Orthopaedic / physio question about my knees

For reasons, I’m doing 55 mile a day on a bicycle. My thighs were sore at first, but I’m over that. What still hurts is the front of my knees, in front of my knee caps. At first it was like kneeling on glass, now I’m left with continuing soreness.

I’ve managed to live my life without learning anything particular about anatomy. What is in front of my knees? Why is it so sore? Why was it painfully sensitive at first?

WAG: repetitive overuse.

Unless the 55 miles a day was a typo, get yourself to a dr. before continuing that kind of daily regime. The Dr. will no doubt then refer you to a physical therapist who will work with you to reverse the harm the marked overuse has done to your knees. At some point, either work with a PT or a credentialed sports trainer recommended by the Dr. or PT to develop a balanced exercise routine to meet your goals.

Doing only one form of exercise and to such a daily extent is a recipe for problems. Pain now and likely long term dysfunction and pain in the future, such as exacerbating arthritis.

All this was based on the American health care system and assuming you aren’t training for a world class bicycling competition.

Ok, repetitive overuse of what? What is the structure of the front of the knee?

Runners knee probably.

Hopefully you didn’t jump into 55/day? That’s a joint killer. With the pain you describe, it’s overuse and the treatment is rest - sucks.

Be sure your bike is adjusted properly. Sitting on you seat, against a wall for leaning/support, move a pedal to the lowest position. Your heel, yes heel, should just rest on the pedal while in the seated position. I suspect you don’t have the seat high enough - probably the most common problem with new bikers. Feet on the ground while stopped and seated will wipe out your knees in short order.

The bike is not set up perfectly (I’m a big guy), but it’s not that bad either. And don’t be mislead by the first response :slight_smile: I’m not exercising for 55 miles – just riding. I don’t know how the body is built, but I think I had soreness in the subcutaneous/skin layer at first, and now I’ve got … ‘runners knee’ ?? The description isn’t very close: I’ve got no grinding sensation with knee movement, no mild swelling. I don’t know what patella pain is, but that might be right, and general ache around the front of the knee might be right. Or perhaps ?Knee Bursitis? (no swelling that I’m aware of, no blow to the knee, but aggravated by kneeling and bending)

I still don’t know what’s actually sore – I don’t have any joint pain or joint disfunction, ‘tendons’ don’t hurt as far as I know, and I don’t think there are any muscles there ???

You can’t examine someone over the Internet. Some common causes of frontal knee pain would include prepatellar bursitis, patellofemoral syndrome and strain of the quadriceps tendons - especially the ligamentum patellae. Patella means kneecap. Basically, there are some fluid sacs (bursae) around the knee which might become inflamed. So might the back of the kneecap (it should slide smoothly, but doesn’t if roughed up) or the tendon (mislabeled as a kneecap ligament) going from the front of the thigh over the kneecap to the tibia. The specific location, whether there is pain on squatting or going down steps might help elucidate the difference. Visible swelling or the leg giving way suggest more severe diagnoses. Many causes are treated with rest and anti inflammatories. Kneeling suggests bursitis (housemaids knee).

55 miles a day bicycling is going to be hell on your knees whether on an exercise bike or on a trail to get from one place to another. Unless you trained for a year ever so gradually to get to 55 a day every day, a carefully designed training program like a marathon runner does, your knees are going to hurt. A healthy fitness goal combines cardio+core+strength+flexibility. ‘Just riding’ is exercising, if there are any inclines, that can be even harder on your joints.

Unless you’ve had bilateral impacts to both your kneecaps, it’s unlikely to be bone pain in the patella bones themselves. Ditto skin and subcutaneous tissue is unlikely the cause-subcutaneous tissues is basically padding, not very involved in moving the knee joint.

Ligaments and tendons can and do hurt a lot, that’s what sprains and strains are. Pissed off cartilage or insufficient synovial fluid is no fun either. They can also take longer to heal than straight forward broken bones. Knees are incredibly complex joints, the anatomical structures in them are incredibly interdependent on one another. If one structure is overused and there is tissue damage, the discomfort and tissue damage gets referred along to the next structure. Discomfort is your body saying quit doing to me what you’re doing to me the way you’re doing it to me. Listen to it.

Don’t try to diagnose from an article. Doctors go to school for four years + 3 more years residency and have almost unlimited diagnostic tools at hand. Get to one. In the meantime, bicycle only as much as needed to keep the knees flexible enough for average range of motion, a couple of slow, gentle low key miles a day at most. While you’re waiting to get into a doc use the following:

P ain relievers, specifically OTC anti-inflammatories like ibuprofen(Motrin)or
naproxen (Aleve). Ask the pharmacist the best OTC dosage and any
contraindications specific to you.
R est (basically, stay off the bike-do some walking to keep knees flexible)
I ce ~ no more than 20 minutes on out of every waking hour.
C impression (supportive and prevents swelling). Either Acewraps or neoprene
sleeves. Sleeves are much easier and easy to leave on all day. Ice can be
applied on top.
E Levation. Footstool or pillows under knees and calves.


Appointment with a doctor before doing more 55 mile rides.

Well, in front of my knees does hurt, that’s the subject of the thread. But if you think that it takes a year to get to safely walking 10 miles a day, you’re starting from a lot further back than I was.

I was referring to your statement of bicycling 55 miles a day, not walking 10 miles. Bid difference. Was the 55 miles a typo? Where does 10 miles walking come in?

I misunderstood your reason for asking the question. When will I ever learn? /s/


I’m not running a marathon. I’m not doing 55 miles of badly-planned fitness training. I’ve given you another reference point, just because we’re having a conversation, and you still can’t get your mind around it :slight_smile:

Let this be a lesson: When you don’t understand something, sometimes it’s because you don’t understand. :slight_smile: I’m glad (and thankful) that failure of understanding didn’t prevent you from contributing. Although I’m pretty sure that pain from a sprain is from the associated blood vessels, muscles and nerves? I’ve never seen evidence of innervation of tendons in the food that I eat.

Well, I asked a question about orthopaedic / physio, and you did get there.

Wrong on all counts:

Nerve endings in human fasciae, tendons, ligaments, periosteum, and joint synovial membrane (https://onlinelibrary.wiley.com/cms/asset/1633d752-de71-4766-a0e2-2e9c48861f4c/ar.1091360208.fp.png)

Guess what a knee is composed of? Who isn’t understanding?

Remember: rest, ice, compression, OTC inflammatories, doctor. The doctor most likely won’t be in their office Monday but you can no doubt leave a voice mail message asking to be called back Tuesday so you can make an appt.