I have a drinking buddy who is a doctor. He insists that medicine is an art, not a science, which I am starting to understand the older I get and see more doctors. My last visit the other day just confirmed everything, while messing up with my convictions and confidence at the same time.
If you’ve been reading this blog long enough (unlikely – the first article I wrote on this subject was 11 years ago) you’ll perhaps recall that once upon a time I thought that I had a sore knee due to the beginnings of osteoarthritis.
I tried all sorts of stuff to try and alleviate this annoyance, including the very successful viscosupplementation (knee shots), until a young sports doctor in Nimes told me one day that because the pain I was feeling was in the tendon below the kneecap, it was obvious that I must have tendonitis. Some physiotherapy followed, then I just didn’t do much at all with the knee for many years. Before I even went to see this doctor, I had found that I could manage the pain without taking anything and I figured I had it solved, at least till age or weight caught up with me.
Well, during Covid I got older and fatter and I didn’t ride as much either. I am guessing that these things have conspired to bring me to where I am today, which is back to feeling pain on the bike enough that it’s affecting my riding.
This led to me going to THE sports doctor in Nimes two days ago, who poked and prodded and scanned my tendon enough to pronounce that there is nothing that he can see that’s wrong with it. He thinks that it might be the osteoarthritis that has been the culprit all along.
Now I need to wait to get an MRI appointment (August) and we’ll talk about next steps. In the meantime, I have to climb some cols with clients starting Monday. I hope they are older and fatter than they look on their Strava profiles.
The Vicious Cycle 
Sorry to hear about your knee woes.
I have two tin knees, one 17 years ago which gives me trouble with a nagging pain. the other. 14 years old is fine. How is that? is it the knee cap, as you suggest?
I guess we’ll both have to try and figure it out. If you find the answer, let me know!
I’d try to find a good PT who will look the entire kinetic chain, not just your knee. Sports docs normally just focus on the pain site – even the good ones. While researching hip replacements, here’s what I learned in passing about knees: the pain is often a symptom of issues in the foot or the hips. And what I also learned by reading, being told (by ‘soignants’ I actually trust), and first-hand experience: the extent of pain you feel does not necessarily correlate with the extent of damage shown in images. Now that I FINALLY found a decent PT, I can’t help but wonder if I could have delayed my hip replacement by a few more years. Given that knee replacements are normally less straightforward, I’d do all I can to find a PT up on recent pain/rehab research to help you keep riding up hills as long as you can without surgical intervention.
Smart
I was sure you’d have something good to say on the subject. I’m not sure I have the patience you have when it comes to these things, but what you say sounds like it makes sense. I’ve actually had other issues this year (e.g. back) that very well could be contributing in a bad way to how my knee feels. I sometimes think that if I just got off my ass and moved around more, things would go back to normal.
This remains theoretical.
Remember I’m an outlier, you’ll respond much faster to PT (my bendy joints + long injury history means I must go ridiculously slow to resume anything). Moving a leetle more – more often, using more limbs, in more directions – sounds like a good start. Yoga?
Oh, another thing I learned a decade too late is importance of *short-term* use of painkillers while doing your activity so your brain & body don’t make too many adaptations to the pain (I was of the ‘painkillers are just a bandaid’ mindset). Note this assumes you’re also doing PT to correct the underlying problem – it’s all about teaching your body to move without fear of pain or injury. Also note I’m NOT advocating the chronic use of painkillers to ride in lieu of PT!
Well that sucks. I’ve got nothing for you except sympathy and a bottle of anti-inflammatories.
I will say, as a one-time client, what I hope you already know, which is that 99.9% of what you offer to your customers has nothing to do with your riding prowess. Not that that makes your knee better or speaks to your personal enjoyment of the sport.
My own Covid fat persists, helped by a stubborn failure of motivation to spend meaningful time in the saddle. This has prompted thoughts about what my athletic life will look like in my late years. Fortunately we both have plenty of models for how to muddle through at a slower pace way into old age without giving up the bike.
As I get slower, I am more comfortable with what you say, Tony. Being faster and stronger is definitely not part of our job, although it does help to not have clients waiting for you at the top of each climb.
I’m with you on the Covid-induced lack of mojo, but I find mine coming back slowly.
Gerry,
I don’t have the history on this blog to know about your physical challenge here. I greatly appreciate your honesty and your diligence. As you know, I’ve had my own extremity challenge and that has taught me that your drinking buddy is right. Too often these matters are and art form when the world of medicine wants us to believe it’s a science. Put differently, as we age we’ll have new and expanding challenges. In my view, the key is constant assessment and awareness of how our condition is changing. Ignoring it is the enemy. My mom in her senior years ignored a problem to her own detriment. I took from her experience the importance of getting advice and being thoughtful. The artful answer may not always be clear, but I’m not sure I understand Jackson Pollock’s art either. But I always look at it to try to find meaning. The meaning I see today isn’t always what I saw yesterday. It’s the journey. I commend you for making that journey with thoughtful awareness. Good luck, my friend.
Thoughtful, articulate post. Good on ya’.
Eric, my little niggle is not much when compared to what you’ve been going through. You’ve had quite the ‘journey’, I know. Looking forward to our next pain-free ride together when you come back to Le Sud next year.
Have you reached the age when you are starting to shrink? I am not been rude. If you are getting a fraction shorter, maybe your riding position needs to be altered. Saddle height and knee pain are very good friends..
LOL. You could have just left the first sentence and had the whole internet rolling in the aisles.
Lord, I hope not! But it’s a good question, so I’ll get out the pencil and draw a line on the wall when I get back from the Alps.
I have lost well over an inch!
I’m sorry to hear about the knee issue. I’ve been battling one myself for a few years now as I get older. The first thing is to find a good physiotherapist, and just do the exercises. It all takes time and then it may not be 100% afterwards. I had a good summer and then it went downhill with the onset of winter and cold temperatures. The thing I found, is to work out what is aggravating it. Deep Heat, wearing thermo’s, and taking care not to twist my knee works for me. Cycling is OK, but I don’t risk jogging much these days
All good advice. I’ve been doing the same battle as you since I lived in Japan in the 90s! Then again, I’ve only once seen a physio about it. If I can find myself a good one, I may get my doctor to hand me a prescription for some ‘seances’.