10/25/13 8:20 AM

Just made an appt with the knee guy, fortunately can get in next week. One knee is killing me whan I walk downstairs, and my first treatment modality (wait a few days and hope it goes away) failed. Good timing in the sense it held off until all my centuries and stuff were over. Bad timing in that my Sachs should be ready to ride fairly shortly, so I gotta get this fixed!

My uneducated differential diagnoses include torn meniscus with the flap getting into the joint, hopefully curable with some arthro snipping. But I dunno of course, hope it's not worse than that.

10/25/13 8:26 AM

Bummer.....not only affects your riding but skiing or skating that will be happening any day now down east....Any recent "incident"? that brought this on? or did this come on gradually? based on your post sounds like it just came on suddenly...

10/25/13 8:52 AM

Basically I dunno the cause. My knees are intermittently creaky but held up well through the season including knee-busters like D2R2. This started about a week after I rode the Dempsey century, but I rode fine and there was no precipitating incident. If I get out of it with arthro, I'll be happy.

Funny you mention skating. In a charity ride a few weeks ago I ended up next to a guy I'd raced against 25 years ago but hadn't seen in a long time. He's on me to join his short track club. Gnarly, Dude!

10/25/13 9:32 AM

Dan--could the shift to cold weather have affected the knee?

10/25/13 9:58 AM

Hasn't been that cold, plus I normally ride and do other stuff down to subzero F. This feels like something is messed up in the joint, plus I've noticed the kneecap is pretty unstable.

10/25/13 10:20 AM

That's not good. I hope whatever it is, you recover fully and speedily.

10/25/13 10:59 AM

Suggest asking doc about a prescription for Voltaren - diflocanec is the generic.

10/26/13 10:40 AM

Did you hyper extend it at some point? My weaker knee has enough slack [especially before 400 miles into the season of the small front ring] that it can do that when I stand too quickly. Then it hurts for a few days, especially when going down stairs or grade walking/hiking. I guess going down you/we may lock it? Maybe a brace to keep that from happening until it calms down? My doc wanted to scope that knee ever year after the initial tib/fib until I got and stayed back on the bike long enough for it to PT out.
Never scoped and it is @ 95% perpetually now [I pray]

I tell you what aggravated my right knee recently was the tugging on the tandem with my wife not feeling the signals to ease or start back up. That back pressure had my lesser knee a bit tender after the tandem rides, but it subsided after a day or two.

Hope your problem is minimal dude!

10/26/13 10:55 AM

Is the unstable knee cap observed at rest, as compared to the other kneecap?

Have you used any NSAID's yet? If so, how did the knee respond?

Often with the onset of colder weather and shorter days, riders will miss a few training days and then experience pains when resuming a week or two later. Often this is the inflammatory response brought on by changes in the diet/exercise ratio and can occur within a surprisingly short time frame.

Can you ride comfortably on the flat lands (assuming you have such terrain locally)? I've been able to recover from pretty severe knee tendonitis by commuting to work 6 miles over flat city streets in a semi-suburban (i.e. not too crowded) environment.


A lot of questions here, I know, but I would sure want to know the answers before any medical regimen was undertaken, particularly surgery (but also including any drugs that would serve to eliminate pain without addressing inflammation).
Do you have to descend stairs daily? This can sometimes challenge the healing process, prolonging inflammation indefinitely.

Lastly, I have been preferring shorter cranks in recent years for their ability to allow me to train over a more irregular schedule without bringing on knee problems specifically.
Do you perhaps have another bike with shorter cranks and plenty-low gearing to use for awhile? The shorter cranks will also allow you to experiment with a wider range of saddle heights and will certainly make life easier on your tweaked knee while it heals!
You might be able to find and buy a single shorter crankarm for the affected side as well, and I recommend this highly. Otherwise, switching the entire crankset for one that's available in a much-shorter length is a worthwhile consideration imo.

10/26/13 11:46 AM

Thanks for the thoughts. Actually the problem seemed to abate yesterday afternoon and then returned and now seems intermittent, so I suspect there is something in the knee moving in and out of alignment, or something like that. Meniscal tears may do that for one.

Yes, the kneecap is less stable than the other kneecap at rest. I have tried Advil and it makes no difference. Yesterday I couldn't ride comfortably on the flat so I left the bike at home at lunch and drove back to work.

I've been riding for 40 years in the northeast so this isn't the result of the temp dropping 20 degrees or missing a few days on the bike.

I think I will keep the doc appointment even if the symptoms abate. I know my knees have problems (an X-ray a few years ago showed significant arthritis in addition to a meniscus tear on the other knee, the tear being fixed), and I consider them the "weak link" in terms of continuing to cycle as I want to. In early spring this year I had a few really bad days and didn't know if the knees would hold up through the riding season, but they did. So I'd like to see what X-rays/MRIs show now, and discuss the best way to deal with it.

Actually if it's something that can be fixed with arthroscopic surgery I'd rather do that than go on meds long term.

The doc is a racer and health nut in addition to being a knee specialist. He will tell me to lose weight and not only to eat fruits and vegetables, but which of them to eat. He won't recommend surgery unless there is a good reason for it. If there's no need for surgery now, I'd like to get a preventative/strengthening program (and incentive to lose weight doesn't hurt).

My short term goal is to take the Sachs (which I may get fairly shortly) for a long, hard ride so I can bond with it.

10/26/13 12:13 PM

"My short term goal is to take the Sachs (which I may get fairly shortly) for a long, hard ride so I can bond with it."


May I suggest a short easy, followed by long easy and longer easier.

I get some knee stuff when switching bikes. Most noticeable tandem to Scott of late. As I said re: tandem back tugging exists, something not on my other bikes, without a running fixed now anyway.

But I also had a bit of knee ache/pain/tweek/discomfort after I took the Paramount [which I had not ridden in a long while] for a 37 mile ride recently.

Turned out I had not ridden it prior to my seat last raising window post femoral nerve pinch seat lowering bouts yada...

I actually went even higher now and am used to it then prior to said bout. I am about 5/8" higher than I always was. Which is over an inch higher than first riding post Femoral issue. The paramount seat was about 5/8" low for what I am acclimated to and planning to stay with. I raised it on the Schwinn at the 1/2 way point of the ride. It was better on the return and then a little sore on that knee for a day or so. But that right knee is my barometer pretty much.

I mention this in case the trends apply to your situation. Check all your saddle heights and setbacks. Rethink if you changed a saddle or something, or just have not checked if a post may have slipped etc. Just throwing out stuff...

All the saddle raising started when I first rode the Scott with the Integrated Seatpost. I did not want to cut it [investment bike] and liked the higher saddle I noticed. Although it was too high initially and is dialed now that I bought my investment partner out of the bike. It is my #1... for now. ;0

So I cut the mast and used the lowest stack seat and highest stack pedals I have to minimize that cut. ;)

FWIW, the Scott is the first more light bike I have ridden that I feel no negative side while descending. Anything lower than 16 lb in the past had a trade off on the descent prior to this bike for me.

It is a better climber, more to do with the stiffness than weight, if the weight even has anything to do with it. Same work, but I seem to move a little faster up longer hills. the AL TCX also. yada

10/26/13 12:43 PM

If it is knee instability maybe intensive work on the weak muscles to improve stability may be in order so hopefully maybe no surgery but time in the gym or at the therapist (fingers crossed)

10/26/13 12:48 PM

Well I switch between 5 different bikes and keep the saddle height the same, and the height on the Sachs will be the same.

I think there's something structural in my knee, but that's what we shall see.

As to PT, yeah that or just exercises I do at home if indicated. That would be my preferred outcome.

10/26/13 12:59 PM

"maybe no surgery but time in the gym or at the therapist (fingers crossed)"


And not hammering your new Sachs and Old joints perhaps. All due respect. Although I totally understand the feeling/comment. ;)

10/26/13 1:49 PM

And if I need to get something cleared up before I can do that, I want to do that now. I'm not going to ride at all unless I can do so comfortably and with normal power and fluidity, and not risk making it worse. If the knee pain abates, maybe I can do that, maybe not. That's why I'm going to see a doc who is a cyclist.

10/26/13 1:56 PM

Is Richard building up the bike, or are you getting the frameset and doing the nups solo?

10/26/13 2:27 PM

I'm getting the complete bike from Richard. The frame and fork are ready, parts are ordered.

10/29/13 3:37 PM

You probably mentioned this before, but if so, I forgets. What are you going with for wheels, parts, etc?

10/29/13 4:19 PM

What Groupo/trim


I am also curious. best I can tell it was left at "might think about SRAM".

10/29/13 4:48 PM

Here is what I'm getting.

Chorus 11 speed, 50/34, 12-27. That gearing will be perfect for me (I'm heavy enough that I can use a 50/12 on slight downhills, and like a low gear for climbing). Having 11 cogs in this range will be way cool. I see no need for Record or e-.

Campy Zonda wheels. I can hear the moans about boutique wheels, but Richard recommended Campy wheels for compatibility, said he'd put these on the last Campy bike he built up, and these have excellent reviews as an all purpose wheel and are not very expensive (relatively). I briefly considered the flashier and much more expensive Bullets, but concluded they are unnecessary both practically and aesthetically. Challenge 23 tires (I have used mostly 26s recently, but decided to start with 23s on this bike).

Zipp stem, bars (traditional bend) and post. I left these to Richard.

Cane Creek headset. Whatever saddle Richard keeps in inventory (I have not used a road saddle more recent than an old flat Flite, and generally do not have saddle issues, so I'm happy with about anything. I think it will be red). I also like Brooks and Berthoud, but not on this bike...

Time Xpresso pedals, which are what I use on the road.

So that's my ride.

10/29/13 7:18 PM

Mechanical Chorus?

Just went to Di2 Ultegra, front shifting amazing...

10/29/13 7:59 PM

I only just went to 10 speed late 2011. I always stay up to date minus a decade give or take...

Di2, 2015 maybe... 16

10/29/13 8:07 PM

Yes

10/30/13 9:45 AM

Saw the doc today, x-rays looked pretty good. So it's not arthritis, which was my primary concern. So I'm not looking at a replacement. I'll have an MRI next week, which would show a meniscal tear or similar. Meniscal tear is the best guess. The doc said I could ride in the meantime. He rode D2R2 this year so we talked about that and he gave me a web address where I can download a good GPS of the 180 km course.

10/30/13 10:11 AM

Either that's a great doctor or he's thinking of ways to limit the competition.