threeteas

I am a former Cat. 3 who primarily rides road and gravel who just started cycling seriously again a few years ago. I have a chronic issue with my right knee that developed last year when I was doing HIIT on an older magnetic trainer. I'm not sure if it's tendinitis or chondromalachia but deep knee bends hurt and also it hurts going down stairs. This isn't severe pain, but probably a 2 or 3 out of a scale of 10 which can become really annoying. Fortunately, it doesn't flare up too badly while riding. I'd like to get this healed up as I'm 47 and don't want bad and chronic knee trouble in old age (like my 73 year old Mom has).

It's basically pain on the very front of my knee-cap. Haven't gone to an orthopedist yet because honestly it really seems like I can lick this with some strengthening exercises or home remedies. I've started stretching my hamstring muscles like crazy because this is recommended as helping. I've also been icing pretty regularly. I'm about 20 pounds overweight--it's also been recommended that I lose this as well to help alleviate symptoms.

I run Speedplays on everything but my mtn. bike and this is helping a ton as well. I was using Eggbeaters but they seemed to be making things worse.

Any other suggestions from folks who have dealt with something similar would be helpful!

randallr

Have you played with saddle height at all? Maybe raising it a bit? Have you ever had a bike fit? I rode w/o any professional fitting until I was in my late 50's. The fit helped my right knee pain a lot.
Cycling Knee Pain: Causes and Solutions

IronM

I'd get evaluated by a orthopedic physical, preferably one who specializes in sports medicine. That's what I did, when having fairly bad knee pain (on the outside of my knee, not the front). They should be able to narrow down the issue. Knee pain is common in cyclists, but the causes can vary widely. Mine was inflammation from a foot alignment issue, but a friend had a torn tendon that had to be surgically corrected.

FBinNY 

Pain when going down stairs (but not up) is a classic sign of a damaged meniscus. This may heal by itself if you ease off, or anti-inflammatories may help.

Of course, this isn't a medical diagnosis, which can only be had with a visit to a specialist.

Other things may also be factors, including too high or too low saddle height, gear selection, foot alignment, etc. So, if you feel it's not that bad (yet) and wish to forgo a visit to the ortho, try tinkering with your riding position and style (spin lower gears), possibly combined with things like vitamin D&E supplements.

FWIW- I have a minor meniscus tear, and surgery isn't indicated, but find that I can keep flare ups at bay pretty successfully with MSM and vitamins plus the aspirin I take daily because it can't hurt at my age.

f4rrest

Mine cleared up on its own after a year.

Had an MRI that indicates level 2 chondro, fat pad inflammation under kneecap, and a tiny cyst, which some say can be caused by meniscus injury.

I swapped out the road doubles for compacts and triples.

I also rubbed Penetrex on it twice daily. YMMV.

Eventually, I was able to ride up Mauna Kea without knee pain.

Sojodave

I was having bad knee pain last year. I got a bike fit and he discovered that the leg with the sore knee was slightly shorter than my other leg. He put some shims on my cletes and that cured it. It could be a lot of things, but I would recommend you go to your Dr. and find out for sure.

threeteas

Yeah, that's what I've been doing. I just got a 12-30 cassette for my road bike (it is a non-compact Ultegra crank) but I'll probably go compact soon. Penetrex sounds intriguing as well.

I always mashed pretty big gears and I think that's definitely a culprit. I have also quit running as that is the only time it hurts like hell. Thanks for the input!

threeteas

Yeah, I have a pretty high seat position as it is, but might raise it a bit more. This is a great link, thanks! Haven't had a professional fit since I was a junior cyclist in the late 1980s, early 1990s (Fitkit era). Worth a look for sure.

canklecat

Same thing, same knee twinge, when I began doing intervals on my new-to-me road bike last summer. At 60, with a family history of knee problems, I didn't want to tempt fate.

I eased up off the intervals for a couple of weeks, just doing steady rides and gearing down for hills, no sprints, etc. Lots of massaging, soaks in a hot bath with Epsom salts, etc.

Meanwhile I tweaked the saddle position and began doing more stretching and strengthening exercises at home. Nothing special, just ordinary stretching, no weights, just squats, lunges, etc.

The trick is to be very patient with the exercises and move as gradually as possible, like a mime doing tai chi while sneaking up on a cat. Ten reps should take about a minute. Don't bounce, don't use momentum.

Best exercise tutorials I've seen are on the Bowflex YouTube channel. They're concise, usually only one or two minutes, and get right to the demos and reasons for the techniques. And they don't try to cram their exercise machines down viewers' throats just for watching some basic exercises that don't involve any apparatus.

I was doing a couple of things wrong:

• Squatting below where the thigh was level with the ground. My knees were cracking and popping when I did that. I still do squat fully to stretch, but I don't do reps. My reps are confined to the thigh-parallel-with-ground technique.
• Keeping the knee behind the toe. I wasn't paying any attention to this. Now I do. No more problems with knee twinges. Very important with lunges, more so than with squats.

You might also check your crank arm length. My road bike has 172.5, the hybrid 175. I actually prefer the longer crank arms on the hybrid, feels like I'm getting more leverage on climbs. But I must be very careful with saddle position on the bike, and my butt position on the saddle. If I'm off too much I'll tend to hyperextend the knee. So I lowered the seat post just a smidge.

No knee problems in months now. If it happens again, I may consider even shorter crank arms. While I'm 5'11" with long legs, there may be some advantage to shorter crank arms for preserving these knees. I'd rather avoid the knee replacements and reconstructive surgeries my older family and friends have needed.

I'll admit, it's a challenge forcing myself to slow down my reps. When I was a Navy Corpsman stationed with the Marines I got very competitive with the grunts and tried to outdo them on PFTs. I got where I could do 100 consecutive pullups. But it was all technique, not strength. I was swinging and using momentum to enhance the effort. I was very careful to do a full length pullup and return, but also careful to avoid hyperextending the elbow. It was a neat trick but the Marine NCO in charge wouldn't let me get away with it for the actual tests. When I used the slow rep technique he demanded I was lucky to do 30-40 reps. (That was 40 years ago -- I doubt I could do 10 pullups now. And I struggle to do three reps of 10 pushups.)

Lunges without knee strain:

Slow reps, gradual, no bouncing or using gravity or momentum:

threeteas

Thanks for this--definitely will try all these things. I also think that strengthening might solve these issues. Good stuff!

FBinNY 

If all else fails, have a friend take a beseball bat to the left knee. I guaranty that this will make the right one feel better.

pesty

+1

As someone who has lived with a torn meniscus issues off and on for about 25 years, I'm going to second just about everything here. I actually tore it about 33 years ago, but it didn't start bothering me until high school.

Over the last 3-4 years I've ramped up my milage to over 5k/year and found that having built up the muscles around my knee has helped a lot with issues. I now only have issues if I'm going up and down a lot of stairs over a few days/weeks. It only bothers me for a few days a time a few times a year, whereas before it was every 6-8 weeks. I found that a good supportive knee brace and some ibuprofen generally gets me through the bad days.

If it's bothering you on the bike, I'd go get your position checked. As someone who grew up in the days of downtube shifters and turning big gears at low cadence; if you do this, consider switching to lower gears at high cadence. If it's bothering you frequently, I'd go to an ortho and have it evaluated.

Chandne

I sometimes have right-knee pain as well. I suspect it is due to my messed up pronating left ankle and biomechanics since that effectively leaves me with a longer right leg length (much stronger side too). That in turn strains my right knee more. I tried a shim but the shim was too much 4-5 mm and it started to really hurt my left side. Currently trying to figure out a 2mm shim and have raised my saddle slightly, which has helped. I will get another fit done soon but in the meantime, I am really hoping I can figure out a ~2mm shim. I am not sure if this is essentially your problem but get a fit done by someone connected to a university's medical div. I got mine done at Univ of Boulder Sport Medicine dept. It was far more comprehensive than the bike-shop and private fits, it seems.

f4rrest

You can make your own shim with rubber sheet, which comes in various thickness. Just trace the shape of your cleat and cut with scissors. Don't forget to slice holes for the bolts.

Chandne

Thanks f4rrest! Any recommendations on what type of rubber sheet to get? I'll try this for sure.

f4rrest

I had a big roll of weighted vinyl sheet used for sound damping. It's too expensive to buy a roll just for this.

PM if you want me to mail you a piece.

DougRNS

You can use a laundry detergent bottle. It has a thickness of about 2 mm I believe. That is what I did over a year ago and it is still working fine. I think my knee pain is from grinding big gears back in the day.

one4smoke

Had the same thing you've described, and after doing some research along with suggestions here, I started taking Glucosamine Sulfate along with drinking tart cherry juicy. That was about 2 years ago, and after about 2 or 3 months I haven't had any problems since.

https://veryvery.com/products/spring...QaAhBsEALw_wcB

Nachoman

here's some ideas, which have probably already been mentioned: raise saddle, ride with faster cadence and lower gears, avoid climbing, especially out of the saddle, apply ice and take anti inflammatories.

McBTC

It sure sounds like chondromalacia and if so, I do not think strengthening is the issue but rather, your knee telling you to do less pushing and more spinning or else... if it hasn't been going on long and you address it quickly it'll probably go away and never be a problem again.