Knee Pain - Patella Femoral Syndrome - Anyone?

lloyd_bower

I've being suffering from knee pain in my left knee now for over 3 months, wasting the best part of summer (I'm in NZ) off the bike. It started to come on at the end of longer rides +100k, but then on shorter rides and effecing my commute too. So I stopped riding in Dec, and did some research on the net, deciding the symptoms were itb sydrome - pain is on outside of knee. Despite doing no end of stretching, I was seeing no improvement & and even noticing it walking - so went to see a physio.

Diagnosis was Patella Femoral Syndrome (actually a general term) and said that weak inner quads was to blame. I was given some exercises to concentrate on (mainly squats with back to wall, crushing a pillow between the knees) and side ways leg raises when on the floor. I've been doing these regularly and other similar exersises for 3 mths now, with no noticeable improvement. I got a second opinion at the same practice a few weeks ago, diagnosis again the same PFS, and told to concentrate on the squats and itb stretch.

Still seeing no improvement and it's beginning to get more than a tad annoying. I was managing to keep active kayaking and swimming (the latter which though deadly boring didn't have any negative effect), but have now got a sore wrist from the kayaking, so that's going to pot too.

Prior to these troubles I was knocked off my bike by a car, and badly damaged my ankle, with a little pain in the knee and back too. But once I was able to walk fine, I was ok & back on the bike for a month, until I started to get back problems on my daily commute - I fixed that by using panniers on the commute instead of rucksack (never had back probs on the bike before mind), then shortly after the knee problem started.

From regularly commuting 2 1/2 hrs + per day and long weekend rides, I can now can barely ride any distance without pain, and even when walking I have the regular pain in the knee, it's usually the outside of the knee, but sometimes the inside too, hence the Patella Femoral Syndrome diagnosis.

But I'm seeing no improvement, and becomming lost for ideas. Has anyone had any similar knee problems, and advice?

ride_whenever

it ended my rowing career. :?

keep up the exercises to remove the muscle imbalance. The continued use of the muscles as they are will continue the inflammation and further increase the muscle imbalance.

You need to lay off the exercise until you've fixed the underlying cause.

-liam-

I suffered this.

Took anti inflammatory pills while pushing on with the biking as resting for weeks didn't cure it and just kept working on the muscle. Disappeared on its on accord after a few months. Haven't felt a thing since early last summer.

popularname

I had bad knee pain after 18 months running (ramped up the distance too quickly and too old to start with :? ). Suffered constant niggling pain for a couple years until I started cycling again last summer.

I have found that low distance and high cadence over the last 6 months have allowed the muscle imbalance that my physio commented on to slowly improve. Now - although itis early days - it looks as if the knees are OK.

Not suggesting you cycle before you're allowed to, but hang in there - it will improve and you will be back on the bike.

Splottboy

Think leg extension, straight then bent, will help. My sister in law was a dancer, and her quads pulled to one side, These exercises helped her a great deal.
But, physio is the best route.

Had a bit of a clearout of the right knee, athroscopy, years ago, no problems now.

I had some knee pain in the left on Sunday and today, very sharp but short lived so, as I'm only just back on the bike after injuries, I'm...burying my head in the sand...

noskcid

How is the cleat position on your shoes? Are your feet externally or internally rotated to much in any direction?

My suggestion is that if the exercises are not working for 3 mths now providing you have been doing them regularly then it may not be a muscle imbalance issue. See if you can find a specialist musculoskeletal physio around your area and get a second opinion.

physiosteve

Hey Lloyd, sorry to hear things aren't going so well. Assuming the diagnosis who have been given is correct, then the advice and exercises you have been given are those suggested in almost every physio, sports medicne, and running text there is, along with orthotics of course, and appear perfectly valid (in our lil physio minds neway). Unfortunately however, they frequently fail to achieve the desired effect, hence the popularity of various surgical procedures to correct this problem, most of which have a spectacular failure rate 12mths down the line.

It's not all doom and gloom however, just an all too familiar tail of crap advice dished out by so many physio's, sports physicians, and athletic trainers etc.

The fundamental problem is that those exercises work muscles in an isolated non functional pattern, and 1 which focuses on the knee, instead of the hip which is so often the root of the prpblem. Check thisout give it a few weeks and id b interested if u post your progress.

http://www.mikedemeter.com/articles/ant ... 9_2006.pdf

Hothouse

i suffered on and off with ITB problems for over 12 mths until going to the physio. As far as i am aware the ITB cannot be stretched as it's not a muscle but there are a few excercises that i was given to help solve the problem. Along with that i made a decision to cut back on the long rides and do "small and often" in order to keep up the fitness and i also looked at my saddle and cleat position. I also slackened my pedals right off in order to get more more movement in my feet when pedalling.