I apologise in advance as I am after some cheeky advice but I have a problem with my knee. I have a muscle (Vastus medialis) http://en.wikipedia.org/wiki/Quadriceps_femoris_muscle in the quad that appears to be engaging a split second before the others and naturally takes more of the strain than its supposed to, particularly when its under heavy loading like climbing or sprinting.

if there are any physios here, can you tell me whether this is something that can be fixed and I should pursue with the physio? can it be attributed to something or can be rectified without surgery? happy to try bike science/retul to see if its a fitting problem?

i have seen a physio recently who said there isnt much that can be done but he is more of a running specialist rather than a cycle specialist (at the time i thought it was caused by my cack running stride but it would appear not)

many thanks.

just to clarify..

be sure its vastus medialis thats firing early and not femoris longus. My initial thought is that femoris longus would fire first. It would ‘fire’ earlier as it is alwasy slack when cycling as in my observations it is usually too tight in many cyclists. Both muscles have the same insertion but Femoris Longus originates at the illiac crest….

Look for some specific stretches that cover both if you havent done so already…

What’s the actual problem?? Pain in the knee? Pain or fatigue in the muscle? Where in the muscle (its vast as the name suggests!)? Immediate onset or several minutes in? It’s not really clear from your description…..

Bike set up/previous injuries/your muscle balance & biomechanic/climbing & sprint technique will all have an influence on motor pattern (timing) of muscle firing……pretty hard for a physio to comment with all those variables and not actually having you on hand to assess….

If there’s no pain there’s every chance this is normal…..lower VM (vastus medialis obliquis) has a role in countering the natural outwards pull on kneecap and normally fires early to counter this. Long adductors sitting on inside of thigh next to vastus medialis are key power muscles in downward stroke particularly if seated….they will fatigue with hard seated work.

Long and short….find a postgrad sports Physio with a cycling interest and get a proper assessment of yours and the bikes setup!

Bristol pablo, where are you based, I know of cycling specific physics in various parts of the country who should be able to sort this out for you.

didnt want to go into too much detail just in case there was no one about with any knowledge of the ailment but thanks for the responses.
the physio i saw diagnosed the vastus medialis but as i said, this was becuase i thought it was a running issue more than a bike issue which perhaps led him ot this thought as i was running more at the time.

the problem is the next day ie this morning where there is a dull ache which feels like its behind the knee. nothing to painful but a noticeable throb, to me there is minor swelling but i have odd looking knees anyway.

based in NE Bristol but happy to travel for a good recommendation with cycling experience.

Sounds like classic patellofemoral pain. Very common. Excessive kneecap friction within its grove caused by something in your bike/biomechanical/muscle balance setup…you’re right in thinking running had a role to play as it’s more common in running than cycling. Would affect both potentially once aggravated. Key is to find/sort the cause……tap into grazed knees network for cycle specific assess and treatment to rule out bike? 🙂

Talk to Scott Cornish at Bike science in Bristol. (cycling specific physio and accomplished cyclist.
If that doesn’t work out email me for others who are a little further away but Scott is a top man!