[Closed] Knee Problems

This is anecdotal, not advice...

I had a case of what my Physio said was Infrapatella Fat Pad Impingement.

He said the only way to cure it was to run really hard to properly inflame it and then the body would sort it out. He says a low-level inflamation doesn't get picked up by the body's defences. He also said do it at circuit training on Wednesday night because he works late, and his clinic was on my way home just in case it didn't have the required effect.
If he hadn't said that, I wouldn't have had the nerve to run through the pain.

It seemed to work (for me) but he might have been talking bollocks. Especially as the clinic was in darkness when I went past on my way home.

Anyway, I haven't had the problem since. But my problem isn't what you've got, probably. So don't do what I did.

See another physio for a second opinion, and/or visit your GP and try to get some scans done to confirm a diagnosis.

Thanks guys, I've spoken to another physio this week who made another suggestion... She said she gets a lot of cyclists with knee pain when the weather cools off, and she puts it down to when they start wearing knee warmers or long tights... I guess it might have a similar effect to Infrapatella Fatpad Impingement in that it compresses the patella and restricts movement.

Now, my problem seems to have started after a 'trauma' but it got me thinking if wearing slim-cut jeans might be preventing the problem from righting itself (I wear jeans for work and my time is spent either seated or climbing up and down stairs).

Has anyone had any experience of this? I've been wearing stretchy jeans this week, and they feel 'slightly' better, but the problem does seem to 'ebb and flow', so I'm not counting my chickens just yet...

I've booked in to see the GP next week...

You need to see a real specialist, not a GP or a physio who claims to be a "sports" specialist. Walking downhill is harder on the knees than going up. my wife did the same in Chamonix two years ago (external ligament damage hurts like **** with a very sharp pain). You need specialist physio and build up slowly, always take the stairs and walk down slowly and deliberately. In future wear a brace and use walking poles.

FWIW I have two buggared knees now, no acl in either, mimiscus damage ... cycling should still be very do-able for you.

EDIT what fife says, an mri is probably the only way to really know. Tell the doctor it hurts, GPs tend not to ignore pain in patients. Good luck and if needed be prepared to pay for treatment. Look up Steve Peat's rehab story

Thanks Jambalaya, the physio I originally saw is a knee specialist, and a former GB Olympic physio, so should know what he's doing.

One thing he was quite clear on is that the cartilage and ligaments are in good condition. He said the inflammation is consistent with the type of activity I was doing... His prognosis was that it could be up to 6 months, but his gut feeling - given my general fitness etc - would be 3-4 months.

The fact that the 2nd knee has started to go the same way (some time later) makes me think there could be some other external factor that's causing it...

Maybe I'm clutching at straws, I'll see if I can push the GP to give me a referral.

Your original injury sounds exactly like the episode of chondromalacia patellae that I gave myself once by sitting back too far on my skis in deep snow. That took a good six months to sort itself out.

If your jeans are tight enough to press your kneecaps, what the hell are they doing to your sperm count?

Is your saddle high enough? A low saddle will cause the same problem as sitting too far back on your skis. I often see mountain bikers bouncing along, seat too low and arse hanging over the back wheel.

Saddle too low gave me a bout of patella tendonitis.
I changed saddles and adjusted the wrong way by a few mm's and it was enough to bring it on after about 20 miles.
I upped the saddle (probably no more than 5mm) and eventually sorted the issue but it took maybe 2 months for it to be right.
Maybe look at adjusting saddle height and seeing if that alleviates the pain when riding?

Piss the sucker off big time with some ass to grass squats, heavy weight low reps, that'll cure it.

@council that's great, try and get back to see him even if you have to pay. IMO he will offer far more than the GP is able. Treat GP as gateway to getting NHS to pay for what you need. Doc I see works part time with a French handball team (they get lots of knee issues), surgeon treats pro skiers and physio is an ex team member who has done Camel Trophy stuff. No disrespect to generalists but they are just that.

What globalti says 🙂 BTW loser trousers are a good idea, mate of mine has knee issues from skiing and dinghy sailing (kneeling a lot on hard glass fibre) and he cannot take pressure on his knee cap.

Little and often with rehab work.

Healing vibes.

Funnily enough, sperm count doesn't seem to be a problem just lately!! 😳

I don't wear those skinny-like-a-One-Directioner or teenager jeans, just a slim, narrow leg - Gap's 'skinny'... They're not clingy, but I definitely notice a tightness across the kneecaps when seated or stepping up stairs...

I mostly ride road these days and saddle height has been identical for at least the last 4 years... As I said, the physio ruled out chondromalacia - he was adamant that their is no cartilage damage.

Jambalaya, thanks again, good advice...

I had the same issue, with simliar pain and age, mine is osteoarthritis, actuallu having Arthroscopic Surgery tomorrow, also having Platelet Rich Plasma PRP treatment too, prior physio helped strenghten surrounding muscles but pain never really went away, especially after recent ski-ing trip, I intend to be cycling a lot more years so looking forward to a new knee, fingers crossed.

Best of luck

I've had various knee problems over the years, some very painful and debilitating. Without exception they have been put right by a course of massage, shiatsu and use of the ITB roller to loosen and relax surrounding muscles. Quite often the problem has started with a big day in the hills or a cramped working position on a DIY job. The last time the pyhiso was convinced I had a torn cartilage and would need surgery but massage and strengthening/balancing exercises sorted it out. It has never been a quick fix, a couple of weeks of work usually does it though. Don't write off the possibility that you may be able to improve things yourself, there are loads of videos for knee problems on line. Also don't overlook the hip area which for me stiffness here had a direct effect on my knee,

Cold weather has also been a problem on the bike, traditionally it was called Easter Knee by the old timers in the roadie club. It's caused by changing from long winter trousers to shorts to early in the year (easter) cos' the sun is out.

this may be no use but i'll comment any way...

i'm having ongoing knee probs through running, but my issues asides for the last month i've started taking both a cod liver oil and a glocosamine tablet daily (from healthspan). i took them many years ago and it helped, and once again i have noticed a great improvement mainly in the mornings walking down stairs.

Depending on whereabouts the pain is situated, rubbing in Ibuprofen gel twice a day actually does work; amazing because I find it hard to believe the molecule can actually penetrate the skin and get to work on inflammation.

Thanks for those extra pointers, I had thought about trying CLO and glocosamine...

Definitely try and get an Mri booked in to assess any possible damage to prevent it potentially getting worse - I've had problems for years after a meniscus tear and it recently transpired the tear was only half the story & there's a bit of bone bruising and wear & tear to several areas of cartilage (base of femur/back of patella primarily) which causes a fair bit of pain when the affected areas line up - consultant told me it obviously won't heal itself & anything that makes it hurt is causing further aggro so essentially if it hurts, don't do it 😕 more than an hour or so on the mtb on anything other than smooth easy trails aggravates it, so much so I'm selling my last remaining mtb & investing in some 38c cx tyres for my cx/commuting bike instead 🙁

/downer

Good luck be positive and try and think a little outside the box. As above it's damn complicated, the joint itself, the way one thing affects another (muscle imbalance, back / hip / foot issues all affecting each other ... ). When I have had an injury it's stunning how quickly miscle wastes or one bit tries to compensate for another and/or you subconsciously change the way you move. Body is an amazing thing really, miracle it all works as well as it does frankly !

This may not address your particular knee problems as you don't seem to have a specific diagnosis.

And mechanical damage; is mechanical damage; knees are notoriously difficult to fix.

But a few general knee thoughts from an Iyengar Yoga teacher who often encounters 'bad knees' in students who are also keen cyclists or runners.

Definitely + one for correct saddle height. Too low and the knee joint doesn't fully extend on down stroke.

I see so many tight hamstrings in cyclists and runners because they have neglected their stretches - boring yes, but also functional.

The knee joint is supposed to fully straighten, to the point where the knee caps are pulled up by the quadriceps.
this needs (sic) to be repeated regularly.

I have had students being free of knee pain after years of bother once they have learnt to use the leg muscles properly... You are effectively creating a knee brace with the musculature itself, and allowing full irrigation of knee joint by making the space in the knee joint.

Its hard to explain in words, best to find a competent bodywork teacher who can show and tell.Oh and you have to practice this regularly. further boo and hiss...

p.s. i'm not suggesting this is cure for all joint ills, or can rehab every injury, but over and over I, and many other teachers like me have seen marked improvement in painful knees with this kind of careful work.

We all want to be happily cycling into our nineties yes??

Years ago I started suffering from knee pain. Initially coming downstairs, then going up, then all the time. GP and consultant didn't find anything. Physio grabbed my leg, wiggled and said "do you ski"? She diagnosed cruciate ligament damage and advised light weight training in order to get the muscles to stabilise the knees. It worked. Many years on, older and generally more creaky, I sometimes have a lot of trouble coming down off big hills (down Hall's Fell Ridge of Blencathra last year was hell). So I'm contemplating weight training again. Cycling seems much kinder.

I used to have iffy knees but a couple of summers sea swimming with body board swim fins really seems to have helped them. They give enough resistance to help build up your legs around the knees without aggravating them. I used to really struggle with walking down hill but now only get the odd twinge after a long walk.

@slowoldman do you use sticks, they make a huge difference walking down hills.

How do you confuse a Geordie physiotherapist? Tell her you've got knee problems.

I don't buy this stuff about tight hamstrings - how would people walk if their hamstrings were over-tight?

What I do buy is that joints take time to catch up with muscles so if you build muscle strength it takes your joints much longer to adapt to the greater stresses. In the same way, if you stop using the muscles the support they give the joints begins to fade and problems begin. I know that in the late Autumn as cycling is slowing down I always get lower back pain, which goes away again as soon as I get out on the bike.

Hmmm, more interesting pointers... For a bit more background, I'm a life-long cyclist and haven't particularly increased volume lately, bike position is dialed in and not changed... I've not ridden mountain bike in anger for 18 months since a broken collarbone, sternum and ribs.

I've never had any 'joint' problems apart from the usual 'blunt force' traumas to the knees that tend to go hand-in-hand with mountain biking...

My latest experiment, "Operation Elasticated Jeans" does seem to be proving positive, although I'm reluctant to attribute any improvement to one change... However, if Fat Pad Impingement is the problem (which seems likely), reducing pressure on the patella 'could' help matters... Sitting down or climbing steps in close-fitting, unyielding denim generates a terrific amount of pressure on the joint.

As with others' advice, this was just my experience and a warning. First off, given that the pain started in just one knee you have probably been compensating for it since, and this would cause pain in the other knee, and possibly other areas such as ankles or hips. But, when I had long term pain in left knee I tried physio and other non-invasive stuff to no effect but then eventually went private and had MRI. The MRI showed nothing but consultant said he "didn't believe" the results and recommended and arthroscopy (keyhole) anyway, which I went with. For a while, maybe 3 years it was definitely better, but is now getting painful again. not sure there was ever a need for surgery so if you're tempted by private I'd recommend trying NHS route first because there's no financial incentive for them to carry out an unnecessary op.

@slowoldman do you use sticks, they make a huge difference walking down hills.