dalava

After years of cycling, my knees are finally getting to a point where some pain will never go away. MRI has revealed some early signs of arthritis, and the doctor basically told me there is nothing I could do other than conserving. It's basically an age thing.

My plan is to keep riding as much as I usual do (~150 miles/week, weather permitting), but not going as hard as before. Also, I will probably experiment a bit with the saddle position to see if I could relieve pressures on the knee joints. Other than that, I am not sure how to deal with it.

Any suggestions or share with me your own experiences. Not riding is not an option.

Elvo

Read this:
Bike Fitting Specialists - Cycling Knee Pain

dalava

Thank. I've gone through most of that, and a few fitters and fit systems along the way.

metalheart44

I have advanced arthritis in both knees. I am a 6k+ a year rider. I have experienced some relief using cleat wedges to ease the load on the inner compartments where the arthritis is most problematic. And, I have an 11-32 cassette so that I do not mash up hills, and I regularly ice my knees. Last year I used a prescription cream called voltaren a topical NSAID since I take blood thinners and cannot otherwise use NSAIDs. It worked very well for me for pain relief, but I did develop an allergic reaction to it and now I just bite bullets.

delcrossv

Talk to your ortho. Semi-annual shots of cortisone and daily meloxicam work for me with moderate osteoarthritis in both knees. There also may be some specific PT the doc can prescribe.

Also, no more mashing. you may want to look into shorter cranks which may help as they lower the range of motion and encourage spinning.

dalava

Shorter cranks (170mm) and granny gears (32t) are definitely the two things I will be doing shortly. I take some Advil on days after a long ride, but I will check into the other options mentioned here. I just can't fathom life without riding. It would be bleak.

Bacciagalupe

FWIW, I would not recommend cortisone. My understanding is that it provides relief temporarily, but actually worsens your condition.

That said, what might wind up happening is your doc gives you cortisone for a year or two, and when that no longer controls the pain, it might be time for a knee replacement.

So, you might want to read this thing, to get a better overall perspective... Amazon.com: What Your Doctor May Not Tell You About(TM) Hip and Knee Replacement Surgery: Everything You Need to Know to Make the Right Decisions (What Your Doctor May Not Tell You About...) eBook: Ronald P. Grelsamer: Kindle Store

bikerjp

I'm having issues as well and experimenting. I got specialized shoes that have the built in varus (or whatever) wedge and you can add an additional one. I've also been experimenting with trying to keep my knees closer to the top tube, thinking more about pushing out and over the top rather than just down as I tend to, and putting more pressure on the inside of the foot. I have no idea if any of these are working yet, but I seem to have less discomfort in my last couple rides than even just a few weeks ago.

delcrossv

True if you take it too often. My ortho says once every six months- max. Frequent users can have big problems.

PaulRivers

I know that for me doing squats (with a barbell) after reading at and looking at form a lot alleviated my right knee pain completely - but I didn't have arthritis, I just had a knee that was used to using a bad position, and this seemed to straighten it out and build up the muscle correctly.

Don't know that that would help you though, and if you have arthritis don't know if it would even be a good idea.

Long Tom

Time wounds all heels...... sucks.

Keeping my knees in towards the top tube, and not mashing, helps keep mine pain-free. At age 48 I can most definitely induce pain from cycling if I don't stay on top of my form. I do love to climb hills, steep ones, so that probably doesn't help, lol. But it just feels so gooood....

copswithguns

Jesus I don't want to get old....

moppeddler

I couldn't ride without using patellar tension straps. They're not real expensive, might do the trick for you too. Mine are made by McDavid (I think). Got them from Amazon for like $20 or less.

petalpower

I'm going through the same issues OP. I've totally stopped all my intervals, and pretty mush ride steady state only for about 15-20miles, 3-4x week. I used to log 180-200 miles a week only 2 years ago.not sure where it all went wrong.

i aggravated the bursae in my left knee working on on of my rentals ( flooring) and I haven't been the same since. Not sure if it's ITB, runners knee, poor fit, etc on the bike that's causing my dull ..... Feeling/sensation as it's not really pain. Knee just feels vague sometime off the bike and on the bike I feel it on the top of my tibia just below the knee both inside and out.

scheduled a fit so I guess we'll see.....

Miami Biker

Well I ride cuz that works best for my knees. Yes turn 69 tomorrow, however replaced right knee almost 10 years ago and left one is moderate to severe osteoarthritus. Getting right fit is important so that should help.

I try to spin higher RPMs rather than mash. Leg muscles have built up past two years riding. Some say collagen helps with joint pain as does replacing salt and water. Diet could be a cause or cure.

Guess should find root cause of pain. Perhaps getting someone to watch you ride (trainer) can see if position is contributing. Too hard to guess without someone seeing you and determining cause of ache.

Good luck

TrojanHorse

I got hit by a car when younger and have very little cartilage left in my right knee and plenty of osteoarthritis to go with it. I'm 46 but my doc says I have the knee of an 80 yr old (and that was 10 years ago he said that). Still, I've had 2 arthroscopic surgeries to clean up the mess and that seems to help for a while, and recovery is fast these days.

Anyway, you can find supplements that are supposed to help your knee health and I tend to take an Aleve before a long ride. You may need to schedule more rest days than before.

Honestly, I rarely let it bother me. What are you going to do, quit? Unlikely. Stuff like running is probably a bad idea, so avoid that like the plague. I actually have a $1500 brace (since I'm missing half my cartilage) I wear when I do any lengthy hiking (which for me is 5 miles or more) and I'll pay for it the next day. Those little knee straps are unlikely to do anything for arthritis, so don't bother.

If it gets really bad you'll probably need a new knee, but delay that as long as you can stand it.

krobinson103

At forty my knees can no longer take mashing up steep hills. I just make myself spin faster in gears with less torque. Not really my favorite thing to do. but it sure beats knee pain.

dalava

Your situation is very similar to mine; I had a Lyme last summer and even though my doctor said I am fully recovered, I felt like my joints have aged 10 years compare to before. Just a couple of years ago, I was doing 25 miles commute every day and then long (e.g. 150 miles) weekend rides with very little issue. Then I think I aggregated the issue by running (which I quit a few years ago) that caused ITBS which took a while to fully recover. It was during the diagnose of the ITBS the doctor saw some early sign of RA which he said is normal for my age (53).

I have done a lot of fitting already, most recently last summer, and as far as I know, the bike and cleats and shoes (Specialized with varus support, I am a supinator with relatively high arch) are quite well set up to minimize any undue pressure on the knees. So I am kind of at the point where the options are really just not riding as hard and not as often and far.

I hears some herbal supplements may help, and do some research and see what their efficacy is like.

Carbonfiberboy 

I've been taking MSM and glucosamine sulfate for many years. At 68, my knees are pretty much perfect. Had them scoped to fix a meniscus tear a few years ago; doc said the cartilage looked very good. Maybe I'm just lucky. Worth a try for a few months, anyway. Cheaper than new knees. Or possibly too late for that. I also have a very good diet, take my vitamins and so forth. Getting old doesn't have to be a disaster.

snookanglr

I also suffer from knee pain in one of my knees. I think it's tendonitis that came about from trying to do too much too fast and my age (42). What's helped me is easing up on the mileage a bit, using the little ring a lot, pedaling high cadence (at least 85), and slant board eccentric decline squats. I try and do about 30 of those daily. I also switched to Speedplay pedals to allow for more float (I like 8 degrees) and of course make sure you have a good bike fit. For big rides I usually wear kinesio tape and ice it afterwards. I also wear a simple Ace knee brace during flareups but not when riding. Here's some links and videos that I found helpful:
https://www.youtube.com/watch?v=1_wb...ature=youtu.be
https://www.youtube.com/watch?v=ul09...eature=youtube
https://www.myfivefingers.com/knee-exercise/
https://www.fix-knee-pain.com/injurie...ee-tendonitis/

banerjek

My guess is that just cranking down the effort like you plan will work. I used to need the usual tricks to manage pain. A couple years ago, I ramped down both the distance and the effort and I feel great. If I feel like riding hard, I absolutely can -- it just needs to be less often.

shoemakerpom

I have had the same knee problem for years probably due to riding in general. As I went to GNC for vitamins I talked to guy and asked him what he uses for knee problems when power lifting (since that is what he does for exercise). He recommended this GNC - Search Results and I have went to many GNC's and most athletes that work there recommend this. Since then I have been using it for 2 years and knee pain has gone down substantially. I have even recommended it to other people over 40 and they all love it. I only take one a day since my daily ride is only ten miles. If you do more then that you can take two. Works very well....

bikerjp

^ Overpriced. I got the same stuff for about $20 at Vitamin Cottage. Not sure the count at the moment but it was a big bottle - 200 caps or more.

vega2614

I've struggled with knee pain for a while after a really hilly two-day 200 miler ride 3 years ago. I've tried pretty much everything: different cleats/pedals, wedges, saddle position, drugs, vitamins, cortisone shots, taping, riding style (higher cadence, rotate knees inwards during pedal stroke), etc. None of these were permanent fixes as the pain was entirely dependent on how much/hard I was riding.

Most people are referencing the above approaches which I'm sure help many people. However, through my quick skim of this thread (might have missed it) I don't see anyone mention working on the muscular support of the knee. That means strengthening the VMO (medial quad) muscle as well as all the muscles involved in cycling (quads, hammies, glutes, calves). This works particularly well for chondromalacia and other patellar tracking issues. Granted, you describe arthritis, but if you can tolerate the muscle strengthening exercise (don't cause more pain), I think it could help.

I should mention that although the muscle strengthening approach helped for my achilles tendonitis, it unfortunately did not specifically work for my knee pain because I ended up having fat pad impingement. I am still recovering from arthroscopic surgery 2 months ago, where the ortho basically gave me knee liposuction and removed a bit of the plica. I have some mild pain when I ride now (sometimes none), but I'm almost at full speed and still well within the recovery period of inflammation due to surgery, so hopefully it subsides. I do have a bit of chondromalacia on my knee, which the physical therapist said is alleviated by quad strengthening.

Another related option is to stretch those newly strengthened muscles. Stretch after a bit of warm-up before the ride, and then after. Also, get a foam roller and roll those kinks out. Throw in some NSAIDs before, during, and after ride (following timing directions of course), and toss an ice pack on there after the ride is over (google "RICE").

Good luck.

dalava

^^ what are some the exercise to strengthen the VMO muscles that you found effective?