Outer knee pain when cycling

[dan]

Hi guys,

I hope you can advise me. I crashed in a cycling race 3 weeks ago. I took 10 days off the bike so that my skin on my left leg could grow back. I did whack my left knee in the crash but could walk around with no problem after a few days.

When it came time to get back on the bike, after an hour I experienced severe outer knee pain. Doc reckons it was a bruised bone combined with bruised ITB. Gave me anti inflams and said to rest a few days. I had problems walking downstairs.

I saw a myotherapist who massaged my itb and now waliking downstairs and around the office s much better. BUT still hurts like hell on the bike.

How can I know if there is no structural (cartilage etc) damage? Two docs have confirmed no miniscus (?) or ACL damage.

Basically I need to know if it's referred pain (and knee is ok) or actual knee pain.

Sorry for the long post but I reckon the more info the better.

Ciao

Dan

[jellybean]

Hi Dan,

I?m not a medico, but the fact that the anti-inflamms and myotherapist massage of your ITB helped suggests that perhaps the bruising to your ITB is a big component of your pain. It may be that the increased flexion of your knee when on the bike stirs up the ITB more, hence the continued pain there. I also ride and used to have ITB problems, but from trying to increase the volume too quickly and/or pushing too big a gear for the amount of training I?d done. My pain also generally used to come on after an hour or so except when my knee was really ?angry?, then it started earlier or as soon as I tried to ride a bigger gear. I had to spend some time off the bike to let it settle down, when I started again I kept the km?s down and rode in a much easier gear (stayed right out of the big chain ring). That helped. How does your knee go if you just spin?

I?ve also had pain on the outside of the knee from a crash ? I never had it checked out but figure it was largely bone bruising. It was ok for riding after a little bit but even now (6 years later) I can?t kneel on that spot.

Re ensuring you have the right diagnosis ? were the docs you saw experienced in dealing with sports injuries and, in particular, knee injuries? If so, then just see how you go, you may just have to be a little more patient. If they weren?t then I suggest you see a sports physician, in particular one who specialises in knees or who has a good understanding of cycling injuries to ensure that you have an accurate diagnosis. (I haven't heard of anyone doing an ACL or meniscus in a bike crash - more likely to be what you've been diagnosed with plus the road rash - but I guess it's important to rule everything out).

Good luck, let us know how you go.

Cheers,

JB

[dan]

I rode today on the 39 ring easy. I lasted 30minutes and had to pedal home with one leg.

It's funny cause I rested 5 days after last weekend racking up about 5 hrs of easy riding over 3 days, with tolerable pain coming and going. But today I could't even pedal back home!?

How long did it take you to recover?

Can anyone advise on the following...
I am seeing a GP tomorrow for a referal, should I request MRI, X-Ray or ultrasound to show any physical damage?

Thanks guys

Dan

[jellybean]

Dan,

I had to laugh (empathetically of course!! ) when you said about riding home with one leg. That is exactly what happened to me. It would niggle a bit and I'd tell myself I could ride through it and before I knew it it was so painful I had to ride with one leg and get off and walk up any hills to get back home.

Was the 5hrs over 3 days the first real riding you'd done since the crash? If so, it could be that you seemed to handle it at the time but that you stirred up the ITB (if that is the problem) again so that the next time you went out it was unhappy straight away. That definitely used to happen to me. In the early stages I could get away with a longer ride or two but the longer or harder rides when I wasn't ready for it would come back to bite me (i.e. pain straight away on subsequent rides).

It's a while since I had the problem so I can't remember exactly how long I was off (several weeks?) and I had to be REALLY careful when I started again. Having said that, everyone is different (injuries are different in terms of severity, etc) - you need to get advice for your particular injury.

I would really see someone who is experienced in sports injuries but if that's not an option, your gp will hopefully know the right tests to order based on what he/she sees (xrays are obviously to check for any bony damage and MRI/ultrasound for any soft tissue damage. I didn't ever have any tests for mine so I can't help you there. Someone else may be able to offer advice there.

Cheers,

JB

[angieliu]

Hi Dan,

I used to have really bad pain on my inner knee when I was younger and no one could figure out what the problem was. It would flair up when I would run and also when I was riding and so I went to the GP who ordered X Rays and also referred me to an OS who ended up sending me back to physio. Physio itself wasn't much help but I did end up going to see an acupuncturist who helped quite a bit for a couple of weeks.

You could consider going to see one to try to reduce the inflammation. But I think that if you are getting pains and that it is ongoing that you should go and see a sports physician to get it checked out properly.
A

[dan]

JB, it sounds to me that I have a similar injury to what you had.

Yes, last week was my first ride back ,so I did 1hr Friday, 2 hrs Saturday and (gulp) 3 hrs with a coffee break on Sunday. Yes, maybe I could've done without the 3hr ride. But I can smell the road race season and I don't think I have to explain the rest to you (hehe!)

What's giving me hope is that this pain may be referred pain. I noticed this after the myotherapist went to work on my itb "with a pair of pliers and a blowtorch" - (pulp fiction). I could walk much easier, especially downstairs.

I will get a scan anyhow just to ensure the knee is ok. It's too important to me.

I really appreciate your input, and knowing someone had something similar and is back on the bike, really helps. I am aware that no one is a medical expert on this site but after shelling out $350 (carbon bars?!) odd this week, no one has been able to tell me what's wrong with my knee, so onto the internet I go.

Thanks mate
Dan

[jellybean]

Hey Dan,

ITB problems (if that's what it is, 'sounds like it) can definitely be overcome - but you must be patient and let it settle down, otherwise it can become a chronic problem and you'll have to spend even more time off the bike.

The knee that I had the ITB problem in is actually now my good knee, I have been dealing with some far bigger issues in my other knee for the last 12 months (a chunk out of the back of my knee cap, meniscal damage, and early onset arthritis - not from cycling, from a climbing fall and skiing) and have been really limited in what I can do on the bike as a result. Before I didn't bother going out unless it was for at least an hour and a half, other rides were 2 - 4 hours, now if I make 1 hour I have to be happy (I've taken to driving over some of my old courses and stopping for the odd coffee just to remember what it was like! But things are slowly improving again and I will eventually get there.

'Sounds like the massage is doing you good, stick to it and if you continue to have hassles, please see a sports physician (sports doctor) who specialises in knees (check out the clinics section of this website for one in your area), after the Medicare rebate an initial consult will only set you back around $60 (there's not much you can buy for your bike for that!!) and they will give you an accurate diagnosis and suggest the right treatment for your injury. GPs are generally not the best at that.

Keep us posted!

Cheers,

JB