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I've started cycling some long rides lately, and am feeling knee pain. It doesn't seem serious, but it's insistent enough that I've mostly avoided riding for a few days. When I do cycle, I do so at a high cadence, for short distances, and don't push myself.

The pain has been in various locations around the kneecap and also a bit at the back of the knee. Sometimes it feels like bubbles inside the knee, which sometimes pop (crack), other times just soreness around the knee in areas that don't seem to be muscles. The pain doesn't seem to have subsided significantly since I curtailed my riding activities.

So I have a couple of questions:

How much pain is an indicator that something serious is going on?

Does the specific location of knee pain indicate what's wrong?

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check your bike position. your saddle may be too far forward or back or high or low. Check with a local bike shop (LBS) for proper fit. –  Ryan Miller Aug 11 '11 at 13:31
    
What do you do to warm up for the ride? The feeling of bubbles "popping" is likely gas buildup in the synovial fluid in the joint. This is usually painless and only a minor annoyance that occurs until the joint is warmed up and has moved around some. –  Berin Loritsch Aug 11 '11 at 15:39
    
I get some moderate knee pain when I run - I find that a couple of Advil before running helps to keep the pain in check. –  Haphazard Aug 11 '11 at 18:42
    
@Haphazard: I'm not bothered by the pain, I just see it as a symptom of potential more serious problems. I really wouldn't want to mask symptoms of an injury. –  intuited Aug 12 '11 at 2:09
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1 Answer

up vote 6 down vote accepted

There can be any number of causes for pain in and near the joints. There is a lot of connective tissue (tendons and ligaments) in major joints, as well as the cartilage and synovial fluid that lubricates the joints. These general rules of thumb will help you diagnose what's going on:

  • No pain, but the sound of "cracking". This is usually a harmless sensation that occurs before the joint is prepared for intense use. Once the gas in the synovial fluid escapes (the popping noise), the joint is usually primed and ready to go. Safe to ignore.
  • Dull pain in the muscles. This is caused by asking more of your muscles than they are currently prepared to give. It's a temporary situation until the body can adapt and take care of the lactic acid buildup. Safe to ignore and push through.
  • Pain in and around the knee with a "looseness" of the joint. This can be accompanied by swelling. Essentially the ligaments (bone to bone connections) and tendons (bone to muscle connections) are not meant to be stretched. When that happens they can't perform their normal duties and more serious injury could result. Apply the RICE protocol as first aid and get it checked out.
  • Sharp pain with the sound of "cracking". Particularly if this is accompanied by swelling, is possibly a torn ligament. Definitely get it checked out as further stress will only make the injury worse.

For further information about knee injury and diagnosis, please check out this article.

Unless the problem is the first two bullet points, rest is imperative. That rest should be accompanied by letting a doctor look at it.

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