Gammy knees WWSTWD?

Hi all,

I’m 30 and have had dodgy knees since around aged 15, mainly coming on if I ran too far too quickly. It’s been a while since I ran, but I feel said knees – one in particular – becoming uncomfortable even during longer rides these days. The pain is actually inside the knee, rather than surrounding muscle (though it can sometimes be in the tendon behind the knee). I gently ramped up my riding during lockdown and this dodgy knee kinda ruined a mini multi-day tour over the summer. Knee was hurting before the end of day 1. Never been a problem with riding before having done a 2-week tours in recent years.

I went to a GP a few years back, who prescribed anti-inflammatories, which worked but problems returned when I stopped them. Similarly, ibuprofen gel works a treat these days for the discomfort but it returns when not using the gel. I don’t like doing this because it’s not actually solving the problem and I fear I may be damaging the knees further by working through it.

What do you reckon? Try to get referred to a physio? Anyone on here had similar and solved the problem – give me a bit of hope…? Any tips for what I can do at home? I have supplemented my diet with Omega oils for a while now and have been taking glucosamine for a few weeks and yet to see any change. I also heat and ice regularly to reduce inflammation.

Cheers in advance,

R

I’d potentially look at getting a proper bike fit if you haven’t already.

It being winter I’d recommend a neoprene knee sleeve like the poundland ones even, if I dont wear one I suffer
Otherwise physio says to do squats and lunges, though my personal trainer says he wouldnt let his clients do that until they know how to do that properly.
My knee’s getting worse, the NHS put me onto their physio as a first step to getting it checked out, sorted etc.
So I’m hoping I can get a CT scan or at least a proper evaluation soon. I’m a lot older than you though
And..SPDs did my knees in, shimano(2000) ones anyway, so I never use them

I’d potentially look at getting a proper bike fit if you haven’t already.

Not a bad shout! Was thinking of treating myself in 2021 to a gravel/tourer so perhaps it’s worth getting something custom.

It being winter I’d recommend a neoprene knee sleeve like the poundland ones even, if I dont wear one I suffer

I have tried these before, but generally after the discomfort starts. Probably worth trying as a preventative.

Interesting about the SPDs… Do you just use flats now?

If you can afford it, be worth looking at paying for an hour with a sport physio (looking at ~£60 generally for an hour). NHS physio, due to resource, focuses on getting you back normal day to day life. For sport specific stuff like this, you might find, esp at the moment, referral takes ages. You might only need one apt as they do an assessment and give you appropriate exercises.

Time pedals are supposed to be better for knees. Don’t know how true that is but I have pretty naff knees (including arthritis and an ACL reconstruction) and I have no problems with them.

See a physio. I have had a bit of knee pain whilst riding, and I saw a physio who suggested my hips are weak and that is putting extra stress through my knee. Not sure its cured yet but seems to be heading in the right direction.

My knees used to always blow up. Turned out was my feet…. I’d prescribe a good podiatrist as a start point.

My knees used to always blow up. Turned out was my feet…. I’d prescribe a good podiatrist as a start point.

Very interesting… Do you think this is something that a physiotherapist would notice?

All I know is that at 30 I shouldn’t have bad knees and I dread to think what they’ll be like in 10, 20 years time…

Time pedals are supposed to be better for knees. Don’t know how true that is but I have pretty naff knees (including arthritis and an ACL reconstruction) and I have no problems with them.

Definitely worth a try with some Time Atac then. I know that the cycling isn’t the *cause* though, given that they have played up in other contexts for a while.

Yep, a good physio can work wonders in finding out what’s causing the problem, then solving it. There was another thread very recently on a similar subject that I replied to, but the abridged version is a half hour with a physio(Andy Berry, Spyre Healthcare, Cardiff), pretty much sorted a problem that myself(and pro cycle fitters)had been unable to fix for years.Pedal-wise, Speedplay Frogs also helped with masses of float, but no sloppiness too, but wouldn’t have, and didn’t, fix my issue alone.

Seems like things are pointing to private physio as a good course of action. Though podiatrist is a good shout. I do over pronate but shouldn’t be an issue when cycling should it? Any recommendations for physios in the Sheffield area? I guess this is a good place to start: Accredited physio’s

@rsmythe it’s my personal experience, but, A lot of problems start lower down the leg, and you experience it higher up. It’s kind of logical as well, bad foundations eequal bad walls. I have high, collapsing arches with flat feet. I used to have my knees blow up when I hit a certain fitness, due to the pressure being placed on my knees by my feet.

I now wear custom carbon insoles, probably on the 3rd iteration in 18 years, which along with regular stretching, occasional work on certain muscle groups etc means I’m completely problem free. It probably won’t be just one thing, may well have VMO and/or glute weakness as well for example, but my podiatrist took a detailed hour and was able to pinpoint the points to work on. Over the course of a few months we sorted it.

If you’re in the North Yorkshire type area let me know and I’ll send you details.

A decent physio should be able to point out if you need to see a podiatrist (my Dad had this, this year for example). Some have podiatrists as part of their team. Start with the physio as they can look at your overall function.

Sorry can’t help with Sheffield. I have some good N Leeds recommendations, but a bit far.

@northernremedy thank you. I’m about as far south in South Yorkshire as you can go so your recommendation will probably be a bit far for me. Good to hear your success story though!

ahsat, thank you but as you say, Leeds is a bit far for me.

Some have podiatrists as part of their team.

I will aim to see someone at a larger clinic in that case then. 👍

Definitely a decent physio, if you’re in Sheffield then fit4physio near Hunters Bar (inside the Tennis club) are great and have a couple of riders who work there. It could be lots of things, mine was basically muscle imbalance and was sorted by regular stretching to balance it out.

My knee pain was caused by muscle imbalance – dragged my knee cap slightly out of track and caused bursitis.

I’d be careful with neoprene sleeves until you’ve had an assessment, it can force the kneecap into the bones worsening pain.

I had a dodgy knee, tried glucosamine, omega oil etc to no effect. Went to a sports physio through work healthcare- no real joy and they didn’t offer any specific cause.
Then at a ski show one year, they had physios doing sessions. I explained the symptoms, they moved my knee through a range of exercise and said likely to be torn cartilage.
Went back to GP, got a consultant appointment through healthcare. On examination he thought the same, arranged an MRI that weekend to confirm and I was booked in for an op PDQ.

Mine felt like it was in the knee, rather than and strain in muscles/tendons. I could do some rides no issue, others it would play up where the loose cartilage would move. Although it “hurt” it didn’t feel like it stopped me riding like a muscle strain would hamper you.

Not dismissing sports physios per se, the one I used had treated other issues for me since with success, just a bit miffed they didn’t pick up on this. Ultimately a CT/ MRI will highlight what’s going on.

I’m a similar age and spent the last 2 years trying to sort my knees. For me it eventually involved two hefty surgeries to correct alignment issues in my legs, but without it I would have arthritis by the time I was 35.

In descending order I’d recommend:

– Seeing a good sports physio ASAP
– Having a bike fit (If cycling is much worse than other activities)
– Get custom orthotics (If the physio notices any issues with your gait or foot structure)
– Requesting an MRI scan from your GP, saying that you’ve tried the above efforts.
– Have a consultant with a knee surgeon if all else fails and/or the scan picks up something that needs sorting. Seeing a surgeon for a private consultation can significantly speed up NHS treatment in my experience, especially if your GP was reluctant to refer you anywhere.

Rich at Fit4Physio (recommended above) has helped me with a couple of knee problems. Good at getting to the root of the problem rather than treating symptoms.

He also does bike fits.

The starting point is what is the problem? Probably sliding joint (knee cap) or cartlidge. A physio should be able to work out which it is

Then ask again on here. I think bike fit and pedals is less relevant to cartlidge etc. My cartlidge means i really need to ride FS on anything rough

PS my physio diagnosed my carhlidge problem

I’ll add my vote to Steve’s and Grant’s for Rich @ Fit4Physio.

Physio and bike fit in one is a nicely joined up solution.

Some good advice here that I have never thought of. I suffer from bad knees aswell, I’m only 39 and in constant pain with my knees and left elbow.

Had all the tests for arthritis but they came back clear, left elbow is golfers elbow but apparently that will clear up on it own (had it for well over a year now), got told on Wednesday to have a break from cycling as that will aggravate the elbow, I have a physical job aswell which doesn’t help.

In regards to my knees it’s the right one that hurts the most, had my ACL replaced 6 years ago after an Ice Hockey injury, also tore my MCL about 14 months ago when I came off my bike. The pain is under the knee cap and it’s swollen. I can feel it stiffening up if I walk more than about a mile.

Been prescribed tramadol and naproxen but not keen on depending on tramadol for the pain. Rubbing copious amounts of tiger balm on the affected areas and taking 2 co-codamol at bed time, but they wear off about 4am and that’s me awake.

Sounds like I need to be seeing a sports physio aswell to try and get to the route problem.

Anyway, thanks for the ideas on this thread, glad to see I’m not alone.

@rsmythe as podiatrist’s go (I’ve had a poor one and that is no fun at all) I can thoroughly recommend Colin Papworth at Hathersage (Colpody) and Chesterfield (Holywell Health Care). Helps me still enjoy long mtb rides and walks in comfort. The combination of orthotics and insulation from POC VPD Air knee pads pretty well removes any residual knee ache on big days in the hills or ss’ing.

Have a chat with Colin first, quietly spoken but knowledgeable, as sometimes if there is a problem elsewhere he will recommend getting that sorted first.

As for sports physios, Duncan Mason at Athlete Matters, Worsley is excellent, though probably to far from you.

Some excellent advice here. STW does it again. Thanks all.

@rsmythe it sounds like you might have Patellar Tendinitis which is caused by an overuse of the knee and is exacerbated by latteral instability in the knee joint.

The pain you describe is exactly what I used to get and in conditions which you describe in your OP.

I cured mine by including strengthening exercises into my post-run stretching after every run. I also included exercises for ITBS (outside of the knee) so as not to simply transfer the problem from side to side. I now have no problems on either long/fast runs or rides less the 8 hours (I haven’t tried further since I started doing this). There are a few online resources which describe the exercises required to strengthen these tendons/bands and they’re not hard, but are initially painful.

Can anyone recommend any of the holy trinity (physio, podiatrist, bike fitter) in the South Devon area (close to Newton Abbot)?