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QUESTION:
I started mountain biking, and I have begun to notice "cracking
and popping" and some pain in my knees when climbing stairs. Is this
serious?
ANSWER:
It is very common to have "cracking and
popping" behind your kneecaps when you have begun performing exercise
that loads your knee while it is bent. Examples are step aerobics, running
hills, and playing the catcher position in softball and baseball. The
cartilage on the back of the kneecap (patella) softens to some degree,
which prevents the lubricating fluid of the joint from coating the surface
completely. Also, due to your activity, a muscle imbalance has probably
occurred, resulting in the kneecap having increased pressure on it and not
gliding correctly as you bend your knee. There is no evidence that this
definitely leads to arthritic change; but, if the lubrication and gliding
are not normal, wear can occur more quickly.
Try these things first. Raise your bike seat to the
maximum height you can and still comfortably ride. Improve the flexibility
of your thigh and calf muscles with diligent stretching. Begin a
strengthening program to balance your muscles. Avoid high steps and hilly
terrain in aerobic activities. Ice your knees down at the completion of
activity for 10 to 15 minutes. If you do not notice an improvement in 8 to
10 weeks, then seek further evaluation.
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