Patello-Femoral Knee Pain (Chondromalacia Patellae)

[Vikeonabike]

Self diagnosed at the moment....Dr's tomorrow.
However does anybody have any good strengthening exercises for the Vastus medialis (inner thigh) I can do at home?
Looks as if I am going to be off the bike for another 2 weeks.

And whoever it was that overtook me on the A15 without even a word or a or grunt or anything whilst I was riding at a paltry 13 mph...as soon as I'm fit I'm gonna make you suffer!

PS sorry for swearing at you if you heard me!

 

[ttcycle]

oooh dear....Vike that's not good...

The docs should send you to physio - they'll have some good exercises there. Take it easy and hope it fixes itself soon

 

[Vikeonabike]

Cheers TT...

 

[montage]

Don't self diagnose. I was told many things about my knees - didn't see the right people. I think I have created new knee problems as I solved old ones, by strengthening certain muscles, creating a muscle imbalance by attempting to fix one in the first place. I've been struggling for a year...more or less off the bike for 6 months. See proper people!

 

[Rohloff_Brompton_Rider]

i self diagnosed with this. i cycled steadily and slowly built it up. much beter and improving daily

 

[Nigel-YZ1]

In November I finished 5 months of physio for injuries that started with severe sprains, leading to chronic patellar bursitis and bad knee alignment problems.
I started with all leg muscles wasted (couldn't bend my knees properly for the previous 4 months).

Heres the list that I'm still doing at least twice a week:
45 step downs per leg
45 calf raises
90 clams (with 1 kilo weight)
90 sideways leg lifts (with 1 kilo weight)
45 gym ball bridges
90 squats with gym ball against wall
I also did 5 minutes rowing machine and 5 minutes exercise bike before each session.

+10 miles of 'interesting' hills on the MTB every sunday.

The onus is on building everything in balance, and improving the rotation of the thigh by strengthening the pelvic muscles.

I can see and feel the improvements in the muscles and the patellar pain is gone. Unfortunately in my case I'm told I'm looking at another year for the walls of my bursas to thin out (hence some RICE sometimes after rides).

 

[Globalti]

Vikeonabike, pain behind the kneecaps is due to riding with your saddle too low. I achieved the same result by skiing in deep powder and leaning back because I was afraid my tips would dig in. It took several months of rest and only gentle exercise before the pain went away. It will go away, you just need to give it a chance - start by seeing a bike fit specialist and getting your position checked out. Ask at local bike shops for the names of physios who specialise in bike fit.

 

[Vikeonabike]

Cheers Globalti,
I have physio appointment tomorrow, will be going to my LBS sometime this week with the bike.
Vike

 

[Vikeonabike]

WooHooo

First ride in 3 weeks.....only 5 miles at a paltry 13mph but it was pain free....hope It feels ok tomorrow!

 

[MacB]

First ride in 3 weeks.....only 5 miles at a paltry 13mph but it was pain free....hope It feels ok tomorrow!

excellent, hope it carries on, the advice from Globalti is good as well. I had knee issues, nothing as bad as yours, at first, and only resolved them by getting saddle height and setback in the range I'm good with.

Below a certain level, or too far back, and it's pain behind the knee, any lower and it's pain at the bottom of the back as well. Above a certain level, or too far forward, and it's pain in front of the knee. It can be quite hard to sort this yourself, I went too high at one point, but I had the assistance of Teef and others when I got it wrong Having ridden behind me for a while he advised on moving my saddle forward and lowering it slightly. I then did a detailed online fit that gave me a range for optimum saddle height and setback, for my type of riding and bike. Lo and behold the Aperitif adjustments fell bang smack in the middle of those ranges

Remember that moving the saddle further back lengthens reach to pedals and vice versa. I also ended up using a spirit level to get my saddle angle correct, I have nose down a fraction.

Of course this then through my reach/height of bars out, but that's a whole other tale

 

[mangaman]

Hi Vike - I had a similar pain and had an MRI which you can see on my avatar!

The surgeons were all for injecting it / snipping off bits of cartilage (there is a small tear in my retropatellar cartilage)

Cartilage won't heal as it has no blood supply but I went for conservative treatment.

As everyone said saddle position is key and muscle strengthening.

I believe cycling gives better balanced knee muscle strengthening than any other exercise (if you have your set up right). I was told that my knee was stable - ie I couldn't make it worse by exercise, and the more I strengthen my quads the less it has hurt.

It still is a bit sore after a long ride but I'm getting older and it doesn't stop me doing any exercise I want. The only thing I avoid is specific quad strengthening weight training eg squats / quad machines in the gym.

They just hurt and don't give such a naturally balanced strong knee as cycling.

Hope it fades away - I feel mine is improving all the time. (Physio should know best)

Good luck

 

[ttcycle]

Hi Vike

How are the knees at the moment?

 

[Vikeonabike]

Hi Vike

How are the knees at the moment?

Getting better slowly, hoping to ride everyday next week, 5 miles each way. Doing lots of stretching now. Although that hurts more than the injury does. Got to be more flexible before I go back to physio. She scares me more than the dentist does! Sorting out bike fit next week just to make sure I have the saddle hight and position correct.
My boss has banned me from riding at work until further notice....but didn't tell me I couldn't continue to ride into work. He says if you're riding 30 miles a day just to get to work, you can find another way of getting around at work. Cool..More time on my motorbike then! Hope to be fit to ride al day at work as well as commute by May/June time

 

[Vikeonabike]

Fingers crossed for me...riding into work tomorrow (15 1/2 miles). Done a few shorter rides pain free so going to give it a go getting into work...Promise I'll take it easy though.


Yay...made it 1.03 and fairly easy. Knee felt a bit tight on the hills so I'll use an alternate route next week!

 

[bigjim]

I had/have this problem. Really suffered and was considering stopping cycling. Looked on Armstrongs health site. Evidently this common problem caused by the inner muscle above the kneecap not working as hard as the outer whilst cycling. This stops them pulling evenly and controlling the patella so it slips out of the ridges it slides in. The advice on the site is to work to strengthen the inner muscle. I do this in the gym using the leg raise machine and spreading the feet wide apart and holding the weight for a few seconds before lowering. You can feel that inner muscle working. You can also do this at home by sitting on a hard backed chair. It has certainly worked for me. I do not have knee pain now in that area though I always excercise this muscle after a workout.