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Discussion Starter · #1 ·
I hate to post a please help, but in the last few weeks I have had to decrease my riding time to basically nothing due to pain on the interior of both of my knees. The x-rays taken by the doctor confirm that it is not a bone issue, and he said that based on the hand tests he gave me (asking does it hurt?) that it could either be the lower interior part of my meniscus or another tendon that is very close to the lower end of the meniscus (I cannot recall the name and have been unable to find it online but I will edit this in a few hours after I call him). The thing about his hand tests was that he said some were positive for the mensicus but some were negative, so it was indecisive. My coach sounded pretty grim saying that his impression of meniscus injuries were that they were career ending injuries. This completely blind sided me. I had been dreaming of cycling very badly the last few weeks and really enjoying the spots that I did go for, more so than regular. Agonizing over the thought of missing training for weeks or months. So to the point, I am to schedule an mri appointment so that they can look at more in depth. But if it is the meniscus or the other tendon near it's lower interior region, and I do not ride/race I cannot think of what then. Has anyone else had a similar problem or expertise that perhaps they can refer me to a potential solution, I am open to absolutely everything.
Thanks,
Matt
 

· Burning Fists of Love
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get another doctor

I have torn miniscus in both knees. I have cracked my right knee cap, dislocated both knees radically, and oh yeah, you can hear my knees creak and grind when I go up any stairs. I am looking at a TJR possibly in my late 50's.

At my heigth in cycling before 2 kids, I was doing 300 mile weeks and could pretty much do sub 6 hour centuries in training without much effort. I have to date a Personal best of under 5 in a solo century and have done sub hour 40K TT. All of this was on my knees.

I would try a PT program which empahasises building up musclews around the knees, avoid squats but extensions and calf raises were helpful for me at least. Also, get a fit on your bike. Otherwise, unless you have other things going on IMO, and I stress, IMO, your doc is whacked.
 

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Discussion Starter · #3 ·
How do you mean whacked, do you mean about me not being able to keep doing 300-400 mile weeks (training) and racing? (which my coach had told me was his impression) or what my doctor said about my knees? My impression from the doctor was that I would basically be letting this run my training for the future, that I would have to keep dealing with this, that it will recur.
Matt
p.s. Also which type exercises would you recommend, I would like to start asap and not have to wait for a pt, you sound like you have dealt with this extensively before, which stretches will benefit me for strengthening that area most, and are there any exercises I can do in addition? Also for said stretches, how many times, and when?
 

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Repair is possible

I am not an expert but I am aware that tearing of the miniscus can be repaired by arthroscopic surgery. I had a different problem with my knee last Fall. I was back on the bicycle within a month following surgery. If it is a tear to the miniscus, a similar result can occur.
 

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mpetersen16 said:
I hate to post a please help, but in the last few weeks I have had to decrease my riding time to basically nothing due to pain on the interior of both of my knees. The x-rays taken by the doctor confirm that it is not a bone issue, and he said that based on the hand tests he gave me (asking does it hurt?) that it could either be the lower interior part of my meniscus or another tendon that is very close to the lower end of the meniscus (I cannot recall the name and have been unable to find it online but I will edit this in a few hours after I call him). The thing about his hand tests was that he said some were positive for the mensicus but some were negative, so it was indecisive. My coach sounded pretty grim saying that his impression of meniscus injuries were that they were career ending injuries. This completely blind sided me. I had been dreaming of cycling very badly the last few weeks and really enjoying the spots that I did go for, more so than regular. Agonizing over the thought of missing training for weeks or months. So to the point, I am to schedule an mri appointment so that they can look at more in depth. But if it is the meniscus or the other tendon near it's lower interior region, and I do not ride/race I cannot think of what then. Has anyone else had a similar problem or expertise that perhaps they can refer me to a potential solution, I am open to absolutely everything.
Thanks,
Matt
Whoa! Wait a second. Meniscus injuries usually have a specific cause and occur on one side at a time. They usually don't gradually come into both knees at the same time for no reason. The ligament you are talking about is probably the medial collateral ligament. I doubt it spontaneously tore on both sides. Maybe I'm missing something, but this doesn't even seem to warrent an MRI. It sounds like you are having a general biomechanical problem that is putting a little wear on the inside of your knees causing them to be inflammed and painful.

Some ideas: Find someone trained to evaluate and treat biomechanical faults, check your bike fit, consider orthotics, shims, or new shoes, got to a PT and get some general stretches and exercises, etc.
 

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Discussion Starter · #6 ·
I forgot to mention

I spoke with a guy who just had surgery for a torn meniscus at the doctor's office as I was waiting. He was a cyclist also, and I asked him about whether or not he would have to take it easy from now on, and could he ride in the future at all. His response was that he could and that his meniscus would be much stronger following the surgery. However, the doctor thought that it was unlikely my meniscus was torn, due to the fat that I can walk with minor pain and have no limp. Is there much that can be done besides physical therapy if my meniscus is not torn to strengthen it?
Matt
 

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yup

mpetersen16 said:
How do you mean whacked, do you mean about me not being able to keep doing 300-400 mile weeks (training) and racing? (which my coach had told me was his impression) or what my doctor said about my knees? My impression from the doctor was that I would basically be letting this run my training for the future, that I would have to keep dealing with this, that it will recur.
Matt
p.s. Also which type exercises would you recommend, I would like to start asap and not have to wait for a pt, you sound like you have dealt with this extensively before, which stretches will benefit me for strengthening that area most, and are there any exercises I can do in addition? Also for said stretches, how many times, and when?
I think your doc was wrong about your knees and your coach might not be off as far as cutting back on the ammount of your riding. You can be very effective and not ride 300+ mile weeks.

As far as stretches etc etc, again, do not dismiss PT. I ususally do calves, groin, hamstring and quad stretches for the legs and I try to mix in lower back as much as I can. As to your bike fit, DO NOT ignore that. You may find that as your knees change, you may have to get used to riding in a newer position or for that matter a newer riding style, you knees will let you know. This will not be easy and you will have to be very patient. IF you get impatient, you WILL re aggravate you knees and you WILL have to take time off the bike.

SO, PT, bike fit and start finding out what works on the bike for your knees. There is NO shame in cutting back the workload on the bike while you figure out your knees.
 

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I disagree

mpetersen16 said:
I spoke with a guy who just had surgery for a torn meniscus at the doctor's office as I was waiting. He was a cyclist also, and I asked him about whether or not he would have to take it easy from now on, and could he ride in the future at all. His response was that he could and that his meniscus would be much stronger following the surgery. However, the doctor thought that it was unlikely my meniscus was torn, due to the fat that I can walk with minor pain and have no limp. Is there much that can be done besides physical therapy if my meniscus is not torn to strengthen it?
Matt
I recall that repairs are not the best option unless you can hshow that the tear is causing you to lose function. Even then, unless you are a pro, why do that to your knees as the surgery can be a bit more invasive than necessary.
 

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Discussion Starter · #9 ·
The doctor is a sports medicine specific doctor, would he be that person, what kind of doctor would treat a biomechanical issue? Also , I own orthotics because I am flat footed, however they suck, and I need to get them redone because they are not supporting the arch in my feet, nevertheless this should not affect my riding, because my riding shoes fit me like aglove as far as my arch and foot support is concerned.
Matt
 

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Discussion Starter · #10 ·
I would do absolutely anything to ensure that I can ride for the rest of my life. If they told me surgery will work for you and fix your problems, most likely perrmanently, I would not even think about it.
Matt
 

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listen well

mpetersen16 said:
I would do absolutely anything to ensure that I can ride for the rest of my life. If they told me surgery will work for you and fix your problems, most likely perrmanently, I would not even think about it.
Matt
If you meet a surgeon, who says, oh sure, you will be better than ever after this procedure for your knees, he is a liar, a fool and at best, mentally impaired.

Passion to ride is admirable, I love to ride as well. HOWEVER, in the area of joint repair etc etc, I have to date yet to meet the surgeon, the actual cutter, not the assistant who will say oh sure, do this and you will be better than ever.

Every situation is different, but surgery is a last resort and NOT a thing you do so you can feel better to ride a bike. You want to ride? GREAT. You want to walk and not be in potential agony everyday and have a quality of life that is not driven by knee pain (I have the T shirt), research your options and above all, enjoy the bike and your life.
 

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mpetersen16 said:
The doctor is a sports medicine specific doctor, would he be that person, what kind of doctor would treat a biomechanical issue? Also , I own orthotics because I am flat footed, however they suck, and I need to get them redone because they are not supporting the arch in my feet, nevertheless this should not affect my riding, because my riding shoes fit me like aglove as far as my arch and foot support is concerned.
Matt
A sports med doc should be able to help. Do you wear orthotics in your cycling shoes?
 

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Rest and heal. Forget this season.

Your coach should be able to bring you back into shape for next year. If not, get a new coach.

You have a biomechanical problem that can be fixed by your equipment, cleats, shims, etc. Fix this first before starting training again. Stretch your legs, IT band, and strengthen your stabilizer muscles.

Go to Boulder and call on Dr. Andy Pruitt
 

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Umm, are you 16?

Is your seat too low? too high?


mpetersen16 said:
I hate to post a please help, but in the last few weeks I have had to decrease my riding time to basically nothing due to pain on the interior of both of my knees. The x-rays taken by the doctor confirm that it is not a bone issue, and he said that based on the hand tests he gave me (asking does it hurt?) that it could either be the lower interior part of my meniscus or another tendon that is very close to the lower end of the meniscus (I cannot recall the name and have been unable to find it online but I will edit this in a few hours after I call him). The thing about his hand tests was that he said some were positive for the mensicus but some were negative, so it was indecisive. My coach sounded pretty grim saying that his impression of meniscus injuries were that they were career ending injuries. This completely blind sided me. I had been dreaming of cycling very badly the last few weeks and really enjoying the spots that I did go for, more so than regular. Agonizing over the thought of missing training for weeks or months. So to the point, I am to schedule an mri appointment so that they can look at more in depth. But if it is the meniscus or the other tendon near it's lower interior region, and I do not ride/race I cannot think of what then. Has anyone else had a similar problem or expertise that perhaps they can refer me to a potential solution, I am open to absolutely everything.
Thanks,
Matt
 

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Oh Lord..

ttug said:
If you meet a surgeon, who says, oh sure, you will be better than ever after this procedure for your knees, he is a liar, a fool and at best, mentally impaired.

Passion to ride is admirable, I love to ride as well. HOWEVER, in the area of joint repair etc etc, I have to date yet to meet the surgeon, the actual cutter, not the assistant who will say oh sure, do this and you will be better than ever.

Every situation is different, but surgery is a last resort and NOT a thing you do so you can feel better to ride a bike. You want to ride? GREAT. You want to walk and not be in potential agony everyday and have a quality of life that is not driven by knee pain (I have the T shirt), research your options and above all, enjoy the bike and your life.

where to start...First of all, yes a Sports Medicine practitioner is who you need to see...I did not see ANYWHERE in the OP that stated the MD told him he would never ride again. His coach made a comment-incorrectly I might add, that a meniscal injury is career ending. Meniscal tears are generally unilateral and cause a catching or locking sensation in the knee, there are various physical exam tests such as an Apley's compression test that can elicit a positive response, however, the tear must be demonstrated on MRI. I am a sports medicine/orthopedic practicing physician assistant, and no surgery is definitely NOT the answer to everything. EVEN if you do have a small meniscal tears, most small tears are managed nonoperatively. they will heal on their own. Large complex tears, especially posterior horn tears generally require operative intervention. NO, they are not career or cycling ending injuries, you may have to cut back slightly while you are recovering from surgery. To make blanket statements as you have above regarding surgeons/assistants and outcomes demonstrates your ignorance and is insulting. To the OP, please follow up with sports medicine doc you have been seeing and inquire about the possibility of an MRI to further evaluate the soft tissue structures and meniscal integrity. Oh, and without seeing you or examining you, I can't tell for sure, but it sounds like he may have been referring to your Pes tendon structure.
 

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mpetersen16 said:
I would do absolutely anything to ensure that I can ride for the rest of my life. If they told me surgery will work for you and fix your problems, most likely perrmanently, I would not even think about it.
Matt


For the most part joint problems occur due to a weakness one of the muscles surroundin the structure. How do your feet point when you walk. If they don't point straight ahead then that is probably what you need to solve. For the most part people tend to walk with their feet pointing out. This indicates weak hamstrings or if you prefer too strong quads. I see this all the time and find a focused plan of strengthening the weaker muscle group solves the problem. This is kind of like doing core work to help lower back pain. Interestingly analitical cycling found that doubling the strength of the quads resulted in a small increase in cycling performance but doubling the hamstring strength made a huge increase in performance.
 

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and....

physasst said:
where to start...First of all, yes a Sports Medicine practitioner is who you need to see...I did not see ANYWHERE in the OP that stated the MD told him he would never ride again. His coach made a comment-incorrectly I might add, that a meniscal injury is career ending. Meniscal tears are generally unilateral and cause a catching or locking sensation in the knee, there are various physical exam tests such as an Apley's compression test that can elicit a positive response, however, the tear must be demonstrated on MRI. I am a sports medicine/orthopedic practicing physician assistant, and no surgery is definitely NOT the answer to everything. EVEN if you do have a small meniscal tears, most small tears are managed nonoperatively. they will heal on their own. Large complex tears, especially posterior horn tears generally require operative intervention. NO, they are not career or cycling ending injuries, you may have to cut back slightly while you are recovering from surgery. To make blanket statements as you have above regarding surgeons/assistants and outcomes demonstrates your ignorance and is insulting. To the OP, please follow up with sports medicine doc you have been seeing and inquire about the possibility of an MRI to further evaluate the soft tissue structures and meniscal integrity. Oh, and without seeing you or examining you, I can't tell for sure, but it sounds like he may have been referring to your Pes tendon structure.
I agreed and have always said I thought that a tear like what we are discussing is not a "career" ender. Look, its not a career OK? The OP (to the best of my knowledge) does not ride for a living. So, last I checked, his "career" should be OK. I would tend to address the issue much like you have, and in fact, I agree. I did state every situation is different. I did not in any way state hey, I know his entire situation by just wordds on an internet forum.

As to my statements regarding surgeons or assistants being ignorant. Hey, go nuts, you have that right to make your statement. However, AGAIN, no doc woth their salt is going to proclaim that surgery is the silver bullet or with 100% accuracy state oh yes, all will be well. IF I met a doc like that, I leave the office. My knees, my recovery my life and I could NOT care less how many letters the fool has after his name. You find that insulting and I am sorry. I mean that.

BUT, you want insulting? Wake up everyday and wonder how the knees will feel. Wake up and test the knee every morning and hope it does not hurt. Are you doing that? If you are, Hey, it sucks and I m sorry. If you are not doing that, then I will respectfully ask you to jam it. Pain you cant escape sucks man and if you cant get that and want to apprioch me about ethics and how I might hurt a surgeons feelings wow, where are my manners?????
 

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Spunout said:
Go to Boulder and call on Dr. Andy Pruitt
I am not a pro rider, not even close, but I have been having problems with my Patellar Tendon for the last few months. It's been basically narrowed down to a biomechanical/muscle imbalance problem and I'm working on correcting it. I received my latest Velonews in the mail and looked at the article on knee pains that Dr. Pruitt was involved with. In it he described my pains bang on and the location. He recommended things to do to improve the situation including lateral cross-friction massage of the tendon for 10 minutes followed by ice. Doing that has substantially reduced my discomfort the day after rides. All I can say was that if I lived in the US and was anywhere close to Boulder I would definitely booked an appointment with him.

Personally I think it's very difficult to find a medical professional who understands the intricacies of what cycling does to the various joints in the leg.
 

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I am

ttug said:
I agreed and have always said I thought that a tear like what we are discussing is not a "career" ender. Look, its not a career OK? The OP (to the best of my knowledge) does not ride for a living. So, last I checked, his "career" should be OK. I would tend to address the issue much like you have, and in fact, I agree. I did state every situation is different. I did not in any way state hey, I know his entire situation by just wordds on an internet forum.

As to my statements regarding surgeons or assistants being ignorant. Hey, go nuts, you have that right to make your statement. However, AGAIN, no doc woth their salt is going to proclaim that surgery is the silver bullet or with 100% accuracy state oh yes, all will be well. IF I met a doc like that, I leave the office. My knees, my recovery my life and I could NOT care less how many letters the fool has after his name. You find that insulting and I am sorry. I mean that.

BUT, you want insulting? Wake up everyday and wonder how the knees will feel. Wake up and test the knee every morning and hope it does not hurt. Are you doing that? If you are, Hey, it sucks and I m sorry. If you are not doing that, then I will respectfully ask you to jam it. Pain you cant escape sucks man and if you cant get that and want to apprioch me about ethics and how I might hurt a surgeons feelings wow, where are my manners?????

sorry that you have the pain you currently have, luckily my knees are good. But I wake up with bad back pain and stiffness every day secondary to Ankylosing Spondylitis. No practitioner worth their salt should ever proclaim that any surgery is some form of utopic panacea, but many surgeries have high rates of success. Personally I don't care if you hurt my feelings, I was addressing, perhaps incorrectly, the sense that I got from your post that all surgeons/assistants feed a line of BS to patients in order to encourage them to have unnecessary surgical procedures, if this was not your intent, than my apologies.
 

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Ankylosing Spondylitis

physasst said:
sorry that you have the pain you currently have, luckily my knees are good. But I wake up with bad back pain and stiffness every day secondary to Ankylosing Spondylitis. No practitioner worth their salt should ever proclaim that any surgery is some form of utopic panacea, but many surgeries have high rates of success. Personally I don't care if you hurt my feelings, I was addressing, perhaps incorrectly, the sense that I got from your post that all surgeons/assistants feed a line of BS to patients in order to encourage them to have unnecessary surgical procedures, if this was not your intent, than my apologies.
I hear there's a new drug they are using with AS. Do you know what it is? Are you using it? Does it help?
 
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