Weird feeling in knee

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Kermithimself
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by Kermithimself

First I want to let everyone know that I have been to a doctor as well as a physiotherapist with this.

About a month ago I was on holiday. I didn't bring my bike, so I decided to do some running in the mornings of 15-20 minutes - I usually don't run. Didn't have any pain at all.

Got back from my vacation, did 2 rides, where one was a short race, and didn't have any pain. The day after I did an easy ride, and started feeling a pain just on the right side of my kneecap on my left leg. You could say that the pain was focused on the plica area. I got the pain when I bended my knee for the downstroke.

Ended the ride early, got a cold, so I was off the bike for a couple of days. So when I returned to riding, I didn't feel anything for the first 45 minutes of the ride, then the pain came back. I did an interval and the pain went away for the rest of the ride.

This pattern continued for the rest of the week, although the pain was harder to get rid of. I didn't have any problems when I was off the bike. After two weeks I had a session where I did some low cadance/high resistance intervals, and the pain was really bad, so I stopped. Afterwards the pain was still there, and the day after I got pain in the knee when I had been sitting with my knee bended for too long. The pain when going from a seated position to standing up, was located on the kneecap.

Went to a doctor, who ruled out torn tendons etc. He said it probably was some cartilage that was the reason for the pain. His advice was to take it easy on the bike - just riding 45 minutes for a week or so, and see how it went. I gave the knee some rest, and after a couple of days I got on the trainer and did some easy pedalling. After 38 minutes my knee started feeling weird, so I stopped. The day after I had the same pain in the kneecap. Went to a physiotherapist, who said it probably was some inflammation of the tendons. Gave me some stability workouts, and said to ride the bike for 30 minutes. Did as he said, but the pain in the kneecap maintained when seated, so asked if it was better to take 2 weeks completely off the bike, and then start slowly again. He agreed.

Took the two weeks off, and then did a 1,5 hour ride outside. It went great. Knee was a tad shaky, but didn't have any pain. Continued to ride the trainer at low resistance for about an hour during the week, still no knee pain. I had a weird feeling in my knee, as if something was moving about by the kneecap, but I'm actually thinking that it might just be me being overattentive of the signs in my knee.

So, I haven't had the pain in the knee the same way, not even when sitting down. However, I have this weird feeling in my knee. It doesn't hurt, it doesn't swell up, I'm able to extend it with no problems, there are no trigger points around the knee that give the same pain as before. The feeling is hard to describe, but it feels like if you've had your knee or elbow bent for too long, and need to extend it for some sort of relief.

Anybody have had this before? Just wondering what on earth it can be, as I've yet to talk with anybody who has described the same type of pain/feeling and what they did to get rid of the feeling.

Is it just the tendons reacting to the returned exercise?
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Kayrehn
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by Kayrehn

I had the 'thing moving in the knee' problem too after many repeats of a small steep hill, and when it persisted (usually no pain but with weird feeling, some pain with hard efforts) I went to see a retul bike fitter. He asked me to use cleats with float instead, set my cleat position, advice insoles with arch support. That was a month ago and the pain/feeling didn't come back since even after a 364km ride yesterday. Might be worth your while to check out a bike fitter, even if they are not as 'qualified' as a real doctor.

spdntrxi
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by spdntrxi

I vote that you have a slight tear of your meniscus .. Something I know too well.. Tough it out or get scoped and trimmed.... You probably need an MRI to be sure
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Rick
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by Rick

so I decided to do some running in the mornings of 15-20 minutes - I usually don't run.

Running is deceptively harsh on the knees and needs to be approached very cautiously when starting out. Especially since the aerobic engine of a cyclist is probably already much more powerful than untrained knees can handle. Once you have an inflammation or damage it can take a very long time to get better. I know this doesn't diagnose your problem specifically, but you are probably just going to have to take it very easy for a while and back off whenever you have the slightest hint of irritation until you get some complete healing.
I have a few nagging injures like that which start acting up if I over stress again and they have gone on for years. Luckily they do subside with care and I usually don't feel they inhibit me during the main cycling season. The transition periods are the most dangerous.

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Nitemare
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by Nitemare

I agree with spdntrxi ... I think you may have a torn meniscus, http://en.wikipedia.org/wiki/Tear_of_meniscus

If it feels tender along the inside of your knee and it feels like it is "catching" or "clicking" then they are classic signs of meniscus problems. I had this last year on my right knee and after arthroscopy surgery to have the torn part trimmed away and the rest stitched I was able to resume cycling away. Only now I have a similar issue with the left one!!!

An MRI scan will identify for sure and give you a precise diagnosis.

Good luck.

11.4
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by 11.4

Could be meniscus, could be either rutting or tears or even loose shreds of cartilage. In either case, careful rehab therapy to strengthen the local musculature properly is the most important single item. You can usually avoid surgery unless it's a very serious case. I've had the surgery and can tell you that it doesn't really improve matters all that much -- wish I hadn't had it. See a sports orthopedist, nobody else. Most physicians just try to treat the immediate pain but don't consider what you need to continue as an athlete. It's worth a trip out of town if you don't have a good sports orthopedist near you. Everyone bills themselves these days as sports orthopedists, but you need someone who actually treats a lot of pro athletes.

dmp
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by dmp

Other diagnoses to consider, especially in view of the precipitating history- patellar tendinosis or patellofemoral syndrome. See http://www.med.nyu.edu/pmr/residency/resources/Clinics_sports%20med/clinics%20NA%20sports_patellar%20tendinopathy.pdf
I'm a physician, but not a sports medicine or ortho specialist. I had this (and get recurrences every once in a while, especially after skiing bumps or running, and then I need to go back to my rehab exercises again). If this is indeed the diagnosis, you will at least be spared the prospect of surgery- the most accepted therapy is PT and rehab exercises.

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Kermithimself
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by Kermithimself

Thanks for all the feedback guys. I hope it's not a tear in the miniscus. It doesn't feel tender however.

dmp - Could you elaborate on which exercises would be good for rehab?

Will see a 2nd PT and get her opinion on the matter.
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Samuel Sanchez Gonzalez
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by Samuel Sanchez Gonzalez

I don't think a teared meniscus would cause a pain located around the kneecap simply because there isn't any segment/portion of meniscus there. I like dmp's hypothesis.

Patellofemoral syndrom is an "easy" diagnosis when you have pain around or under the patella without real explanations/injury.

I think lack and change of exercise might have cause this. I suggest you should do some "proprioception" exercise to strengthen the muscles. A physiotherapist can also help you with patella "mobility" (some sort of massages to reduce friction under the patella)

Sorry my english is a bit limitated to help you better.

jorisee
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by jorisee

Try to change your cleat angle?


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dmp
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by dmp

Hi Kermit-http://mydoctor.kaiserpermanente.org/ncal/Images/Patellofemoral%20Pain%20Syndrome_tcm28-180773.pdf shows some stretches and exercises. I found massage to be helpful, too- my pt specifically targeted the quads and iliotibial band area, as well as around the knee, and suggested a foam roller to do this for myself at home. This site has similar exercises: http://www.nismat.org/patients/injury-evaluation-treatment/lower-body/patellofemoral-pain-syndrome. Good luck and get better soon!

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roadieboy
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by roadieboy

I have a history of plica problems similar to what you describe. If you hold your hand over the place where you are feeling pain, do you happen feel something akin to a tendon 'flicking' over the plica?

Mine is very temperamental, and acts up for no apparent reason sometimes. Good luck with your knee!

Oswald
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by Oswald

When in doubt, do NOT train. Even if you don't train for 2 weeks, your condition will not suffer much. If you do train and aggravate an injury, you may be out for a very long time. I had some problems once with my ankles and kept on training. It eventually kept me of the bike for 5 years... I'm back into cycling for 3 years now and even now I still haven't reached (and probably never will reach) my old level again. Whenever I have but the slightest injury now, I stop training and get medical help asap. I bumped my knee in april and decided to not train for a couple of weeks. Maybe that wasn't necessary for a small injury like a bumped knee, but I feel it was a wise decision since not training hardly affected my condition and at least I didn't aggravate things.

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Kermithimself
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by Kermithimself

roadieboy wrote:I have a history of plica problems similar to what you describe. If you hold your hand over the place where you are feeling pain, do you happen feel something akin to a tendon 'flicking' over the plica?

Mine is very temperamental, and acts up for no apparent reason sometimes. Good luck with your knee!

Yes, I did at the time. Haven't tested it for a while though. But I had that sensation that something was rubbing/flicking over something else. Not that it hurt, it was just a feeling.

Just thought I would update on everything. Went to see a masseuse last Friday who loosened everything up. Her theory was that my left leg is shorter than my right, causing an imballance on the bike. Could be a reason, but I've been riding my bike for 8 years, and not have problems like this.

Did a ride a could of days ago and didn't have pain where I previously had it - around the plica. I did however get an ache on the inside of the knee/leg, at the spot where the femur connects with the tibia. It's not a pain, but more like a toothache feeling. It's tender to the touch, and was felt when I got out of the saddle. I'm guessing it's just the Medial Collateral Ligament that acts up a bit. Talked with my doctor and he said it didn't sound like a meniscus problem, although it's in the same area.
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J0s3m4
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by J0s3m4

Kermithimself wrote:
roadieboy wrote:I have a history of plica problems similar to what you describe. If you hold your hand over the place where you are feeling pain, do you happen feel something akin to a tendon 'flicking' over the plica?

Mine is very temperamental, and acts up for no apparent reason sometimes. Good luck with your knee!

Yes, I did at the time. Haven't tested it for a while though. But I had that sensation that something was rubbing/flicking over something else. Not that it hurt, it was just a feeling.

Just thought I would update on everything. Went to see a masseuse last Friday who loosened everything up. Her theory was that my left leg is shorter than my right, causing an imballance on the bike. Could be a reason, but I've been riding my bike for 8 years, and not have problems like this.

Did a ride a could of days ago and didn't have pain where I previously had it - around the plica. I did however get an ache on the inside of the knee/leg, at the spot where the femur connects with the tibia. It's not a pain, but more like a toothache feeling. It's tender to the touch, and was felt when I got out of the saddle. I'm guessing it's just the Medial Collateral Ligament that acts up a bit. Talked with my doctor and he said it didn't sound like a meniscus problem, although it's in the same area.


I think I have the same problem that yours. Have you checked that your ITB is tight after a ride? I'm doing some strenght exercises for the back of the leg, changed the black shimano's 0 floated cleat which I used to have in my shoes (indoorcycling) for the grey cleats, and doing ITB stretching after every ride, for around 10 minutes and I´ve noticed some benefit (although the problem that you said "something fliking" continues but only a little bit

Does it also "creak" if you bend ?

Sorry for my english, I'm learning for my FCE exam , in spite of this ,I hope I have been helpful for you. Looking forward to know about your(or our) knee "problem" soon!

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