Knee/Thigh Pain

Mountaincoffee

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Good morning all
I'm driven here by an agonisingly protected knee complaint. I'm a cyclist have have been for 10 years. I'm 25 and a teacher so advice I've had to stay seated constantly isn't particularly effective.

In March I was competing in an audax and 100 or so miles in I started to experience a dull ache in my right leg above my knee to the outside. I had no option but to cut short and cycle 70 miles home.

Over the next few weeks I abstained from cycling but the pain didn't subside. I went to see a Physio who diagnosed it as a pulled tensor fascae latae (excuse my spelling) so he manipulated it and prescribed a tens machine. After several weeks off and using the machine to no avail I visited another Physio who attributes it to weak glutes putting excess stress on other parts of my leg and prescribed a series of gluteus activation and strengthening exercises.

These seemed to work for a while and for a period I was able to get back cycling. I kept up my exercises but again the injury returned and now it's worse than ever. I'm currently into a stint of 12 weeks off, now with an NHS Physio who has given a similar diagnosis but the exercises don't seem to be doing anything. I wondered if anyone could offer any advice if they have had a similar injury. I'm still not wholly sure it is my itb and it could be my lat vat.

I have finally been given an MRI appointment (6 weeks time) because in my off time I was recommend to swim and now I have a suspected torn meniscus but I want to do all I can in the meanwhile because I'm getting incredibly fed up and down about not being able to do anything.
Any thoughts/opinions would be greatly received.

reacher

Difficult because I can't see you so these are just some possible solutions, pain above the knee on the outside is classic IT band, first off roll it you will see straight away if it's a problem it will hurt or get someone to go up it heel of hand really hard up and down it, if it hurts it's tight, just below the hip bone you will feel a hollow spot, get a thumb in their and press really hard your looking for a pain, if you get one it's a muscle knot you need trigger point therapy, you can do it yourself get your thumb press hard where it hurts or get a knobbly roller, better than flat ones, you need one anyway to do the IT band e bay £12.00 roll it, if it hurts persever until the pain goes your looking for a pain free roll on the IT band until you get that it's not a healthy IT band , hollow just below the hip bone, lay on your side and use the edge let if go right in the hollow spot, same if it hurts get in and roll it hard, harder the better . Glutes , samQe roll them, then activate them, use the exercises the phisio gave you or pistol squats glute bridge etc. easy to remedy if it's caused by any of these problems, check saddle height bike fit you need to find what's causing the problem or it will just come back, i suspect its comeing partly from the bike if it came on dureing a ride, lots of stretching as a routine you should be doing all the time, glute activation is a doddle if you can get in a gym , squats , glute bridge pistols squats etc all very easy to remedy . Your body works as a whole not in parts you have to train it all or you get an imbalance, the torn what ever in the knee, I can't spell it , is a lateral twisting movement injury I suspect that's just knee pain from the other stuff I could be wrong though, that's more of a rest and let it heal solution, just some ideas I could be totally wrong as I say, but I suspect your phisio is not very wide of the mark, you have to find what's causing it or it will just keep recurring the fact it went away then came back tells you their on the right track, so something your doing or not doing is causing it to come back, personally i would double check bike fit and tight IT band as prime culprits, activate the glutes it's possible that is the main problem but they are really easy to switch back on just be aggresive in the approach with them their huge muscles or should be and can take a battering so hammer them hard they will soon fire up you cant really hurt them or over train them, if their weak which is surprising if you have been cycling so long then very easy to strengthen I suspect their switched off though rather then weak, also roll the calf muscle most important as your body is a chain everything is connected what you think is the problem area often the solution is to one side of it, hope that helps regards R

bondurant

Whilst I don't want to say that you should ignore the massive sentence above, unless you know exactly what is wrong with you it is hard to recommend taking the advice of someone on a forum who has not had the chance to diagnose your issue.

Your physios don't agree and they have met you. To me it sounds like an itb issue but I would certainly not recommend you place any credence in that at all.

reacher

It says difficult because i cant see you and possible solutions, the last time I checked that meant, it could be one way to explore a way of resolving the issue

AK_jnr

The second physio got to the root of it by the looks of it but your bike fit is a problem if it keeps coming back.
Time off the bike, do the exercises he/she orginally prescribed and go for a bike fit. Lateral knee pain could be caused by something as simple as a misaligned cleat.

ut_och_cykla

Misaligned cleat could contribute to knee pain - if the cleat position means the outside of your foot is relatively unsupported, this will cause you to (subconciously) try to "hold" the outside of your foot up, with resulting overuse strain to small narrow muscles on the outside of the calf that fasten into to bottom of your thigh.

Mountaincoffee

I did wonder if it is a misaligned cleat but as part of my rehab I have bene off the bike for 8 weeks now and it still hurts which makes me think it can't be a cleat.

AK_jnr

Or that the misaligned cleat (or something else) caused an injury that you are still recovering from?

The MRI will clear it up once and for all!