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Old 2016-03-13, 02:03 AM   #1
uniscott
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Knee pain finally resolved!

Some extensive physical therapy has helped me get rid of my knee pain so I can uni longer. Thought I would share the experience in case it helps some others with the same problem.

As I've gotten better, my uni riding has been becoming more and more limited by my knees. The steady pedaling of road riding is the worst, after 5 to 6 miles it is like someone throws a switch and I get pain that feels like it is coming from behind my knee cap. It rapidly gets worse. First one knee, then the other. Not as bad for muni where the pedaling is broke up by UPDs. The knees also bother me for steep hikes, and cycling (which is why I started muni in the first place).

Anyway I tried everything I could find on this forum and others - exercises, yoga, knee braces, short cranks, long cranks, pedal extenders, adjusting the seat, joint pain supplements, etc. No luck.

Finally went to see a physical therapist and he figured out I have Chondramalacia patella - a problem where the knee cap doesn't track straight in the groove made by the knee joint. The knee cap rides on the outside of the groove due to certain muscles being tight and others being weak. I had suspected this and had tired PT a few years ago, but didn't see much improvement. I don't think I did it hard enough, or long enough, and gave up to soon.

The current routine has me doing 25 minutes of stretching and exercising twice a day, which is a lot of work and pretty time consuming. But after 6 weeks of this I am seeing a big difference. I went for a 10.7 mile road ride on my 29 inch muni with no knee pain! Very stoked about this! Unicycling Nepal is back on the bucket list.

I attached the routine. Your results may vary of course. My main point is - if you have knee problems see a professional and if they give you some PT do it! And give it some time. Happy trails.
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File Type: pdf knee PT.pdf (360.7 KB, 355 views)
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Old 2016-03-13, 02:44 AM   #2
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I had the same thing back in 2007. It is amazing how much of a difference a few targeted exercises can make.
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Old 2016-03-13, 03:32 AM   #3
UniDreamerFR
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It's nice to read that improvement (referring to our last MPs).
I didn't see any doctor yet, my ITB syndrome issue is under control by limiting the seat->low-pedal distance to no more than 82.5cm, and my other kind of knee issue (still on the left knee) is starting to get better.

Few observations:

-I found that warming before starting to ride (exactly like I had been doing for years when I practiced bodybuilding) , and also going easy the first km (for a warming purpose as well) helps a lot.

-I try as much as I can to lift my legs instead of pushing it hard downward when I pedal in order to have the lightest pedal stroke as possible.

-As soon as I feel a pain I stop and take a 5-10 min break and go on riding, and when the pain comes back too often it's time to stop the ride once for all.

-I also try to Ice my (left) knee at least once a day for 30min, even when I don't ride. it seams to be good for my knee.

-I had been practicing several kinds of stretching for few month in a daily basis but I admit I have stopped cause I didn't see much difference.
Should come back to this.

-the knee brace I use for ITB syndrome on my left knee seams to help with my other kind of knee pain, I probably should afford a better knee brace for this purpose.

I will take a look to your routine on the PDF, thanks a lot.
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Old 2016-03-14, 02:59 PM   #4
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I found a fairly strange way of dealing with this: climb hills.
I am an awful climber (when it comes to Muni) but this healed completely all my knee problems.
well not **all**: I broke my knee last week: 6 weeks without Muni
(not a Muni accident: I was hurt by a motorcycle)
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Old 2016-03-14, 04:37 PM   #5
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Quote:
Originally Posted by wobbling bear View Post
I found a fairly strange way of dealing with this: climb hills.
I am an awful climber (when it comes to Muni) but this healed completely all my knee problems.
Surprisingly, I have been experiencing discomfort in the left knee from time to time for a while. And I decided recently to focus on climbing to improve my technique & physical condition and also because I read about a rider that faced unbalanced in the legs muscles.

Turns out that I haven't had a discomfort in a while and I won't complain
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Old 2016-03-14, 05:33 PM   #6
UniDreamerFR
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WB: too bad to read this, hop you'll recover fast.

After a 32km bicycle ride sunday (pain free)I went this monday for a 33km XC ride on my 36er.
The frontal knee pain I have been feeling for few months came sometimes, and disappeared as soon as I was taking a 2-5min break or each time I was trying to pedal as much round as I can, which means with much less pressure on the pedals but without loosing any speed or efficiency.

I think that those kind of pain sometimes come from a unbalance between some of the antagonist muscles involved in pedaling.
It is easy to over develop quads and under develop ischios for example.

Working out some muscles by practicing climbing for example (or learning geared unicycles) can decrease this unbalance I think (which is not so intuitive)
But going easy with the pedal stroke when it's not necessary is also important to take care of the knees, cause by trying to lift your legs instead of pushing it downward, you develop the muscles that are often left behind, I think.
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Old 2017-01-04, 03:08 PM   #7
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resurrecting this thread because I just can't heal my left knee.
at the beginning of November I had a Muni fall on my knee (damn rock hidden by fallen leaves)!
It looks like some external ligament on my left knee got hurt (by extension)
ever since I just can't heal; walking is ok but trying to stand up after crouching or just not walking straight ahead is pain.
doctors (and physiotherapist) say just "wait and see" .... but I can't ride anymore! so it hurts even more psychologically
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Old 2017-01-04, 05:19 PM   #8
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Sorry to hear that, Bear. Hamstring injuries can be that way, they just linger on and they're really easy to re-injure. Hope you get back on top soon.
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Old 2017-01-05, 04:12 PM   #9
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Quote:
Originally Posted by wobbling bear View Post
resurrecting this thread because I just can't heal my left knee.
at the beginning of November I had a Muni fall on my knee (damn rock hidden by fallen leaves)!
It looks like some external ligament on my left knee got hurt (by extension)
ever since I just can't heal; walking is ok but trying to stand up after crouching or just not walking straight ahead is pain.
doctors (and physiotherapist) say just "wait and see" .... but I can't ride anymore! so it hurts even more psychologically
Last time I went to my physio, he spent more time talking than manipulating, and he gave me an insight that has worked for some later injuries. It may work for you.

Basically, you know better than your physio exactly which movements hurt. The trick is to find a way of stretching towards the point of pain without reaching it.

Just bend/straighten/stretch the affected part carefully to that point of initial tightness/discomfort but not to the point of pain. Then do the opposite movement. Imagine that you are teaching the joint/muscle/tendon (etc.) to move slowly and smoothly without a pain response. Gradually, you should find that you get increased confidence and increased mobility.

Part of this theory is that sensation of pain is the way that the brain interprets signals from the nerves. A very slight bit of physical damage can be interpreted by the brain as quite severe pain. Then the brain starts to "look out for" that pain and becomes over sensitised to it.

Whether this is literally true or a good story I don't know, but I can tell you that 6 months ago I was struggling to dance and now my foot is 100% better, and 2 months ago I was struggling to bend my arm because I got sharp pain, but now it is almost 100% better, and I used these techniques.

I'm 54, so it isn't just a young body healing fast.

I truly wish you well, because I know how long you've been in this forum and how much it hurts to be unable to partake in your hobby. Good luck.
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Old 2017-01-06, 12:49 AM   #10
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I hope you figure out why it's hurting. Two months ago I fell on a concrete surface and my knee took most of the impact. Wasn't wearing knee pads. I can ride but if I twist my knee in certain directions I feel sharp pains. It also hurts when I try deep knee bends. Did you have bruising? Mine looked really bad. Initially I thought I had damaged the meniscus. Like you, I'm waiting to see if it gets better. Had a similar problem with my wrist which took about three months to heal. My doctor is a unicyclist and said to give it time. I'm still riding but very cautious about over doing it. I'll definately stay away from muni until it's 100%.
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Old 2017-01-06, 08:36 AM   #11
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My doctor is a unicyclist and said to give it time. I'm still riding but very cautious about over doing it. I'll definately stay away from muni until it's 100%.
Wow, in term of probability you must be the one and only unicyclist in the world who has an unicyclist as a doctor !!!

your approach seams right, I also try to keep it easy each time I am in a healing process, that's why I try to stay away from real muni because of a shoulder injury 9 months ago.
I Also had to deal with different knee issues that are now under control but I am dealing with a hip/groin muscle/tendon pain right now which forces me to dramatically limits my rides frequency, since I prefer to give it more chances to heal (especially before my next ski holidays in February) than just continuing to ride as often as I could.

Not a so big deal, the cold temperatures are a good excuse to let the body heal, aren't they?
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Old 2017-01-06, 05:03 PM   #12
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@Mikefule: thanks for the advice, it concurs with what my physio told me (but his advice was not so precise!). I will try that (I also go to the swimming pool everyday though I hate swimming).
Winter is my preferred season for muni riding (after fall) so
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Old 2017-01-07, 06:00 PM   #13
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I was shocked when I looked at her webpage after being referred to her for something unrelated to unicycling. Here's a picture of her riding.



I don't think she does much riding these days but did mention she got her unicycle out after my first visit.
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Old 2017-01-08, 04:15 AM   #14
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Originally Posted by UniDreamerFR View Post
Wow, in term of probability you must be the one and only unicyclist in the world who has an unicyclist as a doctor !!!
Come on our unitours

We had three doctors and a medical student on the last one:
http://www.adventureunicyclist.com/unipal/

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Old 2017-01-08, 05:30 AM   #15
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I was shocked when I looked at her webpage after being referred to her for something unrelated to unicycling. Here's a picture of her riding.
Wow, that's waay beyond your typical unicyclist! Wonder if she used to ride with other local unicyclists we might know. What's her name?
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