Tough question. You might want to consider looking into a sports performance doctor/PT type of person to perform a functional analysis and assess the pain first. Part of this is because your local fitters are going to vary in their ability to diagnose and assess any underlying physical causes. That person might then know of the best fitter in your area to help you out, and you can go to them better armed with information.

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Travis Rassat
Vector Cycle Works
Noblesville, IN
BikeFit Instructor | FMS | F.I.S.T. | IBFI
Toughman Triathlon Series Ambassador

You could come to us and have both at the same time!

Does the problem only happen on the bike? If so, perhaps the fitter first.
Does the problem happen all day everyday or with a variety of activities? Doc / PT.

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Go find a local Doctor/Pt that is proficient in diagnosing patellar tracking issues. Seems unusual that simple patellar tendinopathy would last this long if it did not result in a biomechanical issue such as this.

You seriously need to see a top quality fitter. What metro do you live near?

For your knee pain you should see a sports doctor and/or a sports physical therapist.

Good question.

I went to see the fitter first. Not sure if that was the right choice.

Backstory: ACL and posteriolateral reconstruction last spring (i.e. 2013). Got a bike about 6 weeks ago. Outside of reconstructed knee hurts on the bike (near the top, think of an 10 or 11:00 on the clock). In the general area of the posteriolateral work. Only hurts on the bike, and pain stops immediately once I'm off. No pain running.

I had a fit when I bought the bike. Went back to the guy with the knee complaint and he adjusted my cleats a smidge. It's better, but sitll hurts some when climbing (and we're talking small climbs here, since I'm a noob), but I'm not sure what to do now. Seems silly to go back and see my ortho doc for such a minor thing. Is it scar tissue around the surgical site? Some weakness somewhere? My rehab went really smoothly, so I don't think there's anything too weak there, but who knows.

Try and find a physical therapist locally who does bike fits. They can work on both sides of this issue for you.

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Mason

The KC metro area is where I'm investigating scheduling a session.

I'm also scheduled to see an orthopedic doctor later this week. I felt a bit foolish talking to the general practitioner that gave me the referral. My discomfort level is fairly low; it doesn't bother me much while on the bike. Occasionally there will be some localized pain but a few pedal strokes later and I feel fine again. I can always "feel" my knee after the ride, though, and often all the next day, as well, when walking, going up stairs, etc. Sometimes the pain is in a very specific point in the joint, sometimes there is just a generalized discomfort all around the top of the tibia.

The gp couldn't find any real problem during the exam, so she didn't think an MRI would show anything. We'll see what the ortho doc can find. I don't think there is anyone local that specializes in cycling-specific injuries.

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◼︎ We shall soon be in a world in which a man may be howled down for saying that two and two make four, in which people will persecute the heresy of calling a triangle a three-sided figure, and hang a man for maddening a mob with the news that grass is green. - Chesterton

Little bit of a hijack, but I'm in the exact same boat with my left knee too. It flares up mostly running, but increasing volume on the bike will aggravate it a bit.

I've been thinking about coming to see you guys, but it's hasn't been bad enough for the last 4 years I've felt an urgent need. Four years ago it was bad enough that I saw another Boulder PT, was diagnosed with patella tendonitis, had a little PT, and have been better about stretching, and managing it with rest and ice.

My question related to the OP's: am I doing long term damage managing patella tendonitis at a low grade? Should I try to eliminate it completely?

Saw the doc today, found nothing in the x-rays or exam to indicate anything physically wrong or out of the ordinary. Left leg was measured about 1cm longer than the right, but was told that was within a normal range. Would that small a difference need to be compensated for in cleat placement?

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◼︎ We shall soon be in a world in which a man may be howled down for saying that two and two make four, in which people will persecute the heresy of calling a triangle a three-sided figure, and hang a man for maddening a mob with the news that grass is green. - Chesterton