I've had severe knee pain from running lately and went to a sports doc that gave me Celebrex. I don't have what you have, but man - that stuff works. I take it one hour before running and have no pain at all. The knee if getting much better. I was struggling with it for months.

For a quick fix - Celebrex could help. After that, probably a cleat fitting and/or bike fitting by a certified tri shop would work.

Good luck.

I had the same problem. No knee problems running, but pain right under the patella while biking.

Getting a (second and improved) professional bike fit helped. He moved the seat both up and back, and adjusted the cleats.

However, that did not make the problem go away entirely. I had to (a) get off the bike entirely for a long few weeks, (b) build up my bike volume & hill exposure only VERY gradually afterwards. Otherwise the problem would return.

As for your race. I was in the same situation a couple months back and posted on this forum. Some people advised not to race - don't make a temporary problem into a chronic one. That was sound advice, but I took my chances and raced. Here is what I did:

1) Made a pact with myself that I would do the bike portion of the race at a "training" pace rather than full race pace. And would quit if the knee felt bad.

2) Got a sports massage. This was 4 days prior to the race. I think it helped. Something about correcting misalignments that may have contributed to the knee problem. The closer it is to your race, the easier you have to go on the massage. Tell the massage therapist you are racing very soon.

3) Alleve. I did a lot of research here & elsewhere about the warning of taking NSAIDS and racing (particularly: getting hyponytremia in hot races). I decided to take my chances, and stay with a low dose. I chose Alleve because it is ANTI-INFLAMMATORY. Took one the evening before, and one on the morning of the race.

4) Ate anti-inflammatory foods all week. I have no idea if this was beneficial at all. I was desperate. Drank a lot of pineapple juice. Ate things with Omega 3's (salmon, flax seeds, etc.). Avoided acidic foods such as coffee. (If nothing else, this is good for your heart - if not your knee.)

5) No running. Limited, very very easy biking. Lots of gentle stretching, and walking around.

6) Wore a knee brace. It is called something like "cho-pat" and supposedly helps your knee track correctly.

7) Massaged anti-inflammatory sports cream onto my knee in t1.

8) Week leading up to the race: End of day, EVERY day, iced my knee.

After the race, ice the knee immediately. Take a few weeks off if that is what is required. After that, ramp up your volume, long rides, and hills only very gradually. Worked for me.

Good luck!

Thanks for the feedback. I wouldn't classify my pain as nearly severe. I have noticed that increasing cadence and shifting to an easier gear has helped. But I think overall it is a bike fit issue.

My knee pain was never "severe." Just irritating. I just went all-out to prevent it from coming back. Fear of it going chronic, I guess.

I agree totally with O...good suggestions! Also, some people get good relief using a Cho-Pat strap...its the band/support that wraps around your knee at the patellar tendon and helps disperse the stress. Might be something to try. Good luck!

I had this issue that flared up last year about 2-3 weeks before the Gulf Coast Tri. I raised the seat about 10mm, left the seat front/back the same but tilted up the front. My issues were:
1) Seat too low. It had slipped and I hadn't noticed. I ended up raising it beyond the original height, and while I was out on the ride adjusting it the pain *nearly* vanished immediately.

2) Front of the seat tilted down too much. I found myself pushing back at the top of the stroke, which puts a LOT of pressure on the patellar tendon. Do NOT push over the top unless you absolutely have to.

3) I was pointing my toes down a lot in the middle of the stroke. This is effectively like moving the seat down as it closes up the angle of your thigh/calf and causes the same problems.

4) I bought Qrings and started riding them early this year. This reduced the load on my knees on the "over the top" section by quite a bit.

5) Hamstrings way too tight. When I was stretching them I effectively was stretching behind the knee, but wasn't properly stretching the middle of the muscle. Do some stretches with a slightly bent knee. Basically the hamstrings were so tight that they were trying too pull the joint out of whack.

I commented on several things similar to this earlier, but I have no idea when. The search function should bring something up. Search for patellar and username triguy42 and you'll find several different responses.

Other important things to do are ice and Advil/Aleve. ICE, ICE, ICE!

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