Yeah yeah, I know, rest and ice etc. Waiting for an appointment with my usual physio but considering I wasn't going to get to ride over Easter holidays anyway and the summer is now here for a week or two I just need to see myself through one more ride...
Pain is medial side at the bottom of the femur. I've taped as seemed logical to keep the patellar central and am doing basic leg extension stuff as well as usual glute exercises.
Raised seat recently with no ill effects and might try scooting it backwards a wee bit too.
Wondering if there's anything to be said for a compression sleeve during riding in the hope it keeps the patella sort of in place?
Was going to fit some lower gearing anyway for a 4 day tour coming up so hoping that might help a wee bit.
Annoying as I'd been a good boy over winter and kept the miles up so not sure I deserve 'spring knee!' 🙄
I used to be plagued with bad knees that eventually ended in an arthroscopy. Since then I've sworn by doing hundreds of bodyweight squats (4x50 is a good sessions), Doing them with a barbell tended to mean I had to focus on form and having my feet in exactly the same position each time. Doing them bodyweight means that's less critical so more of the joint gets a workout. Superset with 4x50 good mornings for the glutes and finish with 3-5minutes of wall sits (30-60 seconds until you fail, and repeat until done.
That assumes it's not too painful already, but it works for me.
I never got on with sleeves, they always seemed to push in the wrong direction, might work for walking or running, but cycling loads the knee when it's flexed so i found the sleeve tended to want to tip the kneecap by putting too much pressure o the top of it.
It's not that bad, it's very sweaty though!
The idea was explained to me that you're aiming to fatigue ALL the muscles, not just the big ones that doing weighted squats would.
It's a decent alternative to spending time on the turbo trainer anyway, and takes no equipment or warmup, I usually do it in my pants once a week after commuting home if the weather is too bad to go riding or I just don't have time 😂
As I approved 50, I had to refine (lower) my saddle height a bit and ensure the bend in my hip socket; kneee; ankle at the bottom of the stroke stayed above ~30 degrees.
I need to replace the Time XPro cleats and I must pay more attention to how I clamp them down, last time they seemed ok on the ride but then gave me knee tendon grief for weeks, which meant doing no efforts up hills, all because the cleat wasn't pointing enough towards my big toes for my fairly bow-legged legs from apparently walking too early around six months many decades ago!
I was diagnosed with patella tracking disorder last summer and use tapes, supports and braces and made lots of similar changes that you are describing but after sever months of it getting worse I ended up going for an MRI which identified lots of cartilage damage which I had surgery for just over 3 weeks ago.
My physio was sure it was just patella tracking and so said I shouldn't even get a scan. While working on the other things I would suggest trying to get on a list for an MRI in case there is something else going on
3-5minutes of wall sits
Minor saving grace is that I had mis-read that as 3 x 5 minute wall sits 🙄
Tried some bodyweight squats there, I've religiously avoided any sort of squatting as it set off my back issues but I think lots of deadlifting recently has given me the necessary form. Only took it to 17 bodyweight, could have done more but not 50! and certainly not 4 x 50! 😆 Nice benchmark to have though.
Just trying some supine leg lifts at full extension, but with leg twisted so foot pointing 2 o'clock ish. Felt like a good isometric and a very good way to deactivate TFL, you can feel it gradually relax as you turn foot.
My physio was sure it was just patella tracking and so said I shouldn't even get a scan. While working on the other things I would suggest trying to get on a list for an MRI in case there is something else going on
Will keep it in mind, but I seem to need to work through something like this every year, I guess regular riding throughout winter is nothing if you then increase intensity in spring without the necessary strengthening, a mistake I evidently make every year!
My physio is giving me lots of what others have mentioned (squats, bridges, deadlifts) , but also some sideways adductor/abductor stuff to do lateral/torsional loading too. I'm on a return to running program though so might not be directly applicable. But his thing is that lots of single plane of movement work on a trainer is very one dimensional and other structures get neglected and weaker
if I get out of the routine discomfort can happen again quickly
Something else to consider is a bike fit and having your feet/shoes properly set up to minimise the loading through the knee.
I had this issue for a few years until finding the right physio. I didn't find any knee supports or bike positioning that helped.
I used dumbells for exercises, physio suggested that if you used to doing exercise like biking, bodyweight might not be enough, though I guess doing loads of reps like thisisnotaspoon would also work!
I did..
20 x Overhead bulgarian split squats, on each side, 40 total (I held the weight above my head)
20 x Single leg squat touch ,on each side
20 x normal Squats
hamstring streches on each side
all with dumbells, 3x a week.
Tecnique was really important. I was told to keep knee behind toe at all times, sticking bum right out when doing squats.
Imagine you're doing a poo in the woods and don't want to get it on your feet.
I used to get patella tracking issues when I was riding loads, it was sorted with a lot of quad stretching.
Tried some bodyweight squats there, I've religiously avoided any sort of squatting as it set off my back issues but I think lots of deadlifting recently has given me the necessary form. Only took it to 17 bodyweight, could have done more but not 50! and certainly not 4 x 50! 😆 Nice benchmark to have though.
Just to clarify, I mean interlace your fingers behind your head and do a squat, not load a barbell with your bodyweight? Surely you can do more than 17 like that? Same for the good-mornings, hands behind your head and do a Siff legged / RDL type hinge where the focus is on pushing your bum as far back as you can, not the depth of the hinge.
My squatting form went to **** last year for some reason, I took a break and lost mobility in my shoulders so can't position the bar properly as my hands end up in the rack hooks. I've gone back to front squats instead with my arms crossed and offset that with more deadlifts.
Minor saving grace is that I had mis-read that as 3 x 5 minute wall sits 🙄
Haha, no I meant ~ 5x 40seconds or whatever is achievable until failure.
I used to get patella tracking issues when I was riding loads, it was sorted with a lot of quad stretching.
Yeah, have been stretching and rolling more in the last couple of days, feeling better today although I also took 3 doses of Ibuprofen through the day which I don't really want to be taking so will see how I feel after today with none.
The weird thing is I can go 'heavy' and push hard without pain, it seems that there are just occasional lapses in form, mostly on the bike, which then cause a twinge which then needs to calm down again. If I focus on form and pedal stroke for the first half hour of a ride it seems to 'lock it in' for the remainder and I can get away with it.
Suspect I need to do a lot more functional stuff like step ups etc. to nail that form in.
Something else to consider is a bike fit and having your feet/shoes properly set up to minimise the loading through the knee.
This would be nice but the practicalities are too costly, multiple bikes, multiple pairs of shoes etc. (nice problems to have!).
I've been told in the past that my setup is as knee friendly as it can be, I can feel the float in the cleats and never feel like I'm locked against either extent (i.e. foot can move freely, it doesn't feel constrained).
That said, thinking about it, clipping in is when I most often aggravate it, I think I've gotten into a pattern of clipping non-sore leg in first, pushing pedal to get moving, then clipping sore leg in whilst at full flexion and pushing with that pedal, so I'm sort of putting a big push under full flexion, perhaps I just need to adapt that little motion.
Just to clarify, I mean interlace your fingers behind your head and do a squat, not load a barbell with your bodyweight? Surely you can do more than 17 like that?
I CAN do more than 17, just not sure I can 50! Did a bunch of knee/glute stuff yesterday so will leave knees alone today, I'll try again tomorrow and report back, sir 😉
Raised seat recently with no ill effects
Are you sure? I admit my joints are weirdly lax but the closer I gert to full exptension, the more leeway my patella has for wandering