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Knee Overhaul
 

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dan emery
Joined: 11 Jan 2004
Posts: 5960
Location: Maine

5/16/18 2:12 PM

Knee Overhaul

With all my various injuries and conditions, the only thing that bugs me on the bike now is some patellar osteoarthritis in the knee of my non-busted leg. I get some pain on the front of the kneecap with pedaling.

So I am starting on PT, and a course of naproxen.

I could have cortisone or SynVisc shots, but those are a last resort for me.

Gotta have the knee in shape for the PEI Gran Fondo in August and BikeMaine in September.

Funny how just a little knee pain/stiffness totally screws up your pedal stroke, which totally screws up riding in general.

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KerryIrons
Joined: 12 Jan 2004
Posts: 2906
Location: Midland, MI

5/17/18 3:17 PM

SynVisc

I had three SynVisc injections and did/do PT exercises for knee arthritis. For me, the PT works and the SynVisc didn't. That said, I know someone who gets the injections every 6 months or so and experiences great pain relief. YMMV

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dan emery
Joined: 11 Jan 2004
Posts: 5960
Location: Maine

5/18/18 5:41 AM

Thanks

Good to know the PT has been effective. I have had good luck with PT on a couple other minor knee issues. Your experience with the injections is similar to what I've heard - kind of random.

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Sparky
Joined: 08 Dec 2003
Posts: 16462
Location: Portland, OR

5/18/18 9:53 AM

Hope youvrealuze a good result, on several levels.

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dan emery
Joined: 11 Jan 2004
Posts: 5960
Location: Maine

5/27/18 11:36 AM

Coming along

With the PT and naproxen, the knee is coming along pretty well. It's still a bit stiff but I can pedal pretty much normally, without the kneecap pain that was messing with my souplesse (or what passes for it in my case). Of course some (or all) of this may be just the arthritis quieting down, but the PT feels good.

The PT thinks some of this is from compensating for the busted leg on the other side. He identified some quad tightness in the busted leg which I wasn't aware of, as the walking or pedaling ROM doesn't bring it out.

Whenever I get into PT I am impressed how much they know and how much they can identify by just watching you or doing a few simple tests.

Now to test it with some longer rides.

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Sparky
Joined: 08 Dec 2003
Posts: 16462
Location: Portland, OR

5/27/18 6:30 PM

Sounds good. once you start walking and stepping trying to stay off the one leg, you do other things to the muscles and the other knee/hip etc.

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dddd
Joined: 11 Jan 2004
Posts: 3203
Location: NorCal

5/28/18 11:49 AM

Could this perhaps be a case of an irritated tendon, i.e. tendonitis?

I've found that riding more regularly in controlled stages can overcome what sounds like similar symptoms. My kneecap area can become irritated following a rest stop, and it takes another gradual warmup to get going when that happens.

I always do better with shorter cranks with symptoms such as this, 165's are not hard to find and sometimes turn up cheap.

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Sparky
Joined: 08 Dec 2003
Posts: 16462
Location: Portland, OR

5/28/18 12:18 PM

Bike PT, it seems harder to use your body non symmetrically on the the bike. Unless you are Chris Froome that is.

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dan emery
Joined: 11 Jan 2004
Posts: 5960
Location: Maine

5/28/18 12:49 PM

Arthritis

X-rays and the ortho say arthritis, and the PT thus far is effective. The last couple rides the knee hasn't bothered me much and I've jammed up a couple short hills.

I just need to get all body parts working at the same time.

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Sparky
Joined: 08 Dec 2003
Posts: 16462
Location: Portland, OR

5/28/18 1:46 PM

"I just need to get all body parts working at the same time"

This occurs less and less times a year for me as time passes..

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dan emery
Joined: 11 Jan 2004
Posts: 5960
Location: Maine

6/23/18 1:00 PM

Just shoot me?

PT has been helpful for the knee, but has not eliminated the problem - I've had a couple of flares and while it currently feels reasonably good riding, I'm unsure if it will hold up to a long, hard ride (one way to find out, I know, which I may try tomorrow). There is still some stiffness. I go back to the ortho Monday, and the option is to get a shot, which could be cortisone or synvisc.

Based on a discussion with the PT, I'm thinking of trying cortisone. I guess the best case is you reduce inflammation temporarily, keep doing the PT, and maybe when the shot wears off the symptoms are not as bad because strength, flexibility, balance etc have improved. I guess the worst case is just that it doesn't work. He thought the cortisone would be a better place to start than the synvisc, a less aggressive change. The PT had a cortisone shot years ago and found it very helpful.

So I'm thinking of giving it a "shot." Any thoughts?

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April
Joined: 13 Dec 2003
Posts: 6326
Location: Westchester/NYC

6/23/18 7:53 PM

I don't know anything about Synvisc. Cortisone has been very helpful for me.

Granted, I don't have arthritis, yet. So the "shot" I've got were very useful in quieting down the inflammation. Allowing me to do PT at full power. Once the muscle and ligaments work back to their original strength, the inflammation didn't come back.

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