Runner 1

Sorry for so many injury posts, but they're all different injuries

There's something weird I've had for a few months. I think it's a "domino effect" injury caused by my main injury.

Basically, when I'm sitting in a chair for a while, if I bend my knee from 90 degrees to straight, the kneecap sort of tracks weird -- kind of like it jumps from one position to another.

To resolve this issue, I place my hand on the kneecap and push it inward (medially) while extending the leg, and the kneecap audibly pops, and then the problem goes away for about 30 minutes (I can extend my knee normally during this time). Given more time, the problem repeats itself.

I feel no pain with any of this, and I haven't ever had the kneecap slide out of place or anything. And it doesn't feel like it's out of place before extending or after.

The problem is particularly prominent when I go out to ride my bike. For the first few pedals strokes when my leg is at a certain position, my kneecap "jumps" just like it does when extending it while sitting in a chair. To fix it, I have to unclip my foot, extend my leg and press the kneecap inward until it pops, and then the rest of the ride it's fine.

Does anyone know what condition this is? I've had little success Googling.

HokuLoa

Sounds a lot like a meniscal tear. Be VERY careful trying to self treat by pushing your patella around. If you have insurance (or even if you don't) it is HIGHLY advisable that you have an orthopedic specialist check you out. Bad news is, if they think it is a tear in the knee you are going to have to get an MRI which can be pricey. Don't delay though. If it is a tear and you catch it early you are more likely to avoid surgery. If you dink around and keep training on a tear you are not only destined for surgery but you also increase the likelihood of a less successful outcome. These are you knees not a finger so take the warning (from your body and from me) seriously and get a checkup.

BTW, a good ortho knee specialist in a facility that also caters to sports med is the way to go. They are often more likely to take into account your desired sport/activity level and other related concerns should surgery be required.

Runner 1

Thank you for the advice! But I just got a 3 Tesla MRI a few days ago and no meniscus tear was present. I think it may perhaps be more muscle related. I'm going to see the OS again in the next 2 weeks, but until then I was hoping someone might have had a similar experience -- I find these invaluable.

dykim90

ITBS. do you have lateral knee pain when riding, specifically when you get out of the saddle?

i had the exact same symptoms as you. everytime i sat in a chair for awhile i would extend my leg and i could feel the pop when i had my hand over my knee. i went to the doctor and said everything muscle in my legs were tight. i started stretching, foam rolling, strengthening my glutes and hamstrings. now, the popping and lateral knee pain does not exist and i can go a lot farther on the bike.

lazerzxr

My immediate thoughts which may of course be wrong are as follows:

Knee cap mal tracking to the outer side will result in chondromalacia. Been there done that. If you dont have pain then you are not at that yet but you need to get the tracking issue sorted before it becomes a problem. The tracking isse could be caused by a number of things including tightness of sort tissues around the knee or weakness in certain muscles.

Stand on the one leg in front of the mirror and bend your leg. If your knee does not track over your second toe, go see a physio immediately for some glute strengthening exersises. This is too important to ignor.

On the bike the same can happen, if you have a tendency for your knees to lean in to the top tube then the muscles in your leg will tend to pull the knee cap sideways and wear the cartilage under the edge of the knee cap. Arch support and varus wedges in your shoes can help, again your knee should idealy track over your second toe to avoid putting large stress on the soft tissue of the knee.

It sounds like your knee cap is tracking outside its natural groove. If this is the case, and i am no doctor then it will only get worse. Physio is your best bet - and i normally speak against physios....

HokuLoa

Good news ;-)

Def worth getting looked at as "minor" and inconvenient knee probs can turn major and long lasting if unaddressed for cyclists. You seem to know that though... Good luck!

Runner 1

Thanks for the additional replies. Dykim90, your case is particularly interesting, because I have also had ITBS-like symptoms.

I just got back with my visit from the orthopedic surgeon, and I'm a bit disappointed. He didn't really address the ITBS issue. He asked how much I was cycling. I told him I haven't ridden my bike in almost a month (symptoms still here), but when I was riding it, I did about 20-22 miles a day.

He said it was "overuse" and that 22 miles is apparently really high mileage. I said, "No, not really", but that seemed to end the conversation. I added, "Well how do I get rid of this pain?" And the reply, "Stretch". Uh, okay...

dykim90, if you don't mind me asking, what specific exercises did you do to strengthen your glutes and hamstrings? I'd like to replicate what has at least worked for one person.

Thanks

hairnet

I too have this sometimes and I have read that an imbalance in the strength of the vastus medialis and lateralis muscles of the quads can be a cause.

tadawdy

The VMO really is kind of just a theoretical entity. Regardless, training the vastus medialis seems to help. Physios usually only care that something works, not so much why or how.

Peterson step-ups. short-arc knee extensions. If your physio says, of course.

dykim90

it was my left leg that had the problem and i believe it was from my injury to my left hamstring a couple years back. i never really did a full rehab for my hamstring, it was always weaker than my right after the injury. when i did the cycling thing, my knee started to pop right away.

I bought a foam roller. they are good in the beginning however they become useless later on because they lack concentrated pressure. so i used a nalgene bottle instead.

i also bought a exercise ball and did hamstring curls.

then i did glute bridges.

then i got a stretchy band to put around my ankles and shuffled my feet sideways, one step at a step to build my gluteus medius.

you can youtube all these videos. you basically need to get a bigger ass.

HokuLoa

Yeah, it is good to note that orth surgeons are not necessarily your "go to" for sports specific information. They are often great at surgery but lousy at all else (sadly). Good example, if they specialize in knees and treat mostly skiing, soccer, B-Ball etc injuries they may be great surgeons but know little to nothing about the repetitive stresses/dynamics of cycling. Try a sports med knee specialist w/ a good background in cycling specific issues for better feedback/advise. This includes non-surgical sports med folks who can often better address the ongoing cycling dynamics relevant for better injury prevention.