Fixed + knee injuries

Late last year I received a grade 1 medial ligament tear to my knee. I got some physio and after 6 weeks it was healed. I have been snowboarding since then, had a few falls and no repeat of the injury. I then rode DH on the weekend and had a bit of a stack. My left thigh got a bit of a cork but at the same time I tore the ligament again. I have just come back from physio on a bit of a downer as she mentioned that this sort of injury will keep popping up for the rest of my life.

It just has me thinking about bike priorities at the moment. Stacking is part of the sport, it happens when you don’t expect it so there is nothing I can do about that. I want to know if anyone out there is riding fixed often with a similar sort of knee injury and how they handle it? I am just thinking priorities at the moment and riding singlespeed for reduced pressure on the knee is making sense at the moment.

theres a couple of threads about this already in the Help forum, have a look there perhaps.

The problem with a lot of these types of sporting injuries, knee or otherwise, is that they keep flaring up so long as you keep working that part of your body… especially joints.

What a n00b. Didn’t even use the search function. Mods can lay the smack down on this thread now.

when you get to 1000 posts, we cut you some slack.

besides, your question is a little bit different to the other threads.

i’d say that instead of a physio you should try to find an exercise physiologist. building up the muscles around the joint should stop it happening so often.

The physio I am now going to are very reputable in the cycling community in Canberra. They have a gym and excersise equipment so it isn’t one of those places where they hook you up to an ultrasound machine and leave you (which is where I went before this).

As part of my rehab last time they gave me a lot of at home exercises to do that was specific to getting my muscles to ‘turn on’ for stabilising the knee which is what I needed when snowboarding. It worked for snowboarding I guess! My main concern is that I am going to have to give up a few riding styles in order to think more long term about my knee and the first style that comes to mind is riding fixed with the added pressure on the knee and it’s joints. I know that sounds silly due to me receiving the injury when on the down hill bike though.

EDIT: FYI, this is where I am going to in Canberra
http://www.movehappy.com.au/page4.htm

Many differing and opposing view points on this, re fixed gear and knees.
The following is only my experience,and in no way intended to be taken as gospel or medical fact.
A couple of years back I tore my medial ligament and also my meniscus when squatting down.
anti inflammatories and physio healed the ligaments, but the meniscus was torn in such a way that it needed removal.
Unfortunately I lost 50% to the arthroscopic procedure.rehabbed my knee back with plenty of cycling and felt it was pretty good.
Started riding occasionally on track at 91 gear inches and immediately felt it hurt again,and feel like it was internally bruised.this bruising to the bone takes ages to fade away.Stopped it for a while and then had a recurrence of the ligament tear(milder)and a clunk start up in the joint again, due to a change of work tasks.Too much kneeling and twisting, caused a spur or horn to protrude from where the last site was trimmed.no surgery, but 9 months on it’s still clunky internally , but without discomfort.Back on a fixed gear(brakeless) at 63 GI to see if that was more suitable. didn’t take to long for the bruising and tenderness to recur from the back pressure and skids.
Through out this whole period i’ve continued to commute and rec ride my roadies to maintain muscle integrity and keep the synovial fluid lubricating the joint. my style has changed to a much more spinny, high cadence motion ,and this seems to suit me.
from time to time , i feel my knee begin to over extend or flex on the medial side from some innocuous move whilst walking or getting out of a car.i don’t think my knee will ever be as structurally strong or trustworthy, no matter how much work i put into the muscles around it.
Riding fixed and even S/S on hills means I have to grind a little more than is comfortable for me, and that aggravates the site internally that is effectively bone on bone.
Once again i stress that this is only my experience personally ,and others may have a completely different experience.
I would however say to only listen seriously to folks who are talking from experience, not the opinions of the masses who are spouting/regurgitating internet research.
treat you knee with respect and get it to a comfortable zone with rehab and then try the things that may aggravate it and see for yourself, that’s what I did.
good luck with it.
have you had a tear in the meniscus or any removed as yet?

Thanks for your input! Yes I have had a tear in my meniscus about 10 years ago from going over the handlebars and my foot staying in the cleats, I don’t know if the current injury is somehow related… the physio does know about the previous injury so I guess they would have made mention of it if it were.

The main thing that went through my head when she said ‘this could be with you for life’ is what can I do to make sure that my main activity, being cycling, isn’t going to be too effected by this. The only reason I ride fixed is to commute, I don’t NEED to ride fixed as I have never ridden proper track. I just thought it would be a good way to train and build up some strength for XC riding. Is it a case of hanging up the fixed gears and concentrating on singlespeed or just the roadie… don’t know. Thats why I am asking to see if there are any other fixed riders out there who have gone through the same thing and realised that the fixed gear isn’t doing them any favours. I guess I just have to concentrate on the strength building and then go on the try it and see method. Gaaaah, frustrating old man knees!

I’m 42 this year

Yeah it sucks don’t it?
My surgeon tells me that now I’ve had cartilage removed and it’s bone on bone, that I’m a likely candidate for arthritis as I get older.
No running, jumping off the back of utes or trucks,and no excessive kneeling squatting or twisting with feet placed firm.I have permanent restrictions written into my work conditions.
If I’d opted not to have the cartilage removed it would have kept moving(read clunking) and causing my ligaments to tear,and if dislodged and moved too much could cause knee lock up.
It will be with you for life so to speak, but if it’s anything like mine then cycling will be the one thing that keeps it healthy.
Riding a bike, as endorsed by GP, Surgeon and physio is the only time when my knee feels normal,and it’s noticeably more uncomfortable when I havn’t ridden for 48 hrs or more.
I’m currently putting in around 150 k’s a week,and am riding a recumbent HPV in the open class of the pedal prix events in S.A this year, so it’s certainly not holding me back any.

Buy a Powerband.

Thanks Dave, it has made me feel a little at ease with the injury! It sounds like you aren’t letting it get to you too much with the riding.
I just turned 30 last week and so far being 30 feels like what I would have thought 60 feels like, with the limping around and complaining and all.

Yeah I had two of them in the early 90’s as part of my 2 stroke phase.
One was on a Yamaha RD 350 LC, and the other on Kwaka KR250.

Having knees older than the previous mentioned ones I have given this much thought and some research over the last ten years. Knees wear out , some faster than others due to genetics and some due to accidental wear. The mechanism of wear is a reasonably hot research topic and the answers are far from clear. Intuitively it would seem that stress on the cartilage would be proportional to wear and this is true to some extent between high impact and low impact sports.
In terms of riding brakeless It feels to me when when i ride 45/17 that the torque generated climbing a 12 percent grade is much more than generated skid stoping. A biomechanical friend of mine and I spent a day with wax plates stuck on the pedals and the preliminary findings supported the feeling that riding uphill generated more stress. We have never got around to doing this formally but it is back burner project,

Having done minor meniscal tears it was my experience that keeping on riding and doing the exercise physio stuff the injury eventually settled down . I would make sure you did not have any complicating factors like a tendency towards gout etc.It would be sensible to step the gearing down some .

Therefore it is my advice supported by alcohol fuelled conversations with orthopaedic surgeons that you keep riding regularly, that you seek physio support, that you get checked out for things that can decrease your healing like uric acid, vitaminD , homocysteine etc. The evidence for the long term advantage of arthroscopy and debridement is pretty poor but is advantageous in the short term . If you are being paid a million dollars per year to ride then get your meniscus and cartilage trimmed and get back on your bike but no one will suggest that your knee will be better off in 30 years than someone who did not

I would also add that I would not be riding brakeless if my knees were not trust worthy. It is one thing to say ouch grinding up hill it is a totally different experience to feel that pain as you try to avoid sliding under a bus

fullface

Ps never had a power band I was more a reggae type

Hehehehe, it’s a slippery slope…

…past that certain age you have to stretch more, recover longer, listen to your body more (b/c it gets really pissy at you when you don’t).

BUT older blokes have higher pain thresholds, cos we live with it all the time. On these things I speak from knowledge :(.

Thanks again for the replies!

So to the people with knee injuries. Have you hit the weights to build up the muscles to support the knee?

i’m a recent convert to using a foam roller to work my IT band. it hurts like 15 bastards on a bastard-boat, but i’m slowly noticing improvement.

a number of people have suggested pilates or yoga which i’m planning on getting into soon.

i’m hoping that a supple body is a somewhat pain-free body.

  • 1 on yoga!
    You can hear my knee pop and crack throughout the whole room at yoga, instructor even asked if everything OK… but best thing i’ve ever done to ease knee issues.
    Be careful with weights as you can cause other probs to surface.
    Surely Canberra as base for AIS would have some of the best physios,etc.

Yoga hey… cool, might need to give it a go. One of my clients is Canberras best Pilates studio so I might start chatting to her about a few pilates sessions too. I have never really thought about that sort of fitness.

No weights for me. Surgeon recommended cycling and swimming as they are low impact and keep the joint moving in a relatively normal range. To start weights would most likely stress the joint and make it flare up for me.The muscle rehab and development around the joint is more about maintaining and strengthening a joint and muscle group to keep it in the best shape ,as opposed to favouring it or not using it to a point where it becomes even weaker.Exercising the joint helps as it keeps it lubricated with synovial fluid.
Yoga and pilates get a good wrap from all the people I’ve spoken to who do it, seems to be a good pre emptive thing to do to avoid many niggling injuries from day to day exercise.really must try it some time.

I use one of those, yep it hurts (but in a gooood way)

a worthy goal, good luck with that one.