# Orthopaedic / physio question about my knees **URL:** \ **Category:** Factual Questions\ **Created:** [September 4, 2020, 3:59am UTC](https://boards.straightdope.com/t/orthopaedic-physio-question-about-my-knees/919775 "2020-09-04T03:59:53Z")\ **Posts on this page:** 12\ **Page:** 1
**Author:** ![Melbourne](https://avatars.discourse-cdn.com/v4/letter/m/b5e925/32.png) [@Melbourne](https://boards.straightdope.com/u/Melbourne)\ **Post date:** [September 4, 2020, 3:59am UTC](https://boards.straightdope.com/t/orthopaedic-physio-question-about-my-knees/919775/1 "2020-09-04T03:59:53Z")
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? ---
**Author:** ![BippityBoppityBoo](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bippityboppityboo/32/5745_2.png) [@BippityBoppityBoo](https://boards.straightdope.com/u/BippityBoppityBoo)\ **Post date:** [September 4, 2020, 4:19am UTC](https://boards.straightdope.com/t/orthopaedic-physio-question-about-my-knees/919775/2 "2020-09-04T04:19:47Z")
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. ---
**Author:** ![Melbourne](https://avatars.discourse-cdn.com/v4/letter/m/b5e925/32.png) [@Melbourne](https://boards.straightdope.com/u/Melbourne)\ **Post date:** [September 4, 2020, 4:40am UTC](https://boards.straightdope.com/t/orthopaedic-physio-question-about-my-knees/919775/3 "2020-09-04T04:40:34Z")
> [@BippityBoppityBoo](#): > > repetitive overuse. Ok, repetitive overuse of what? What is the structure of the front of the knee? ---
**Author:** ![Dallas\_Jones](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dallas_jones/32/3277_2.png) [@Dallas\_Jones](https://boards.straightdope.com/u/Dallas_Jones)\ **Post date:** [September 4, 2020, 4:41am UTC](https://boards.straightdope.com/t/orthopaedic-physio-question-about-my-knees/919775/4 "2020-09-04T04:41:55Z")
Runners knee probably. > **[Front Knee Pain: Causes, Symptoms & Treatment](https://www.knee-pain-explained.com/front-knee-pain.html)** > > Front knee pain aka anterior knee pain is extremely common. Here we look at 13 common causes, symptoms, diagnosis & treatment of pain at the front of the knee. ---
**Author:** ![smithsb](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/smithsb/32/12107_2.png) [@smithsb](https://boards.straightdope.com/u/smithsb)\ **Post date:** [September 4, 2020, 8:28pm UTC](https://boards.straightdope.com/t/orthopaedic-physio-question-about-my-knees/919775/5 "2020-09-04T20:28:24Z")
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. ---
**Author:** ![Melbourne](https://avatars.discourse-cdn.com/v4/letter/m/b5e925/32.png) [@Melbourne](https://boards.straightdope.com/u/Melbourne)\ **Post date:** [September 4, 2020, 11:33pm UTC](https://boards.straightdope.com/t/orthopaedic-physio-question-about-my-knees/919775/6 "2020-09-04T23:33:32Z")
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 🙂 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 ??? ---
**Author:** ![Dr\_Paprika](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dr_paprika/32/3042_2.png) [@Dr\_Paprika](https://boards.straightdope.com/u/Dr_Paprika)\ **Post date:** [September 5, 2020, 12:14am UTC](https://boards.straightdope.com/t/orthopaedic-physio-question-about-my-knees/919775/7 "2020-09-05T00:14:44Z")
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). ---
**Author:** ![BippityBoppityBoo](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bippityboppityboo/32/5745_2.png) [@BippityBoppityBoo](https://boards.straightdope.com/u/BippityBoppityBoo)\ **Post date:** [September 5, 2020, 12:36am UTC](https://boards.straightdope.com/t/orthopaedic-physio-question-about-my-knees/919775/8 "2020-09-05T00:36:17Z")
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. P R I C E Appointment with a doctor before doing more 55 mile rides. ---
**Author:** ![Melbourne](https://avatars.discourse-cdn.com/v4/letter/m/b5e925/32.png) [@Melbourne](https://boards.straightdope.com/u/Melbourne)\ **Post date:** [September 5, 2020, 1:27am UTC](https://boards.straightdope.com/t/orthopaedic-physio-question-about-my-knees/919775/9 "2020-09-05T01:27:55Z")
> [@BippityBoppityBoo](#): > > 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 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. ---
**Author:** ![BippityBoppityBoo](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bippityboppityboo/32/5745_2.png) [@BippityBoppityBoo](https://boards.straightdope.com/u/BippityBoppityBoo)\ **Post date:** [September 5, 2020, 4:30am UTC](https://boards.straightdope.com/t/orthopaedic-physio-question-about-my-knees/919775/10 "2020-09-05T04:30:37Z")
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/ 🎤⬇ ---
**Author:** ![Melbourne](https://avatars.discourse-cdn.com/v4/letter/m/b5e925/32.png) [@Melbourne](https://boards.straightdope.com/u/Melbourne)\ **Post date:** [September 5, 2020, 5:57am UTC](https://boards.straightdope.com/t/orthopaedic-physio-question-about-my-knees/919775/11 "2020-09-05T05:57:00Z")
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 🙂 Let this be a lesson: When you don’t understand something, sometimes it’s because you don’t understand. 🙂 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. > [@BippityBoppityBoo](#): > > I misunderstood your reason for asking the question Well, I asked a question about orthopaedic / physio, and you did get there. ---
**Author:** ![BippityBoppityBoo](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bippityboppityboo/32/5745_2.png) [@BippityBoppityBoo](https://boards.straightdope.com/u/BippityBoppityBoo)\ **Post date:** [September 5, 2020, 6:25am UTC](https://boards.straightdope.com/t/orthopaedic-physio-question-about-my-knees/919775/12 "2020-09-05T06:25:37Z")
> [@Melbourne](#): > > 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. Wrong on all counts: # Nerve endings in human fasciae, tendons, ligaments, periosteum, and joint synovial membrane[†](https://onlinelibrary.wiley.com/doi/abs/10.1002/ar.1091360208#fn1) ([https://onlinelibrary.wiley.com/cms/asset/1633d752-de71-4766-a0e2-2e9c48861f4c/ar.1091360208.fp.png](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.