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Discussion Starter · #1 ·
As if I dont have enough problems, I woke up this morning to my knee hurting on the inside edge starting from about mid-way and going as far down as where it connects to the tibia. It feels like a bruise when I push on it, but there doesnt appear to be any swelling.<br><br>
I've noticed in the past that it sometimes gets sore, but it is always temporary and it goes away. I noticed it was a little sore in spin class the other night. Most of my injuries hurt when I run, not cycle, so I noticed, but just kind of ignored it. Well, I was scheduled to run 18 miles and it was raining hard. I was really frustrated so I went to the gym and ran on the treadmill....yes, the whole 18 miles.<br><br>
Anyhow, I noticed in the middle of the night last night it was sore. I woke up this morning and it hurt to walk. Once I was up awhile, it didnt hurt as bad...so much for cycling today.<br><br>
I'm training for Ironman in April....I have my hands full battling the ITBS on the other side and am just starting to make progress. I'm hoping it is something that will fix with a couple days off running/cycling...I guess I could use the swim practice.<br><br>
Anybody have this before??? What was it?
 

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I've had something that sounds similar and it was inflammation of the patellar tendon. If it gets inflamed it will no longer track in the groove and it pops in and out making things worse. Icing it until it stops hurting and eventually working to strengthen the Vastus Medialis solved the problem for me.<br><br>
I'm not making any claim that the problem I've had is the same as yours, only that it sounds similar. But I'd suggest a little caution taking the standard advice that if your knee is bad you should stop running and spend all your time on the bike.<br><br>
If your tendon pops in and out of the groove every time you go through a full Range of Motion it will only get worse, and trying to find a bike which requires no knee ROM is not practical. All I'm really suggesting though is that you continue to take notes as to what makes it worse and what doesn't.
 

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It does sound like a tendon issue. I would stop all offending activities, ice it whenever I think about it and take some Advil (or NSAID of your choice) to reduce inflammation.
 

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I had a simular issue, for some reason I can either run or bike without knee inflamation, not both. I got rid of the bike. Larry
 

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Discussion Starter · #5 ·
I'm almost afraid to ask, but how long did it take to get better?<br><br>
Update- I'm really surprised, but it feels way better today. I didnt bike or run yesterday, just swam. It is still a little tender if I press on it, but movement or walking doesnt hurt. I even hopped on one foot with no problem. I'll spin tonight and wait to try and run a little tomorrow.
 

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It could be that the IT band on that side is getting tight. That will pull on the kneecap and keep it from tracking properly. If you are being treated for ITBS on the other side, you may be prone to tight IT bands.<br><br>
A good injury treatment/sports massage therapist should be able to look at it and, if the IT band is tight, do some myofascial release and nip it in the bud before it gets too bad. I've had clients training for tris who came in with sore knees and it was actually tight IT bands. We spent a few painful, grueling sessions treating them and fixed the problem before it affected their training. Depending on how tight it is and how agressively you can be treated (how much can you endure in one session), you could probably see good results in 2 or 3 sessions on the newer problem. The other leg could take up to 6 sessions to get you lasting relief.<br><br>
Hope that it gets fixed and you are pain and injury free!
 

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Discussion Starter · #7 ·
I don't think it is the IT band, it doesnt feel anything like it.<br><br>
I did spin last night and I could feel the knee was swelling a little right afterwards. Woke up this morning and it hurts. Not as much as it did before, but VERY disappointed the bike annoys it. I have had all kinds of injuries, including a tibial stress fracture and was always able to cycle through the recovery...just couldnt run. If I can't do either, I will feel like it is the end of the world.
 

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If it's swelling, it's not likely ITBS. Your original message didn't mention swelling and that changes a lot.<br><br>
I hurt a knee biking but found it was due to an improperly installed pedal clip that kept my knee slightly rotated. You might check out some biking forums as they discuss knee issues, pedal float, and fixes. Is there enough float in the spin bike pedals to accommodate your biomechanics?<br><br>
With swelling, use ice, which you probably already are. See a doc if it persists.
 

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Discussion Starter · #9 ·
That's because it wasnt swollen before. I did injure it running, not cycling. Like hippo said, it is the range of motion that irratates it.<br><br>
I am icing and taking ibuprofen, which relieves the pain and swelling almost entirely, but I can almost gaurantee as soon as I bike or run it will come back.
 

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So to echo what fbgrrl says, tightness in the IT band can be one part of an imbalance that causes tracking problems. Tight IT, well developed vastus lateralis (quad on the outside) and underdeveloped vastus medialis (quad on the inside) will all combine to pull everything off track to the outside. This is a very common problem with runners, and sadly biking doesn't help much.<br><br>
But kneecap tracking is not what you seem to be feeling, more likely patellar tendonitis. In my case, the cause was two parts. One was pure vicious circle: inflamed tendon won't fit in the groove and pops out and snaps back and forth as you move and gets more inflamed. The second is that the vastus medialis stabilizes the tendon and if it is weak and gets tired it allows the tendon to misbehave in the first place.<br><br>
The great news here is that strengthening the VM actually works to solve both mistracking and tendon problems. The bad news is that if you're like me this is a life sentence - you're going to have to work to fix this and then basically do strength training of the VM for life or else suffer recurrences.<br><br>
Now here is the tough judgement. If the tendon is too inflamed, strength training will piss it off even more because of the vicious circle thing. But strengthening the VM will take a while, so you probably want to get started as soon as possible. What has helped me is to really work on developing my judgement. As the inflammation reduces my knee could begin to tolerate increasing amounts of intensity plus duration in both training and rehab strength exercises. Learning how hard to work and to stop at the instant the tendon starts to misbehave will really help you come back quickly.<br><br>
Again though, all the disclaimers about YMMV. I'm definitely not a doctor and I could be way off base on this stuff.
 

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Discussion Starter · #11 ·
I bike 3-4 times a week, run 3-5 times a week with one long training day in there for each. I swim 3 times a week, do yoga twice a week, and lift weights twice a week. It's frustrating I have weak anythings.....BUT I had not been doing my legs at the gym because I run a lot of hills and I just hate being sore for the cardio...but i'm going to start. I have indeed been doing band exercises and bridges to strenthen my hips and glutes to help correct the IT band. What do I do to correct the other muscles you were talking about VM?? I had a trainer give me a quick easy workout for the hips so I am more likely to stick with it.
 

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I would advise against trying to strengthen the lateral (outside) quads. They're probably fine and you want to shift the balance back towards the inside (or more into balance.)<br><br>
Really, getting a PT or trainer to show you how might be worth it. Machine leg extensions will work, though some people avoid open chain exercises. Leg presses or squats may help too. The tough part of all of it is to try to isolate on medial recruitment over using all of your quads or relying on your overdeveloped and ready-to-go lateral quads.<br><br>
I think that going deep on anything is probably not worth it - more knee ROM and irritation and it gets increasingly hard to get your VM to do the work as your foot gets closer to your butt. One thing you might try as a way to get started is to work on your neural "wiring." Do one-legged machine leg extensions with light weight and make sure you wear shorts. Just stare at your leg while you do it and pick out your vastus medialis - the "teardrop muscle" low on the inside. Just keep staring at that mother while you do slow reps and try to get the wiring hooked up in your brain to work it more than the neighboring muscles.<br><br>
The other thing people do is to put a pillow or little rubber ball between their knees and squeeze as they do leg presses or squats to shift the work to the inside. Ultimately anything to teach that little bugger to cowboy up and do more than it's share of the work <span style="text-decoration:underline;">for all movements</span> is part of what you're looking for.
 

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Discussion Starter · #14 ·
Turns out it is the bursa....So, all my grief is being caused by bursitis. The doctor said everytime I attempt to run it's like ripping the scab off a sore.<br><br>
So, it's going to be more than a few days, and maybe a few weeks, but he does seem to think I can continue to cycle. He is quite positive that my base is such that I can easily miss running for awhile and still do the ironman (he has done several himself, besides helping others) He says the cycling will carry me over. So for now, I am relieved.....assuming I can continue to bike.
 
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