Knee trouble--tendinitis

In article <[email hidden]>,

dccyclist said:

Does anyone have any recommendations on how to deal with knee
problems like this? Thank you.

What is causing the knee stress? Is your pedalling motion flawed,
causing unnecessary twisting of your knee?

"dccyclist" : After six years of bike commuting, I have my first knee
problems. The
: doctor said it was probably tendinitis with a strained and possibly
: tearing ligament. I tried ice, ibuprofin and a knee brace, but it's
: getting worse, and I'm going to stop riding for a week or two (it helps
: that it's getting colder). I probably should have stretched before
: rides. Does anyone have any recommendations on how to deal with knee
: problems like this? Thank you.

When I had a similar problem (from a misaligned pedal), my doctor injected
the knee capsule with Synvisc for instant relief. Then, I took it easy. Look
at your pedals. Is your foot pointing inward too much? Where is the pain?

Pat in TX
:

dccyclist said:

After six years of bike commuting, I have my first knee problems. The
doctor said it was probably tendinitis with a strained and possibly
tearing ligament. I tried ice, ibuprofin and a knee brace, but it's
getting worse, and I'm going to stop riding for a week or two (it helps
that it's getting colder). I probably should have stretched before
rides. Does anyone have any recommendations on how to deal with knee
problems like this? Thank you.

I am neither a doctor, nor an expert on tendonitis, but I have had
similar problems in my wrists and elbows and this is my experience.

REST! Rest the knee! Rest is the main thing that can restore your knee
to good working order. Anti-inflammatory drugs can help, and you may
consider taking them every day for a while to speed the healing, but
don't think you're good to put strain on the knee just cause it's
stopped hurting, exercising while on anti-inflammatory or painkilling
drugs can be dangerous, it's easy to overdo it and make things worse.

I don't know about ice, but braces don't work. I tried all sorts of
braces, from loose tensor bandages to specially moulded things with
rigid inserts, and found that none of them could hold the joint stiffly
enough to prevent a significant amount of motion, and with the muscles
pulling against the brace to move I think they can also make things
worse. Just my experience though. The only advantage they can have is
keeping the joint warm, which is important if you strain it at all in
cold weather.

Most of the time I think tendonitis is caused by a jerky or uncontrolled
motion that repeatedly strains the tendons and ligaments in the joint.
The only way to prevent this is execute the movement with good posture
and good control. The second part means strengthening the supporting
muscles, not just the muscles responsible for power output. You need
your knees to be competent, not just strong, and they should definitely
be exactly where you want them throughout the entire pedalling motion.

My arms were nearly crippled by high-output outdoor activities. My
theory is that the high level of exertion resulted in my body producing
endorphins that allowed me to continue to work at a significantly
reduced level of pain, which in turn allowed me to disregard the
injuries for weeks or months until they worsened (I would be stiff and
in pain in the mornings, and then loosen up). When I returned from the
woods my arms hurt just holding onto handlebars- I had a job as a
mechanic and could barely lift the bikes or spin the wrenches. What
worked for me was rest and physiotherapy. I did gentle arm and wrist
excersices, with an emphasis on control over brute strength. I tried
juggling weighted balls, bouncing them off the backs of my hands, etc. I
also had a gyroscope type thing that you hold and twirl, and it resists
the motion but only if you spin it in a perfect even circle - built in
feedback to ensure precise movements. Happy to say, a little under a
year later, I'm back to all my old tricks with no trace of pain,
although I'm keeping up with the exercises.

For a knee injury I think low-exertion swimming is great exercise. At
the athletic center I visit, they have a pool devoted to rehabilitation
of sports injuries. Just remember to take it easy and focus on control,
you're not there to make it worse. Of course all of this is just from my
own experience, I'm not an expert and you should consult with your
doctor before following my advice (which you already did) blah blah blah.

Find a good physiotherapist and he'll be your best friend.

I don't know what's causing the stress or about my pedaling motion. I
don't use toe clips, but maybe I should. It's just hard to come into
them every time I stop at an intersection.

Jacobe Hazzard said:

dccyclist said:

After six years of bike commuting, I have my first knee problems. The
doctor said it was probably tendinitis with a strained and possibly
tearing ligament. I tried ice, ibuprofin and a knee brace, but it's
getting worse, and I'm going to stop riding for a week or two (it helps
that it's getting colder). I probably should have stretched before
rides. Does anyone have any recommendations on how to deal with knee
problems like this? Thank you.

I am neither a doctor, nor an expert on tendonitis, but I have had
similar problems in my wrists and elbows and this is my experience.

REST! Rest the knee! Rest is the main thing that can restore your knee
to good working order. Anti-inflammatory drugs can help, and you may
consider taking them every day for a while to speed the healing, but
don't think you're good to put strain on the knee just cause it's
stopped hurting, exercising while on anti-inflammatory or painkilling
drugs can be dangerous, it's easy to overdo it and make things worse.

I don't know about ice, but braces don't work. I tried all sorts of
braces, from loose tensor bandages to specially moulded things with
rigid inserts, and found that none of them could hold the joint stiffly
enough to prevent a significant amount of motion, and with the muscles
pulling against the brace to move I think they can also make things
worse. Just my experience though. The only advantage they can have is
keeping the joint warm, which is important if you strain it at all in
cold weather.

Most of the time I think tendonitis is caused by a jerky or uncontrolled
motion that repeatedly strains the tendons and ligaments in the joint.
The only way to prevent this is execute the movement with good posture
and good control. The second part means strengthening the supporting
muscles, not just the muscles responsible for power output. You need
your knees to be competent, not just strong, and they should definitely
be exactly where you want them throughout the entire pedalling motion.

My arms were nearly crippled by high-output outdoor activities. My
theory is that the high level of exertion resulted in my body producing
endorphins that allowed me to continue to work at a significantly
reduced level of pain, which in turn allowed me to disregard the
injuries for weeks or months until they worsened (I would be stiff and
in pain in the mornings, and then loosen up). When I returned from the
woods my arms hurt just holding onto handlebars- I had a job as a
mechanic and could barely lift the bikes or spin the wrenches. What
worked for me was rest and physiotherapy. I did gentle arm and wrist
excersices, with an emphasis on control over brute strength. I tried
juggling weighted balls, bouncing them off the backs of my hands, etc. I
also had a gyroscope type thing that you hold and twirl, and it resists
the motion but only if you spin it in a perfect even circle - built in
feedback to ensure precise movements. Happy to say, a little under a
year later, I'm back to all my old tricks with no trace of pain,
although I'm keeping up with the exercises.

For a knee injury I think low-exertion swimming is great exercise. At
the athletic center I visit, they have a pool devoted to rehabilitation
of sports injuries. Just remember to take it easy and focus on control,
you're not there to make it worse. Of course all of this is just from my
own experience, I'm not an expert and you should consult with your
doctor before following my advice (which you already did) blah blah blah.

Find a good physiotherapist and he'll be your best friend.

I was going to post about tennis elbow. I've had it for two years and
have been though PE and exercises and celebrex and cortisone and ...
still have it.

I was considering having surgery since nothing else has really helped.
But last week I couldn't ride for the whole week because I was going
to a customer site instead of my office. So, it got better. Now, back
after biking for two days, it is worse.

I didn't think that biking had much of an effect, but I was wrong. I
may have to give up biking for a few months. It is preferable to
surgery.

I should point out that I had planter fasciitis about six years ago in
my left arch. I could not get rid of it no matter what I did. Until I
broke my right ankle (on a mountain bike) and spent two months in bed.
I do NOT recommend that particular approach for curing PF by the way.

Moral: Rest cures certain ills. Good form does also. My backhand is
much better now although I don't play tennis much.

: I was going to post about tennis elbow. I've had it for two years and
: have been though PE and exercises and celebrex and cortisone and ...
: still have it.
:
: I was considering having surgery since nothing else has really helped.
: But last week I couldn't ride for the whole week because I was going
: to a customer site instead of my office. So, it got better. Now, back
: after biking for two days, it is worse.
:
: I didn't think that biking had much of an effect, but I was wrong. I
: may have to give up biking for a few months. It is preferable to
: surgery.

Have you tried wearing one of those straps on your arm, right below your
elbow? I had tennis elbow a while back from shoveling snow (of all things!)
and the doc fitted me with a strap.
http://tinyurl.com/6yqol

:
: I should point out that I had planter fasciitis about six years ago in
: my left arch. I could not get rid of it no matter what I did. Until I
: broke my right ankle (on a mountain bike) and spent two months in bed.
: I do NOT recommend that particular approach for curing PF by the way.

I had to make a "slant board" and stand on it from time to time to stretch
the plantar fascia. That helped a lot! It made the pain go away.

Pat in TX ( I was shoveling the snow in Germany)

dgk said:

Quoted message said:

Find a good physiotherapist and he'll be your best friend.

I was going to post about tennis elbow. I've had it for two years and
have been though PE and exercises and celebrex and cortisone and ...
still have it.

I was considering having surgery since nothing else has really helped.
But last week I couldn't ride for the whole week because I was going
to a customer site instead of my office. So, it got better. Now, back
after biking for two days, it is worse.

I didn't think that biking had much of an effect, but I was wrong. I
may have to give up biking for a few months. It is preferable to
surgery.

I should point out that I had planter fasciitis about six years ago in
my left arch. I could not get rid of it no matter what I did. Until I
broke my right ankle (on a mountain bike) and spent two months in bed.
I do NOT recommend that particular approach for curing PF by the way.

Moral: Rest cures certain ills. Good form does also. My backhand is
much better now although I don't play tennis much.

Exactly. Physiotherapy and drugs do work, but only if they are combined
with rest. After all, the *only* way to heal properly is for your body
to heal itself, so let it!

It's shocking how wide a range of activities can affect a joint in ways
you wouldn't expect. If you can notice any amount of pain from your
tendonitis, you're doing something you shouldn't be. Listen to your
body! Tendonitis comes from excessive and uneven force applied
repetitively to ligaments and tendons, which causes pain and swelling,
which exacerbates the problem.

The hardest part of my wrist injury was having to stop playing guitar
entirely, for three months. Now, after healing for months and then
practising my playing daily for short intervals of time, I've got my
chops back (such as they are) and I can honestly say it was worth it. I
blame all the problems I had on my ignoring the pain in my wrists when
it first developed. I'll never do that again.

Quoted message said:

After six years of bike commuting, I have my first knee problems. The
doctor said it was probably tendinitis with a strained and possibly
tearing ligament. I tried ice, ibuprofin and a knee brace, but it's
getting worse, and I'm going to stop riding for a week or two (it helps
that it's getting colder). I probably should have stretched before
rides. Does anyone have any recommendations on how to deal with knee
problems like this? Thank you.

Tendon & ligament problems sometimes respond to moving the cleat back,
toward the rear of the shoe. This puts more of your foot over the pedal,
reducing leverage on your foot (and the various things that try to hold your
foot in place as you apply pressure). It cost nothing to try, and sometimes
can work wonders. The theoretical downside is that you lose a small amount
of power when you move more of your foot over the pedal, but, in my
experiences, this is miniscule at best, and the potential upside makes it
worth a try.

--Mike Jacoubowsky
Chain Reaction Bicycles
www.ChainReaction.com
IMBA, BikesBelong, NBDA member

"dccyclist" <[email hidden]> wrote in message
news:[email hidden]...

Quoted message said:

After six years of bike commuting, I have my first knee problems. The
doctor said it was probably tendinitis with a strained and possibly
tearing ligament. I tried ice, ibuprofin and a knee brace, but it's
getting worse, and I'm going to stop riding for a week or two (it helps
that it's getting colder). I probably should have stretched before
rides. Does anyone have any recommendations on how to deal with knee
problems like this? Thank you.

Hello,
I was diagnosed with patella tendonitis in October, after my duathlon
season. The doctor recommended rest and naproxen sodium (Alleve). If you
have patella tendonitis, it can be caused by your muscles getting out of
balance (one of a pair stronger than the other). I've also started strength
training again (something I had neglected this year), and it has helped. You
want to do leg extensions with low weight, and high reps. Be sure to get
your doctor's ok, especially since he mentioned a possible tear.

Thanks,
Larry

Pat said:

: I was going to post about tennis elbow. I've had it for two years and
: have been though PE and exercises and celebrex and cortisone and ...
: still have it.
:
: I was considering having surgery since nothing else has really helped.
: But last week I couldn't ride for the whole week because I was going
: to a customer site instead of my office. So, it got better. Now, back
: after biking for two days, it is worse.
:
: I didn't think that biking had much of an effect, but I was wrong. I
: may have to give up biking for a few months. It is preferable to
: surgery.

Have you tried wearing one of those straps on your arm, right below your
elbow? I had tennis elbow a while back from shoveling snow (of all things!)
and the doc fitted me with a strap.
http://tinyurl.com/6yqol

Oh yes, I have three of them. I kept losing them. I wear one all the
time while biking. I also wear a wrist cast thing at night. It
prevents pulling on the ligaments as the wrist bends.

I figure that January to February I won't bike, maybe. If it doesn't
get better, I go with surgery. I do not wish to mess up another
summer. I also ice the elbow after riding to work and riding back
home.

Quoted message said:

:
: I should point out that I had planter fasciitis about six years ago in
: my left arch. I could not get rid of it no matter what I did. Until I
: broke my right ankle (on a mountain bike) and spent two months in bed.
: I do NOT recommend that particular approach for curing PF by the way.

I had to make a "slant board" and stand on it from time to time to stretch
the plantar fascia. That helped a lot! It made the pain go away.

Pat in TX ( I was shoveling the snow in Germany)

I bought a sort of big boot that pulls the toes upward as you sleep.
That stretches the planter ligament and really did help. I think that
is very much the same concept.

When I started biking seriously back in May I started feeling little
twinges in the old PF ligament. So I got some shoe inserts and that
made it much firmer (I mostly wear sneakers!). I still need something
firmer I think. I'm considering the SPD type shoes.

:: >Have you tried wearing one of those straps on your arm, right below your
: >elbow? I had tennis elbow a while back from shoveling snow (of all
things!)
: >and the doc fitted me with a strap.
: >http://tinyurl.com/6yqol
: >
:
: Oh yes, I have three of them. I kept losing them. I wear one all the
: time while biking. I also wear a wrist cast thing at night. It
: prevents pulling on the ligaments as the wrist bends.

Wow! You have it much worse than I. What did you do to get it? Was it really
tennis playing?

:
: I figure that January to February I won't bike, maybe. If it doesn't
: get better, I go with surgery. I do not wish to mess up another
: summer. I also ice the elbow after riding to work and riding back
: home.

Has a doctor already recommended surgery? What does s/he plan to do in the
surgery?

:
: When I started biking seriously back in May I started feeling little
: twinges in the old PF ligament. So I got some shoe inserts and that
: made it much firmer (I mostly wear sneakers!). I still need something
: firmer I think. I'm considering the SPD type shoes.

Yes, stiffer shoes definitely help. I had plantar fasciitis from playing
soccer. Too much moving slowly then suddenly breaking into a sprint....I had
to change shoes to more of a "turf" shoe from the cleats I was wearing at
the time. You should be able to find shoes on sale at this time of year and
get a pretty good deal.

Pat in TX

dccyclist said:

Does anyone have any recommendations on how to deal with knee
problems like this? Thank you.

Fro anything like rheumatism, arthritis, tendonitis and carpal tunnel
syndrome, try wearing a copper bracelet!

Many people, even completely non-superstitious ones, have experience of
relief with this method. It seems to have something to do with the
continuous deposition of copper oxide on the skin and its absorbtion,
although the exact reason _why_ it works has not been isolated by medical
research.

My own experience was a shoulder that was inexplicably sore for months. It
was even waking me up at night. Doctor said rheumatism. I tried a
magnetized copper bracelet that I bought on E-bay. Pain went away, not
immediately, but after a few weeks and has never recurred. I used also to
get knee problems from kick-scooting so I know I have a susceptibility, but
so far I have had no knee problems with cycling or exercycling.

In any case, it doesn't hurt to try.

EFR
Ile de France

: Fro anything like rheumatism, arthritis, tendonitis and carpal tunnel
: syndrome, try wearing a copper bracelet!
:
: Many people, even completely non-superstitious ones, have experience of
: relief with this method. It seems to have something to do with the
: continuous deposition of copper oxide on the skin and its absorbtion,
: although the exact reason _why_ it works has not been isolated by medical
: research.
:
: My own experience was a shoulder that was inexplicably sore for months. It
: was even waking me up at night. Doctor said rheumatism. I tried a
: magnetized copper bracelet that I bought on E-bay. Pain went away, not
: immediately, but after a few weeks and has never recurred. I used also to
: get knee problems from kick-scooting so I know I have a susceptibility,
but
: so far I have had no knee problems with cycling or exercycling.
:
: In any case, it doesn't hurt to try.
:
: EFR
: Ile de France

When anyone posts something new to me, I immediately go to google and look
it up. What I have found is not entirely positive: http://tinyurl.com/59ocs

The symptoms of poisoning depend on the duration of
exposure and whether copper metal (fumes etc) or copper salts
are involved. Copper salts are gastric irritants and are
corrosive to gastrointestinal mucosae, producing nausea,
vomiting, and local bleeding; lethargy and headache are early
CNS effects; liver and kidney failure occur later in more
severe poisonings. See section 2.2 for a list of possible
symptoms.

Copper salts may also be absorbed through the skin
causing systemic toxicity (Holtzman et al., 1966).Copper
salts have local toxic effects on the skin (Sittig,
1985).

Copper oxide is one of the copper salts talked about in the article. I
suspect the "placebo effect" is possible with the copper bracelets. If no
harm occurs, it is probably because such a small amount is transferred
through the skin. So, if this amount is so small, does it have the
possibility to do good? And, if you are getting copper in your diet,
wouldn't that also help your "rheumatism"?

Pat in TX

:

Thanks everyone for your advice about taking care of knees. I
especially liked the advice for rest and for riding differently on my
pedals. I'll go back to leg extension exercises, too. I used to do them
but stopped because I figured the bike riding did enough to exercise my
legs. I guess it didn't.