight legs, these are the other two stretches I do, the cross legged one in particular really helped loosen up the muscles around the knee

[img] [/img]

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Cheshirecat speaks the truth - the same is true of osteopaths (I am one).
IME anterior knee pain generally involves poor control of femoral rotation at the hip. This can only be improved by the patient (exercises). Effort free recovery from muskuloskeletally based problems is a myth IMHO.
Gluteal strength, ankle mobility, cleat & saddle position would be good places to start.
PS the quads stretch above is very easy to do ineffectually. It is much better done on the floor wih the front of the pelvis down & the body supported on the opposite elbow.