Cycling / knee injury - ugh

russG

Hi all

I thought that cycling was generally an injury-free activity as long as one avoids contact with other objects or surfaces...

A week and a half ago I experienced a twinge in my knee during a VO2 interval.

Injury-free is a priority for me so I stopped the intervals, but I did continue the ride (options were limited - it's a longer walk).

Haven't been able to ride without significant pain since.  

Had bike fit checked by my fitter, who I trust - he's great (Dean Phillips, Fitwerx, Peabody, MA)  He opted not to touch much; he turned my heel in a little on the left cleat, and to make room for that he added a washer between the pedal and the crank.

Gave it a full week rest; tried a 16-mile easy ride yesterday (8 to the pond and 8 back) ...and ... pain.

The only thing that I added to the well established routine were the intervals, which may have pushed a sore tendon into injury.

Exact location of pain - left knee, not inside the knee, but outside, rear, outside, slightly below the axis - near the top of the fibula.  I can touch it and it feels bruised.

The good news is that I can swim without a problem, and I can run with only a very minor sensitivity (1..2 on the 1..10 scale), although I worry that running will exacerbate the problem and keep the inflammation from resolving.

What I can use - specific guidance from the team if anyone has experienced this type of overuse injury before or is otherwise familiar with this type of injury; moral support because it sucks to be injured and it's really hard to give it the time and space it needs to heal.

Thanks!

cgres123

Sounds like a knee cap tracking issue if I read this correctly and the fit correction for that is bring the heal out some with toe in which brings your knee closer into the bike. That will take pressure off the knee in that location.

Nate Parady

In my mind the more common overuse injury slowly starts to appear and raise its head slowly getting worse and worse until you either rest or begin PT to remedy the issue. That's just been my experience with ITBS and Tendanitice

You experienced a specific "twinge" on a specific day during a VO2 session. 1 week later its still hurts.

-Walk with a limp, does it hurt in your daily life?

I've had tracking issue in the past caused by changing from Tri Bike to Road Bike and it felt more in the knee cap. A few months later I developed ITBS so I now suspect what I thought was a tracking issue was in fact the beginning of my ITBS flaring up. Any chance what you have related to an IT band issue??

russG

@David - funny - my fitter brought the heel in, not out.

@Nate - doesn't hurt in daily life; in fact, running has been ok, although I worry about it...
Not impossible that it's ITB related, but it's lower down - more fibula than femur.
That said, I suspect your experience holds - if I don't let it heal - because I want to train - then I will one day regret that decision...

rmiller

Russell -

When you do other activities, such as squats or lunges - do you feel anything then? Curious whether it is something that shows itself any time there is force applied, or maybe only at certain points within the range of motion, etc.

My left knee cap has a tendency to occasionally track incorrectly while on the bike - I can feel when it is off, but it doesn't hurt.. usually straightening my leg fully sorts it out - but there have been a couple times that it popped back into place while riding, and I can hear the pop. Not sure whether I actually hear it through the air, or the vibration of it through my bones to my ear - but whatever. Either way, just bringing it up because in my N=1 experience, an incorrectly tracking knee doesn't necessarily hurt - just something feels different. I also bring it up because I found that if I keep my left heel out during cycling (my cleats have 7 degrees of float in them), it occurs less.