Jim’s Tech Talk
By Jim Langley
I’m opening this week with a funny story because I’m in a much better mood recently (tell you why in a minute). It’s a tale about something that happened while my wife Deb and I were biking across country in the winter of 1979.
We left New Hampshire in October, just days after the season’s first snowstorm. So my custom Richard Sachs and her Takara were as loaded as bikes can be with our winter camping gear. Every time the road rose – like when scaling the seemingly never-ending walls through Massachusetts’ Berkshires, we slowed so much it seemed we might fall over.
Our route took us to Florida to visit relatives and then hugged the coast to Texas. Covering about 65 miles a day, we had lovely weather across Florida, Alabama, Mississippi and Louisiana. It turned cold again in Texas and we were glad to still have our woolies in our bags.
Texas is huge and it took over a month to cross it. We met so many friendly and super hospitable people there – to the extent that families in Galveston, San Antonio and El Paso let us stay in their homes and even took us out on the town.
A Soothsayer Speaks
The day after Christmas, while heading out of El Paso, the funny incident took place. We probably looked pretty road-worn by then with roughly 2,800 miles under our wheels and everything but the kitchen sink still hanging from our bikes – even a goofy “California or bust!” cardboard sign I stuck on. We were surely crawling along, too, since we weren’t in any hurry.
As we cruised through a quaint neighborhood like this, an old timer sitting in a rocker on his porch apparently took notice. Because he hollered out something loud and clear that cracked me up at the time and has since come back to me many times over the years.
What that guy shouted was, “You better enjoy it – because you won’t be able to walk when you’re my age!”
I was 26 at the time, fit and injury-free. The previous year I’d pedaled 5,000 miles and ran enough to qualify for the Boston Marathon. I didn’t foresee any problems walking in my future.
The Worst Kind of Gravel Grinding
Fast forward to the winter of 2018 – as in seven months ago, and I (now 65-years-old) was almost convinced that Texan was spot-on about me not walking again. Well, I could walk, but cycling had become so painful that I was only able to get my daily rides in at a conversational pace.
This was frustrating because I had big goals for 2018, but there was no way I could train, let alone put out the watts to compete. Due to the drop in intensity, over a period of weeks I started putting on weight, lost motivation and began having trouble sleeping.
The feeling in both knees was like there was gravel under the kneecaps. I could spin the pedals fine but every time I applied pressure the pain was so severe I had to back off. I started riding easier and easier. I stuck to flat routes. I stopped doing the team’s weekly training rides. I rode the trainer more and more.
But the pain didn’t get any better. None of my regular stretching and foam roller work that helped before did anything. 1,000 mg of ibuprofen dulled the pain but it didn’t last.
Doctor Spiegel to the Rescue
In May I’d had enough and decided to get professional help. I had X-rays taken, which showed that both kneecaps were bone-on-bone. There’s supposed to be clearance between the bones and zero contact. Even to my untrained eyes, it was obvious why it hurt so much to turn the pedals.
Then Chris Baker, one of my teammates who heard I was suffering with knee pain told me that he too had a bone-on-bone knee condition. And, that he had seen Santa Cruz, California orthopedic surgeon Dr. James Spiegel. Chris said that he and the doc had determined his best option was knee-replacement surgery.
The prospect that I might need knee replacements terrified me, however, hearing the name Dr. Spiegel gave me hope. He’s the doc who put three screws in my right hip to fix it when I fell on black ice in 1993. I was riding like new only 10 weeks later. I made an appointment straight away.
And, just like how he got me back on my bike after my broken hip, Dr. Spiegel.. in just a few minutes essentially took me from the depths of despair to giddy with excitement over the possibility of actually getting past the knee pain and successfully training and racing again.
I should pause here and state clearly that if you have serious knee pain and a bone-on-bone condition, you should get checked out by a doctor, too. However, I want to share how Dr. Spiegel helped me just in case his advice might help you, too.
Helpful Words and an Easy-to-Perform Exercise
After reviewing my X-rays and sharing his observations with me, Dr. Spiegel did a physical exam of both my knees. Then he asked what I was hoping to hear from him. I told him I wanted badly to be able to race again and did not want to have knee replacements.
At that he smiled and told me a few things that made my day and completely turned things around for me. In a nutshell, what Dr. Spiegel told me was (I’m not a doctor – I’m paraphrasing what I heard here):
- Your knees are already ruined. You can’t hurt them any worse riding. If you can stand the pain and discomfort, your knees will keep on going.
- To ease bone-on-bone pain all that’s required is the tiniest amount of clearance between bones.
- There are lots of things to try to ease the pain including physical therapy exercises and even home treatments such as cannabis oil and other salves.
- Cortisone shots can be effective and last for up to six months. Usually not recommended for young athletes, cortisone is less worrisome as you get along in life as I have.
- Having knee replacement surgery is the last option and only considered when every other option has been tried. Also, there’s no guarantee that a knee replacement will eliminate pain and discomfort. It might, but it’s possible to have issues with artificial knees, too.
My Recovery Track
It’s been three months since my visit with the doc and I’m delighted to report that I’m back training and racing. While my knees hurt a little now and then, it’s nothing like before and I don’t see them stopping me meeting my goals again.
I’m not 100% sure which was the magic cure, but first, I took Dr. Spiegel’s advice and had him give me a shot of cortisone in both knees. I didn’t notice that that made a difference cycling right away but it might have.
The reason I don’t know if the shots did the trick is because the same day I had the shots, I also started doing an exercise Dr. Spiegel recommended called the Muncie Method or Exercise. It’s a simple one done at least three days a week while sitting on the floor (no apparatus required). It strengthens the quadriceps muscles inside of the legs just above the kneecaps. As these get stronger, they pull on the kneecaps in such a way to create clearance to help my anterior bone-on-bone condition.
The first week I did the Muncie Method my legs were super sore, so I am pretty sure it’s this exercise that did the most for my recovery (there’s no soreness after doing the exercise any more). I don’t know if the Muncie Method will help everyone with bone-on-bone knee pain, however, it is helping me and I wanted to share it.
The exercise is not difficult but it needs to be done correctly. So, please follow this link for clear instructions and an illustration. You can also search on the “Muncie Method” or “Muncie Exercise” and find lots more. I hope that if you have bad knees it can help you as much as it has me.
For more information, see http://www.sportsmed.net.nz/knee then click on Muncie Exercise.
Here’s a YouTube video that also demonstrates it, but it makes more sense if you read the instructions and then try to follow the video.
Ride total: 8,961
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Jim Langley is RBR’s Technical Editor. He has been a pro mechanic and cycling writer for more than 40 years. He’s the author of Your Home Bicycle Workshop in the RBR eBookstore. Check out his “cycling aficionado” website at http://www.jimlangley.net, his Q&A blog and updates at Twitter. Jim’s streak of consecutive cycling days has reached more than 8,000. Click to read Jim’s full bio.