Knees and pain

[LBKloppers]

This is a cycling health issue and I need advice from all those well-educated and experienced Hubbers out there.

I am 57 and I have been cycling for eons. Through the years I have encountered some incidents that took me off the bike for a couple of weeks, and at the time I just bit the bullet and heal up all by myself. Medical aids and funds for treatment were just not available.

Three serious events impacted my health. 1. There was an attempt on my life in Madagascar while out cycling, whereafter I had to start wearing glasses, and I was diagnosed with Osteo-Arthritis. 2. I broke my shoulder going OTB on the other side down Fangs1 during the Transbaviaans. 3. And I broke my collarbone going down while crossing the rails in the Cape Town Harbour. Several smaller crashes happened over the years and each time, it was just a case of HTFU and ride.

Well, getting older, these things start to show up and it is slowly starting to threaten my cycling. Maybe it has become necessary to have a look at the more serious old injuries and I hope I can somewhat be mended. My question/s to the Hubbers out there, help me decide, please?

When I am cycling, it feels as if the outside of my feet slope down. I ride with cleats since I can not remember anymore, and I had a fitting when I got my latest bike. Even when I try to focus on my technique while peddling, my feet wiggle and the inside of my left knee is bothersome, and it feels as if my left leg is weaker than the right. I experimented by putting a little washer as a spacer underneath the outside bolt holding the cleats and it did feel a little better, but then to top my knees (especially the left knee) started to complain. My left lower back also becomes so painful that I wish to stop riding. I used to cycle 5 to 6 times a week and it's already down to 3 to 4 times a week and my cycling is my therapy. What am I going to do!?

Compounding the knee issue, I have a rather painful situation on the edge of my ribcage. This one is hard to describe. I can pinpoint the location of the pain, but there are no organs where the pain occurs. I was tested and screened for a whole bunch of stuff and there are no out-of-range indicators in my blood. When I am cycling, it is as if there is a muscle cramping at this one spot and it makes me breathing shallower with all the associated disadvantages, but the doctors I have seen can not tell me what it is and they can not help me to heal.

The costs of hospitalization are just scary and to become a lab experiment is not my idea of a solution, but I do love my cycling and I do wish to continue doing so for many more years.

Any recommendations will be welcome.

[RichPad]

Hi My advice go see Biokeneticist and have him/her look at your weak points because it seems you not stretching your hamstrings hip flexor and glutes enough and its leading to other issues in your back and legs. They will help with the stretching, strength and other issues you might getting from your accidents as well.

[Headshot]

I'm 55 and almost only ride mountain bikes. I have also had numerous crashes, broken ribs, collar bone and torn ligaments. I'd agree that injuries that are not resolved properly do impact on your strength and fitness. For instance, my collar bone shoulder is sore and clicks which discourages me from doing push ups and pull ups. I get occasional knee pain in my ligament knee especially if I have been off the bike for a while. That said, there is nothing that is so debilitating i.e so sore that I cannot ride properly.

I would love to take the advice above and go for a biokinetic assessment and start some kind of program to deal with my ongoing pain. All that said age is also a factor - its that much harder to retain strength and fitness as you age. 

[HdB]

Sounds like a slightly different area of the knee than what gave me pain, so I agree with the suggested visit to a biokinetisist, but could be worth trying what my GP told me until then: while lying down or sitting with your leg/foot on a coffee table for example, lift your leg slightly, hold for a few seconds, then lower back down; repeat a few times. Doesn't have to be high, all you are doing is to activate the muscles around your knee. You can do it with your foot turned outward as well, seems to activate slightly different set of muscles.

[ChrisF]

26 minutes ago, LBKloppers said:

... I was diagnosed with Osteo-Arthritis. .....

..... I have a rather painful situation on the edge of my ribcage......

 

You clearly have some "battle scars", and the cookie-cutter answers most probably dont apply.

 

A couple of possibilities:

- arthritis is affecting the knees ... (osteo being a bummer as they only have symptomatic relieve, no way to undo or stop the damage)

- depending how you recovered from the various issues you may well have some sort of core-strength issue ....

 

Two years ago my knees finally conked in after more than 20 years of arthritis.  Turns out it was not the arthritis, though that did not help.  

 

My core muscles were .... uhm jaaaa ... very much a recovery still in progress.

 

Combine these two with a torn meniscus and cycling was seriously painful !!

 

 

The torn meniscus is in the "white tissues", i.e. no blood flow, and thus not repairable.  So I am supposed to avoid gap jumps and harsh landings ....  My knees remind me quickly after a fast decent of a corrugated single track !!

 

 

With the scans and medical reports the Bio knew what was wrong and set about structuring a recovery program.  After 6 weeks we saw some good progress, and the world got locked down ....  I carried on with the exercises, for a while, then got lazy/busy during the winter.

 

With the core properly in shape I can spend a good few hours in the saddle.

 

 

Which then led to other issues .... turns out was concentrating only on the core and cycling (and walking), and completely omitted stretch exercises .... this caused a whole different set of issues.

 

With the stretching exercise done all is well.

 

 

The "fun" part is that the time needed for a proper core workout AND then a proper stretching session is more than I have available during a typical work week .....

 

 

 

 

So with my school fees on display .... my recommendations are:

1. May be worth having that bike fit checked .... (I had a proper bike fit 2 years before my knee issues)

2. Go see a physio.... if it is "just" a stretching type issue they may be able to help.  

3. Go see a Bio ... though a good bio may request, with good reason, to see scans and a Dr's report of underlying issues.....

 

 

HOPE you find an answer to this, and that you can get back to "normal cycling" 

 

[ChrisF]

9 minutes ago, HdB said:

Sounds like a slightly different area of the knee than what gave me pain, so I agree with the suggested visit to a biokinetisist, but could be worth trying what my GP told me until then: while lying down or sitting with your leg/foot on a coffee table for example, lift your leg slightly, hold for a few seconds, then lower back down; repeat a few times. Doesn't have to be high, all you are doing is to activate the muscles around your knee. You can do it with your foot turned outward as well, seems to activate slightly different set of muscles.

 

You have just described one of the key exercises the Bio gave me for my knee AND core strength.

 

The direction of the foot (up or at some angle) is important in terms of the muscles you want to build, also to those you may want to protect.  Mine is done with the toes pointing up.

 

I do these lying on my back with a roller under the knee .... core muscles are activated, then the foot is lifted.  As the knee and core muscles improve, weight bands are placed around the ankles.

[RobertWhitehead]

Two suggestions from my side: 

• StretchingSA 
• Bike Fit Calculator | Find Your Bike Size | Competitive Cyclist 

I believe without me trying to explain myself too much and running the risk of looking like a plonker my suggestion is look at get your body conditioned and back into alignment and then re-look at your set-up.

[Eldron]

Go and see 2 professionals. A physio/chiro and a bike fitter.

Don't start randomly adding shims, angled inserts etc without knowing what the problems are  - it is a recipe for disaster!

[Paul Ruinaard]

18 minutes ago, Eldron said:

Go and see 2 professionals. A physio/chiro and a bike fitter.

Don't start randomly adding shims, angled inserts etc without knowing what the problems are  - it is a recipe for disaster!

I was looking at this string and about to comment and I saw Eldron on here and smiled. Whilst i certainly don't have your list of injuries I also didn't believe that a proper bike fit would solve the issues. I even argued back quite a bit when he gave the above advice as i was in the same frame of mind. 57, not a small lad, been on bikes for 25 years plus and kind of just decided that HTFU was what was needed. You can go and find the string here on the hub. Anyway I went to Richard Baxter locally. The changes to my riding and comfort were material. In many aspects. Comfort was improved, endurance therefore better and some others which i am not sure i should get in to the details (VO2 and FTP). I also am built like a rugby prop so a Q factor of a Bianchi that Pantani rode also leads to me pushing off the edge of the pedals.  I. had used spacers but nothing like the ones i now ride with.

I cant comment on the injuries that you have and how they influence things but i can comment on the bike fit piece and the attitude of "I am getting old so HTFU as its just a bit of pain etc". That was what changed. I can say that it was eye opening and i constantly wished i had done it a lot earlier.

Disclaimer No1 is is that this isn't a cheap exercise t cheap and that if your setup is wrong it may involve costly new bits like bars, saddles and stems. But if you look at how much time you spend on the bike and new groupos, tyres etc, what's the point of not getting yourself comfortable on it and properly sorted. It's a very good use of your money.

[Eldron]

28 minutes ago, Paul Ruinaard said:

I was looking at this string and about to comment and I saw Eldron on here and smiled. Whilst i certainly don't have your list of injuries I also didn't believe that a proper bike fit would solve the issues. I even argued back quite a bit when he gave the above advice as i was in the same frame of mind. 57, not a small lad, been on bikes for 25 years plus and kind of just decided that HTFU was what was needed. You can go and find the string here on the hub. Anyway I went to Richard Baxter locally. The changes to my riding and comfort were material. In many aspects. Comfort was improved, endurance therefore better and some others which i am not sure i should get in to the details (VO2 and FTP). I also am built like a rugby prop so a Q factor of a Bianchi that Pantani rode also leads to me pushing off the edge of the pedals.  I. had used spacers but nothing like the ones i now ride with.

I cant comment on the injuries that you have and how they influence things but i can comment on the bike fit piece and the attitude of "I am getting old so HTFU as its just a bit of pain etc". That was what changed. I can say that it was eye opening and i constantly wished i had done it a lot earlier.

Disclaimer No1 is is that this isn't a cheap exercise t cheap and that if your setup is wrong it may involve costly new bits like bars, saddles and stems. But if you look at how much time you spend on the bike and new groupos, tyres etc, what's the point of not getting yourself comfortable on it and properly sorted. It's a very good use of your money.

I find 50+ customers both the hardest and most rewarding to fit.

Once men hit 50 they seem to galvanize all their beliefs. 50plussers argue and debate and check and double check me - they try and school me in bike fitting while I'm fitting them 🙂

Once I'm done and they go ride (mumbling to themselves that I'm stupid) they realise that times have changed and cycling doesn't have to be permanent pain (and you can ride a bike with spacers under the stem and a stem shorter than 140mm). My most satisfying reviews and feedback come from older men that realise they can ride another 30 years without pain/discomfort.

Of course this is all tongue in cheek (I am 48) but there certainly is a trend for older men to HTFU and self diagnose. Bike fitting has come a LOOOOONG way in the last 5 years and is far more scientific, consistent and reliable than it used to be.

[ChrisF]

4 minutes ago, Eldron said:

I find 50+ customers both the hardest and most rewarding to fit.

Once men hit 50 they seem to galvanize all their beliefs. 50plussers argue and debate and check and double check me - they try and school me in bike fitting while I'm fitting them 🙂

Once I'm done and they go ride (mumbling to themselves that I'm stupid) they realise that times have changed and cycling doesn't have to be permanent pain (and you can ride a bike with spacers under the stem and a stem shorter than 140mm). My most satisfying reviews and feedback come from older men that realise they can ride another 30 years without pain/discomfort.

Of course this is all tongue in cheek (I am 48) but there certainly is a trend for older men to HTFU and self diagnose. Bike fitting has come a LOOOOONG way in the last 5 years and is far more scientific, consistent and reliable than it used to be.

So basically what you are saying is that it was a very good thing I went to Irma at 49 ... 

 

 

 

Really need Comic Sans on Android

[Jbr]

3 hours ago, RichPad said:

Hi My advice go see Biokeneticist and have him/her look at your weak points because it seems you not stretching your hamstrings hip flexor and glutes enough and its leading to other issues in your back and legs. They will help with the stretching, strength and other issues you might getting from your accidents as well.

I have a few battlescars myself although I'm a fair bit younger, most treated with the "I'll worry about it later, it doesn't hurt that bad" therapy. First couple of times I went to the bio she pretty much made me understand I was all skew and everything was wrong with my posture, then after a few weeks of training it all got better and haven't had to complain much since, this was a couple years ago.

You should really follow this advice and go see someone who knows what they're doing, and do all the exercice they give you as often as you can. It helps.

Edited December 17, 2021 by Jbr

[Help.Me.]

I am following this with great intrest , also battling with lower back pain, seeing a Pilatus lady and a chyropractor. Had 2 sessions with the chyro so far. It feels like a sciatic nerve issue , I dont have pain on the bike or idt at all, but they both think that because i do  not stretch at all, that the ITB muscle is thight which causes the issues..... i will watch this space. Growing old is not for sussies ..... 

[RobertWhitehead]

8 hours ago, Help.Me. said:

I am following this with great intrest , also battling with lower back pain, seeing a Pilatus lady and a chyropractor. Had 2 sessions with the chyro so far. It feels like a sciatic nerve issue , I dont have pain on the bike or idt at all, but they both think that because i do  not stretch at all, that the ITB muscle is thight which causes the issues..... i will watch this space. Growing old is not for sussies ..... 

https://www.stretchingsa.co.za/

[mazambaan]

Getting old ain't for sissies, particularly if you want to try and keep having a happy childhood. I am about 10 years older than the OP and a similar list of hospital needing injuries; knee in the SADF, vertebrae, ribs, collapsed lung, collarbone later, I can 1000% agree with bike fit then physio and biok, before doctor (unless actually recommended by the physio or a break etc) but get good, cycling recommended ones (physio & biok) if you can. The nature of the sport means there are plenty.  I have managed most of the races and stage races in KZN (Sani 8 or so) and a few longer multi day MTB tours but I am drifting to the dark ebike side now.

Two suggestions; one is to actually evaluate when you need rest and try not aggravate an injury. The other is more contentious; YouTube. I have picked up a list of exercises for back and knees that help me on top of stretching and core BUT I have to do them daily if at all possible and weed out the ones that aren't so great. Diet may also be a factor; lots of info about that.

Currently working through rib bruising and lower back pain caused by stupidity (fall then heavy lift with back bent until I felt the dreaded "pop"). 

Good luck, positive attitude and work at it doggedly.

[Eldron]

Yup. As we get older we get less flexible, more sensitive to foods, get injured more often, break easier, take longer to heal etc.

Stretching is my current "must do". If I stretch 3 or more times a week then I feel better on the bike and in general. It's a gospel I teach to my customers as well - if you want that "more aggressive" position you need to be more flexible to be able to hold it for long periods. Earn it :-)

Stretching has relieved lower back pain for many, many customers.