Question: Two months ago, I started getting pain and stiffness behind my knee where the calf and hamstring muscles connect. It began after doing 9 hard, 5-minute intervals in big gears on the trainer. Last week after 2 very hilly races I could barely walk. Two physicians can’t figure it out, but I suspect tendinitis. I’ve been using ice and NSAIDs but it still hurts. Any ideas? — Bill G.
Coach Fred Matheny Replies: It’s always hard to play doctor using email. It would help to see you on the bike. But here’s an educated guess: I think you’re on the right track with your supposition of tendinitis. Evidently the trainer workout created irritation, it lingered, not quite healed, and the hard racing pushed it over the edge.
One reason might be bike fit. Often, a saddle that’s too high can create this injury in the location you describe, especially when combined with high-force workouts.
When pedaling hard in a big gear, the heel tends to drop. This has the effect of shortening the leg, which in turn makes the saddle too high. Your 9×5-minute workout would have been enough to cause the problem, considering it was done with an effectively higher saddle.
I recommend a professional bike fit to make sure your saddle isn’t too high in normal riding, too. Get one from a local coach or a shop with a fitting system.
The usual treatment is indicated here: non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, plus ice, stretching and easy spinning. There’s no way of knowing how long healing will take, but patience is important. Don’t let this injury become chronic.