Tuesday, April 16, 2013

I "Knee"d Some Assistance

Maybe I jumped in too fast, too soon, with my return to mountain biking. Maybe I love food too much and carrying those additional pounds is too much of a strain . Or maybe my aging joints just can't handle repetitive motion any more.

Regardless of the cause, I'm finding that the more I bike, the more pain and weakness I'm experiencing once again in my post surgical right knee. Lately I'm finding that sometimes as quickly as the first couple of miles on a trail, I begin to experience a deep tender ache just below the front of the kneecap which wraps around the entire outside of the knee. With continued pedaling, and particularly the exertion of climbing or standing, the pain progresses to a searing sharp pain with associated give-way weakness.

I'm married to a bike geek/mechanic and in an effort to mitigate the knee pain and weakness we've tried adjusting my bike (the frame itself seems to fit me perfectly) with all varieties of stems, saddles, pedals, cleats, seatposts, through the whole range of positioning of said items, to no real avail yet. I had my previous bikes fitted years ago when I was being coached and that seemed to work okay, but that was prior to having my knee surgery. Following a right lateral retinacular release, I ended up basically taking a few years away from regular biking and racing. In the intervening several years, I got fat, got old, got weak and got disgusted enough with my lack of activity and ambition that I decided I wanted to come back to the sport that meant so much to me for so many years, so I started mountain biking again.

With my recent return to riding - probably too much too soon, which is likely a big part of my current issues - I'm now finding that the pain and weakness have also returned with a vengeance. It's gotten to the point where it's once again quite painful to put any real resistance to the bike pedals, climb and especially descend stairs, or sit for prolonged periods, and the knee gives way often with biking and sometimes even with routine activities like kneeling or sitting/rising to stand. I've been told (by an orthopedist who bikes) that I most likely have an ugly combination of patellofemoral syndrome, iliotibial band syndrome, degenerative joint disease, osteoarthritis and a chip in the kneecap bone. To make matters worse, I also have a slight leg length discrepancy, with the post surgical leg being a tad longer than the other, which makes adjusting seat height a nightmare. Lastly, I'm now in my 50s and have gained a lot of weight over the past few years which is not helping matters at all. I've been trying all manner of stretches, exercises and anti-inflammatories to try to strengthen and loosen things up in my lower extremities but so far, the pain and weakness are tenaciously resistant to any and all attempts at mitigation.

I'm wondering now if I might need to have a professional bike fit done just to make sure I have things generally set up as well as they possibly can be to accommodate all these concerns. Unfortunately, I suspect that the fact of the matter is it's likely I am probably not ever going to be able to ride pain-free due to all the joint and bone problems. However, it would be nice to at least be able to get through more than a small handful of miles on a flat easy course before being in so much agony that I have to hobble back to the trailhead, dragging my bike behind me...

So with that in mind, I'm checking the local bike scene to see if I can locate a superior bike fitter with knowledge and experience in knee issues. Wish me luck - I have a gut feeling I'm gonna need it.