As a follow up to a post of mine about a month ago where I thought I had knee tendonitis I've now visited my GP and been diagnosed with Chondromalacia patella in my right knee, almost certainly linked to some new SPDs I was trying (only got to use them on 5 rides before the condition came on!).
Has anyone on here had it, any good successful tips to treating it?
As someone who rides 75-200 miles every week the sitting at home resting the knee for another month with no cycling is going to drive me completely & utterly crazy!!
Cheers.
Usually do 250k a week, been on and off with knee pain since November. Rest doesn't help (3 weeks+), physio has helped much, chiro doesn't help either. Been told it's just a mechanical thing but it's still driving me crazy not being able to ride when I want, and noticing how much I've lost when i do.
seanoc - have you been diagnosed with it aswell then? With me a winter of spinning classes seems to have caused it together with trying to use new Shimano SPDs with minimal float.
I usually spin with a really high cadence whereas the spin classes have you spinning high loads at really low cadence, this seems to have caused a leg muscle imbalance which inturn is now causing the kneecap to not track across the knee as it used to.
From personal experience I'd be wary of a diagnosis of Chondromalacia patella from your GP
For many Chondromalacia patella = Pain behind the kneecap
A bit of a 'get out of jail free card' for some health care professionals, much as the IBS label can be used for Stomach related things they don't quite know how to answer.
From what you've said with the cleats, it could be [url= http://www.questdiagnostics.com/kbase/topic/major/tn7304/descrip.htm ]patella tracking issues[/url] brought on by said cleats. I had similar issues for other reasons because of over development/mis-timing between the muscle groups within my Quad's, [url= http://tinyurl.com/ng7wok ]VMO specificity[/url]
I had results with physio but personnel think an Osteopath is the best way to go with this sort of thing. They're more likely to look at the whole package of alignment instead of just focusing on your knee which might not be the root cause. best to try and find one that's got a sport interest/background still though
n.b. I'm no Dr so take from this what you will, just my personal experience thats all
HTH
I had this as a teenager (which sadly was a very very long time ago). Diagnosed by a proper sport injury specialist. I suggest you do the same. I seem to remember that it was something that you can grow out of - not sure if you are in that category.
I'd advise seeing a good physio or chiropractor type to get a proper diagnosis and treatment (which may include looking at your bike position etc).
I don't use sods at all now due to problems with my knees. Once I stopped using cleats the problem improved greatly
Ooh yes!
As above, GP's may diagnose any patella related pain as Chondromalacia patella.
However, pain around or behind the patella is very often caused or worsened by a weak VMO, or the VMO not working quickly enough.
Try and strengthen the VMO. (Sit on floor with leg straight and concentrate on tensing it in isolation- hold for 5 seconds and repeat a lot would be a good start)
Stretch the main leg muscles regularly: quads, hamstrings, calves, and also IT band.
Make sure your bike seat is high enough and far enough back. Bin the spd's and get something with proper float... eggbeaters for instance.
Don't stop cycling, but do back off on the pressure you put through the pedals. Think about your pedalling technique.. knees not wandering about.... push through the bottom of the stroke.
See a good physio. McConnelly taping may help.
I'm not a professional, but offer this advice after suffering for years. Had two arthroscopys, and an open procedure to do a "lateral retinacular release". This release was done 8 weeks ago and is still very painful. Just about riding again but it doesn't seem much better. The release aims to relieve pressure behind the patella and improve tracking.
Good luck!
I had a lot of problems with it as a kid, and have had a couple of legs injuries since. Rest and then cycling again isn't the most proactive approach to rehabbing an imbalance originally caused by cycling. As 29er Keith says once you have an imbalance somewhere it tends to move around and be difficult to shift, or to be exacerbated by problems elsewhere. If you are doing a lot of spinning stood up you might have tightened your hip flexors and/or IT band, both of which will affect your knee.
I would look at getting a balanced strength and conditioning programme from a decent physio/PT, doing plenty of stretching, and investing in a foam roller. A bit of cross training will go a long way, even if you hate the gym it beats the frustration of doing nothing.
stanley +1
2 arthroscopies one side, one the other. The root cause of my pain is hypermobility, and my left knee is the weaker one. Currently very sore and has been for a month. Unfortunately for some, despite doing all the physio/stretching/strengthening/swiss ball/foam roller/food supplements it's something I have to live with. Riding soemtimes is very sore, sometimes it's ok. Not riding for a while it gets worse.
currnet daily regime includes 10 mins on wobble board, squats with swiss ball on door, VMO strengthening with foam roller, IT stretches with same roller, hamstring work on ball and floor. ****in sore day and night, but very loathe to let surgeon back in there. Last MRI was in the Autumn and all 'looked fine'
I once had infra pattelar fat pad syndrome and my physio said the only way it could be cured was to "run through it" i.e. run till it hurt then run a bit harder. It took a while to build up the courage to do it but it worked for me.
I'm not saying that's what you've got though.