Sidebar #1If you are having problems, or should we say, "When you have knee problems," it will be helpful to give your doctor as much information as possible to help him or her with the diagnosis. Dr. Evans suggests bringing the following information if you are having a knee assessment:
- Information on any prior injuries, surgeries and/or therapies
- History and timeline for the onset of pain
- History of training practices (hills, time-trials, average mileage, cadence, intensity)
- Information on how the symptoms relate to pedaling
- The type of pain (sharp, dull, ache, jabbing, grinding)
- The exact location of the pain
Sidebar #2Anterior knee pain or pain on the front of the knee is quite common, and the patella is most frequently the culprit. Overload of the patella will result in pain, post-activity ache and a sense of instability and/or locking. There may be associated grinding or swelling. Inflammation of the patellar tendon or quadriceps tendon should also be considered.
Sidebar #3Pain on the outside or lateral side of the knee is most commonly caused by iliotibial band syndrome (ITBS). The IT band is a broad band of tissue on the outside of the knee that can rub across the lateral side (outer side) of the femur causing inflammation. Recent studies have documented up to 24 percent of cyclists with this problem. Symptoms include pain and burning, and the rider may feel snapping, a gritty sensation and swelling. This syndrome has to be differentiated from a torn meniscus or cartilage, tendonitis or kneecap (patella) overload.
Sidebar #4Medial knee pain (pain on the inside of the knee) is a complaint in about 20 to 60 percent of riders (depending on the study). The most common diagnosis is plica syndrome. A plica is a fold of synovium (the lining of the joint) that is a remnant of membranes that form the knee. It is normally not a problem but it can become inflamed with strenuous, repetitive exercise as it rubs over the side of the femur.
The rider will have pain, and often times there will be some swelling. There may also be snapping, popping, grinding and tenderness over the band of tissue. Other considerations include a torn meniscus or cartilage and patellar problems.
David Alden-St.Pierre, is a physician assistant working in emergency medicine and internal medicine in the Boston area. He's a follower of the SS29'er church, paying homage and making sacrifices as often as possible.
Dirt Rag is an independent magazine with an open-forum format that allows readers and writers alike to participate. Dirt Rag has been immersed in cycling culture since 1989 and has remained true to grassroots, independent coverage of what really matters to mountain bikers: what, where, how and why we ride.