Over the past few years, I've been getting recurring pain behind one or both kneecaps with increasing frequency. It seems to be correlated with a few things. Foremost is excessive volume plus intensity without enough recovery. I think mostly the bike is responsible. Running doesn't seem to exacerbate the problem, it just delays it going away. I can run with zero pain when riding hurts. Letting my knees get cold also aggravates the problem. Even when it is not cold out, sometimes if my knees are achy, I'll feel them, and they are cold. The other thing I noticed is there seems to be a direct correlation with dehydration and achy knees. Often, when I know I'm low on hydration, my knees will be tender going up or down stairs. This isn't all the time, just when two or three of the above are present simultaneously.
Back in March, I went down to North Carolina for an intensive week of mountains riding. On the first day, Arik and I went out for short, hard spin to Sassafras Mtn and back. It got wicked cold on the ride back as a winter weather front moved in late in the day. My knees got extremely cold. Whole body got cold in fact. Back at the house, I was pretty much an invalid when it came to the stairs. I needed to support most of my body weight with both hands on rails. The pain was excruciating. I was probably dehydrated, and we went awfully hard up Sassafras. I thought my trip was doomed, but a couple Aleve, rehydration, I was good to go the next day. I think I wore AmFib tights. Knees stayed warm. I did not have trouble with it the rest of the trip.
I was concerned though. Definitely as I get older, my body parts are breaking down. I started searching for remedies. Several people I know, including my dad and long-time riding partner Steve G., swear by glucosamine. Steve has been taking various preparations of it for many years, my dad the last couple years. My dad has had both knees worked on years ago and was having a lot of trouble in his 70's. Since he started taking Osteo-Biflex, he claims his knees feel the best in 25 years. That is a pretty bold statement.
So I picked up a bottle of glucosamine with MSM at Sam's Club and started taking it right after I got back from my trip in March. I took recommended dosage of 1500mg per day, a tablet in the morning and evening.
Fast forward to the week leading up to Memorial Day. I was increasingly feeling not well. It was a not quite put your finger on it, kind of a general malaise thing. My weight was mysteriously going up. I stayed below 160 lbs almost all winter, and my weight typically goes down in the spring when my total training volume goes up. Instead, my weight peaked above 165 lbs with a 10.5% body fat on the Tanita scale. I was even trimming calories as weight was going up. WTF!
That wasn't all of it. I'd wake up with a headache every morning. I rarely get headaches, and now I seemed to have a low-grade headache most of the time. I could hear my heartbeat go whoosh, whoosh, whoosh in my ears too, kind of like I had pressure in my head. I would have thought maybe a sinus infection, but I never got sick and had zero sinus symptoms. Then to top this all off, a couple times going out at lunch, I bonked immediately. One in particular was an easy run day. Two miles out I was in a hallucinogenic bonk state. I almost had to sit down, it was so bad. Something was very wrong. I started thinking Lyme disease? Pancreatitis? All kinds of scary things went through my mind.
Then on a whim, I Googled glucosamine and weight gain. I got 800,000 hits and started reading. Wow. Glucosamine, in dosages that people often take for osteoarthritis, can wreak havoc on your whole insulin response thing. Didn't understand the minutia of mechanisms behind it, but it appears that glucosamine causing Type 2 diabetes systems is far more supported in research than mending bad knees. In fact, the most thorough study concluded that glucosamine is statistically insignificant in helping joint pain.
So I checked the flip side, Googling glucosamine and weight loss. 2.5 Million hits! Oh man, it can't be both ways, can it? Well yeah, people have amazing ways to attribute effects to causes, aka placebo effect. But then I started reading. Pretty much every correlation with glucosamine and weight loss were cessation of weight loss. That is, people that were in weight loss programs stopped losing weight when they started taking glucosamine.
That pretty much clinched it for me. I couldn't think of anything else that changed in my diet or lifestyle to be causing the changes I was experiencing. I stopped taking glucosamine. That was about two weeks ago.
The first couple days, I didn't notice any change. But then on the third or fourth day, I woke up without feeling like I had pressure in my head and no nagging headache. Of course, my weight was still up.
Now, two weeks after stopping glucosamine, I feel 100% normal again, and a little weight has come off. Did glucosamine do this to me? I didn't have 100 of me to control this experiment. I'll never know. One thing is certain, I won't blindly jump into a supplement again.
So what about my knees? There's also chondroitin. Seems much less risky from what I read. Strangely, I think the glucosamine was working. Maybe a much smaller dose is all I need. Steve takes a Hammer product with glucosamine, 250mg I think. I was taking 6x that amount. Maybe I need to adjust my bike(s) fit. I have Pruit's book on bike fit and common cycling maladies. Pain behind kneecap is often over-use/over-training related and extended rest period can make it go away. I'm not doing anything atypical from seasons past, other than I'm 50 now. I'd be interested in any experience readers have had with this.