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Author Topic: Can you dignose my Knee Problem. Long Post.  (Read 964 times)

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Offline shades1

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Can you dignose my Knee Problem. Long Post.
« on: March 21, 2006, 01:37:56 PM »

I have had a problem with my right knee on and off for two years now but I still haven't figured out what the problem is exacty. Would appreciate you folks looking through my symptoms below and letting me know if you have any ideas.

Im 36 years old and for the last ten years have done a variety of sports mainly circuit training, cycling and swimming. A little bit in the gym too. In the last two years I have increased my cycing alot and have probably over trained.

The Problem:

Two years started to get very severe knee pain in the right knee 2-3 hours into my bike ride. This happened for both road and mountain biking. I should say that I can usually cycle for 5 hours no problem. The knee would be fine for 3hrs but then suddenly become very painful indeed within 20 minutes. I usually feel a slight niggling tightness at the back the knee first, but then soon after  the pain seems to focus to just under the knee cap. I have to stop cycling immediately, although i've noticed that standing up on the pedals during cycling eases the pain. Sitting down on the saddle and continuing cycling is too painful.  Even swinging my leg over the handle bar when getting off the bike had me gritting my teeth.

Once off the bike I then find that lowering my body weight on that knee is incredibly painful. When I get home ( usually by calling my wife for a lift!) going up and down stairs is very painful. And yet, if I ice the knee and rest the swelling goes down within 24-48 hrs and I can soon swim and circuit train with no pain. But if I get on the bike then 2-3 hours in the pain starts again.

This has gone on now for two years.  I am fine for short bike rides of even quite high intensity, swimming and circuit training but on longer ones the pain always starts at some point.

If I drag my right foot along the floor, in the manner of  a bull  pawing the ground, I feel a pain at the back of the knee. Leg curls hurt a little too.

What have I done about it:

Changed bikes and pedals and shoes. No change.

Had two MR scans. The first one was clear, the second which I had quite recently indicated a slight lateral tilt of the patellar, some slight swelling  of the fat pad, a small grade1 tear of the posterior ligament. Nothing too serious according to the  orthopeadic surgeon. He said go see the physio.

Physios suggest  weak VMO muscles or patellar tenditis/tendonosis or ITB and prescribed a whole bunch of stretching and strengthening excercises too numerous to list. I followed these for a year. 
Curiously, I  have noticed that the right problem leg doesn't seem to tighten up as much as the left leg. Its a very subtle thing but there IS a difference..

I also saw a podiatrist and got myself some orthotics.

I  drastically reduced the amount of sport I was doing. I now circuit train infrequently and have not cycled over 30 miles for 1 year  now.

Where I am now:

I am now a knee expert!!

Six months ago I tried to slowly buid-up my milage but the  knee just swelled up again 4 hrs into the ride. It was like all the excercises and stretching had made no difference at all !

Following that I took  three months off ALL excercise except swimming once a week. I  took up Yoga. Then I slowly crept into my sport again over the following three months. The right  knee pain came back yet again !!

When I cross my legs, right knee over left,  OR when I squat down, the right knee still feels slightly stiff. Not pain really just a stiffness. And if I paw the ground as I descrived above there is a still this slight niggling pain/ tightness at the back of the knee.

My right butt feels tight due to maybe  piriformis syndrome. Other than that health is okay.

If you can diagnose this you can marry my daughter.

Offline Audice

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Re: Can you dignose my Knee Problem. Long Post.
« Reply #1 on: March 21, 2006, 01:57:33 PM »
I wish I could help you with your problem, Shades, but I haven't a thought about it other than to say maybe it's time to find a new OS to see if someone different might offer something new. But I did enjoy your last comment. Great sense of humor. Wishing you well...Ellie
April, 2005 - ACL rupture, medial meniscus tear within posterior horn to articular surface, abnormal signal within lateral meniscus, partial tear MCL, bone contusions tibia/fibula, Baker's cyst.
No repairs.

Offline blackbeltgirl

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Re: Can you dignose my Knee Problem. Long Post.
« Reply #2 on: March 21, 2006, 09:03:02 PM »
I agree with Audice.  Your first step is probably a new OS.  But it sounds like articular cartilage damage to the back of the patella.  Every time you bend your knee, you run the patella through its groove, rubbing against any damaged areas.  And unfortunately, it is  very difficult to diagnose this with x-rays or mri.  And it's difficult to treat.

One option is to try raising your bike seat.  You can experiment on a stationary bike, and you may be able to determine the angle at which the pain kicks in.  For example, the part damaged may not be rubbing against anything until you hit a 90 degree bend.  In that case, if you can set the saddle to reach max bend at 80 degrees, you wouldn't be abusing the damaged area.  (I tried this once, though, and couldn't complete a revolution at less than 90 degrees.)

At any rate, it's worth researching.  Stairs, rowing machines, hamstring curls, and leg extensions all require the knee to bend to 90 degrees or more, and would therefore have a similar impact on the patella.

Good luck-
ACI was supposed to be 2/21/06.  On 6/29/06 Insurance co said have another scope, and if it still looks good, they'll ok the ACI.
Microfracture Dec 7, 2004
   3cm x 6cm lesion, LFC; 3cm x 1cm lesion, trochlear groove; lateral tibial plateau lesion
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