Old hip injury leads to fresh knee pain for bicycling

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Update: Dec. 8 — The physical therapist told me today that it's OK to ride my bike, even though there will be some pain. The knee cap should be realigned so it's not rubbing the femur after about 10,000 repititions of the exercises he's given me. That means 3 to 4 months.

I'm still kind of stunned that a bicycling fall I had way back in January has forced me off the bike in November.

Although I had badly bruised the muscles around my right hip in that fall, it's my right knee that's been feeling the pain since August.

I finally found the time (got up the nerve) to visit my doctor about the knee pain about a week ago. That's after three weeks of self-imposed rest off the bike hadn't made anything better.

My doc referred me to a good physical therapist, who guessed at my problem before I could even suggest it.


Here's my tale of woe as a lesson to anyone with knee pain in the past, present or future. Obviously your knee pain can stem from other causes, but it's illustrates the importance of keeping our muscles, ligaments and tendons in balance.

The knee pain first cropped up in August when my son suggested we take a short jog along the Green Lake Trail over to a Subway sandwich shop. My right knee started screaming at me less than 2 minutes into the run and I had to stop.

I continued riding my bike in August, with the knee pain. Bike riding had never hurt my knees before, and I figured I would just be able to ride through it. The knee was obviously swollen, and fluid was building up in my right ankle.


The knee pain didn't stop me from taking a few day bike tour from Cle Elum to Wenatchee and back in early September. The pain would reach a peak about about 20 minutes of riding, then subside. Also, the swelling in my lower leg disappeared.

The knee didn't get any better in September, though, and it got more painful to put weight on it. I still couldn't stand in the pedals, and the knee pain continued throughout my rides without stopping.

When three weeks off the bicycle didn't help at all, I finally got around to seeing the doctor, who offered me a visit to a physical therapist or an MRI.

Atrophied muscles

Figuring I could get the MRI, and possibly surgery, as a last resort, I opted for the PT. Here's what he noticed in just a couple of minutes:

My right knee was still swollen. My right calf muscles were atrophied compared to my left calf. My right leg couldn't hyperextend as far as it should.

Essentially, he said my right knee cap was out of track and that's what was causing the pain. Then he asked if I'd ever injured my hip.

I recalled the fall in January, something I hadn't thought about in months. He had me lay on my back and brace my leg when he pushed against it. He moved it easily.


Simply put, that fall in January caused damage that threw my leg muscles out of balance. The right joint was rotating slightly inward, while my knee cap was pulling outward. That short jog in August simply exacerbated problems that would have cropped up sooner or later.

So now I've started a regimen of leg strengthening exercises, which I think is kind of ironic for someone who bicycled about 2,500 miles this year. I'm hoping this helps pull the knee cap back where it belongs and stops the pain.

Until then, I'm doing my leg lifts and knee extensions.

Here's a link about the connection between hips and knee pain that suggests some exercises to strenghten the hip.

Permanent link to this article: https://www.bikingbis.com/2009/11/28/old-hip-injury-leads-to-fresh-knee-pain-for-bicycling/

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