Patella Fermoral Syndrome

Discussion in 'Health Nutrition and Supplements' started by PeteGettins, Aug 14, 2013.

  1. PeteGettins

    PeteGettins New Member

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    Hi there,
    I've recently got back on the bike after a few years off due to lower back issues. I used to race, but now ride a hybrid for a more upright position. Was all going well till I did a sportive on the weekend & now my old patella femoral syndrome is back in my right knee. Without a doubt it's down to overuse, the ride was 5 1/2 hours and very hilly.
    I've got some exercises off the web but they're all geared to the long term strengthening of the various muscles which generally cause it. Does anyone have experience of this & can recommend any specific exercises?
    Thanks
    Pete
     
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  2. bmoberg337

    bmoberg337 Member

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    [SIZE= 10pt]Pete, if you are suffering from knee and back problems I would first address what is causing these problems. Doing exercises and stretching will not help you if your bike is not fit properly i.e. saddle height, cleat position, bar reach, stem height etc. It's well worth the time and money to get a professional bike fit done. Look for someone in your area that has a professional certification. If your PFS is from overuse, that would imply you are not gradually increasing the stress you put on your body in a given amount of time. For example, if you only ride an hour here and there, then try to do 3+ hours at one shot your body is not going to respond well. Not sure what your approach was to this big ride, but you need to gradually and consistently build yourself up to that distance.[/SIZE]
    [SIZE= 10pt]I don't have experience riding a hybrid, but 5 1/2 hours seems like a very long time to be on one. You may want to explore other bike options. I know a lot of bike manufactures carry a line of bikes that have frame geometries that are somewhere between the aggressive road bikes and the casual hybrids. They usually offer a more upright position than a traditional road bike, but are more complimentary to longer rides than hybrid’s. [/SIZE]
    [SIZE= 10pt]Also, you should be spending a good deal of time stretching after rides. Cycling strengthens specific groups of muscles while neglecting others. This results in muscles imbalances which push and pull on the knee at abnormal angles. Stretches that target your IT band, hamstrings, and hip flexors can greatly reduce knee pain associated with muscle imbalances. However, the longer you have neglected to do this, the more work you will have to do before you start to see pain relief. [/SIZE]
     
  3. PeteGettins

    PeteGettins New Member

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    Many thanks for your reply, there's lots of food for thought there. I had been thinking about getting a bike fitting done both for my road bike(s) & the hybrid so yes I think that'd be a good idea.
    If I'm being honest, there was no way I'd done enough long rides before doing the sportive so I know that was a mistake, but I got a bit carried away with it all. I do agree that actually it probably would be more suitable to doing it on a road bike, but I'm concerned that if I go back to riding frequently in that position my back problems will come back. The good thing about the hybrid is that since I've been riding it I've not had any issues in that area at all, whereas even just a couple of hours on the road bike it'd start to twinge. The other reason as well though that I'm riding it is that to commute on it I can put panniers on rather than carry a rucksack which also wasn't great for my back. The commute is about 1h15m each way so it adds up. It's a Specialized Sirrus (Elite) which is a bit more leaning towards the road geometry as you mention.
    Your advice about stretching is very true, as many people are I'm quite undisciplined in that area, but I'm making a conscious effort to do it specifically for the muscles you mention as when I saw a physio many years ago when I first got the PFMS, he suggested I do that, but as with many things once the pain subsides you tend not to bother.
    I think though that the bike fit will indicate the correct positioning and then once I know that I can ensure I stick to it.
    The good news though is that overall I'm very pleased to be able to be back cycling again, despite this issue (which I realise is a lot of my own fault) as I missed it. If I can ultimately get back to a road bike that would be great, but if that's not a viable option then at least I can enjoy the more upright hybrid
    Thanks once again
    Pete
     
  4. bmoberg337

    bmoberg337 Member

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    If you are able to get a professional fitting done on your road bike, I think you might find that it resolves, or at least partially resolves your back problems. I can't stress the "professional" part enough though. A lot of shops offer fitting services, but it is usually just the standard saddle height and cleat adjustment deal. A professional fitter will be certified and will take several hours to determine the best bike fit for you. They usually spend some time going through stretches to see where you are tight/flexible, as well as look at your posture, pronation in your feet etc. This will all roll into how they determine the most optimal fit for you. The price of a professional fit reflects the effort, but its well worth it to ride without pain.

    The Specialized Sirrus was definitely not what I had in mind when you mentioned hybrid although, outside of commuting, I don't know how good of a bike this is for really long rides. I was thinking more along the lines of the Scott CR models or the Felt Z models, as they offer frame geometries that are built specifically for comfort and performance. I'm sure there are other bike manufacturers that carry similar model as well. Going that route may not be necessary if the bike fitting resolves your problems though.

    -Best of luck with resolving the knee and back issues I know how frustrating it can be.
     
  5. DonS

    DonS New Member

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    Pete, what I've done to get my patella back in its groove is this: 1. Do this exercise one leg at a time--alternating left and right. 2. Sit on the floor with both legs in front of you, heels resting on the floor, toes pointing up. 3. Point your toes back toward your head as far as you can. 4. While pointing your toes back, flex your quadricep muscle as tight as you can and then lift your heel off the floor 2-3 inches. 5. Hold that position for up to 30 seconds at a time (in the beginning, you may only be able to hold it 10 sec, for instance). 6. Do 2-3 times per leg, 3-4 times per day. You can actually do this sitting at a desk, if you have room. You should start feeling results in a few days.

    Hope this works for you.
     
  6. PeteGettins

    PeteGettins New Member

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    Thanks again for the replies. It certainly seems a bike fitting is worth getting done. I live in London UK & there are a number of places which do it, several have been recommended on various forums, and yes they say that they take several hours so it's the kind of thing you mention. My 2 road bikes are definitely racing bikes, they're quite old now the Trek 5200 & Fausto Coppi Campionisimo. I think I should get the Trek & the Sirrus fitted as I intend to keep using the Sirrus for commuting. I don't think it really is designed for long rides, but the Trek certainly is.
    Thanks DonS for your detailed exercise. I've got a few which I'm doing in particular for the VMO muscle and I'm doing your one stting at my desk right now [​IMG]
    Cheers
    Pete
     
  7. Limbatus

    Limbatus New Member

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    be careful about bike fitting. I think my knee problems developed due to improper fitting. the most important thing to know about bike fitting, is that you must understand the changes. there is a lot of trial and error, small adjustments, and trial periods / evaluation. don't think that the way some guy measures you for 2 hours in the shop will be a permanent fit. Also be careful stretching. i Just saw a cycling specific chiropractor for 8 months. he identified the root of my problem as tight piriformis muscles and began me on a rigorous stretching routine (45+) mins per day. just recently i discovered that these stretches are causing more pain than they are alleviating. I'm experimenting with new stretches to find a better solution for my geometry. I guess the major point i'd like to make is that everyone is different, and your treatment is likely different than others. do lots of research, read as much as you can, and develop a recovery system that works for you.
     
  8. Acheno84

    Acheno84 Member

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    Well, it certainly has been a while since this post was active, but I hope that you're feeling better and that you have found a routine that works for you to keep you active but pain free. I have a lower back injury as well so any biking that I do has to be low key and nothing too strenuous or I just become physically useless for the next few days, which eventually puts me at square one. Take care, and ride safe.
     
  9. Corzhens

    Corzhens Well-Known Member

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    Whenever I would read a post about an injury or physical issues of a rider, the first thing that comes to my mind is abuse. I have this swelling on my leg, a bulge behind the shin and the doctor said it was due to abuse. And I suspect that the knee problem is also due to abuse.
     
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