pttrnlanguage

Hi all
Did a Zwift "FTP build me up" session and came out of it with some posterior knee pain in my left knee. Did a similar session the next day – started gingerly and felt pretty strong on the bike so plowed on. Pain wasn't an issue on the trainer.
Off the bike, however, different story. It's been 3 days since and everything in the back of my left knee feels super tight. Hard to fully extend and "lock up" that left knee.
Walking around the city it feels like my left leg could buckle at any moment.

Waiting to get into a PT for an evaluation, but this is NYC and it's taking a while. Wondering if the group has recommendations for stretches or other self-care for now.

Cheers
Chris in NYC

Carbonfiberboy 

The usual advice is to lower your saddle. Try 1cm. Back of the knee pain resulting from cycling is usually over-extension. I do these stretches every morning: https://www.bikeforums.net/road-cycl...l#post15372967

When stretching, discomfort is OK. Pain is not OK. Gently hold each pose for at least 20 seconds. My link says to do the stretches 3 times until you feel better, but it means at different times of the day.

Another thing worth trying is 600 mg ibuprofen every 6 hours. Try that for a day. If it helps, it's a tendon issue. If it doesn't, it's something else. These things will give you some knowledge of what's going on to discuss with the PT. Meanwhile, don't ride.

pttrnlanguage

400mg ibu is helping, so I guess tendonopathy?
Does icing still help a few days after the initial injury?

canklecat

There's no consensus on icing. Experts say it doesn't help. Feels good, though, so sometimes I use it. I always ice impact related injuries ASAP.

Regarding knee pain, that's usually a bike fit issue. Usually saddle height and fore/aft position. Lots of tutorials and tips online.

And I'd suggest taking it very easy for a couple of weeks. Zone 1 or 2 rides only, easy gears, and concentrate on smoothness. Sometimes that's all we need to heal and prevent a recurrence.

A week or so ago I felt a rare twinge in my right knee. My knees are generally good so I knew something was off in my bike fit. Sure 'nuff, I'd forgotten to reset the saddle height after a brief experiment with clip-on aero bars. I needed to raise the saddle and scoot it all the way forward to get comfortable on the aero bars. But after a week I got tired of the experiment -- the aero bars messed with the bike's handling in stiff cross winds.

But after removing the aero bars I forgot to reset the saddle to the original position. Not a huge difference, maybe 1/4" on the seat post, same on the saddle. But it was enough to make my knee complain.

I reset the saddle (I had tape marking the original position) and did mostly indoor trainer easy spins for a week before tackling an outdoor ride. The knee is still a bit tender but it should be fine in another week as long as I take it easy. So I'm gearing way down on climbs rather than stomping and mashing for a new PR.

Carbonfiberboy 

The downside of icing is that it restricts blood flow to the problem area, which of course slows healing. OTOH if swelling is causing a problem, rather than fixing one, it's the other way 'round. Since the ibu worked, swelling is a problem and icing might help. Try it.

Daniel4

Would lateral knee pain be the same thing? Saddle height? I have no problem, no pain standing or even doing the squats at the gym. But I feel the stress while pushing down during pedalling.

Carbonfiberboy 

IME lateral knee pain will go away if one stretches. I do these stretches every day: https://www.bikeforums.net/road-cycl...l#post15372967

canklecat

Could be saddle height, could be saddle fore/aft position, or a combination of both.

When I'm tweaking my fit I'll set up a video camera to record myself on the trainer. I'll let it run awhile until I'm warmed up and no longer aware of or "posing" for the camera. Often my posture changes as I warm up and again when I get tired. All of that can influence bike fit and comfort, including avoiding or causing knee pain.

Stretching is controversial and much disputed among cyclists. I still do it because it feels good (bum neck, back and shoulder from injuries). But now I warm up before doing any serious stretching.

And I don't regard stretching as useful for my bike fit or efficiency below the waist. It seems to introduce more variables that complicate fit.

My current knee twinges are due to messing with a fit that was already perfect, but I messed it up with experiments. So I'll probably revert to the saddle, saddle position, and chainring set I'd been using without problems before swapping saddles, position and going from 50/38 round rings to 52/42 Biopace and, as of this weekend, to 52/39 round rings.

In between all that, I also experimented with clip-on aero bars that necessitated raising the saddle and scooting it forward. Now my knees are balking at messing around so much with what had been a perfectly comfy bike.

I expected some adjustment period but the knee aches after recent rides are new to me.

My best guess is the saddle is just a wee bit too high, maybe 1/4". I'll lower it, do an hour or so on the trainer and go from there.