patellofemoral syndrome pain

[Onix]

So, forgive me---I don't know how to include text from previous posts in replies when I am replying to more than one person....

Wahine: About the speed play having less of a connected base to push off compared to other pedals.... I was under the impression that the bases of cycling shoes were made of hard plastic/carbon to counteract that sort of effect. I was thinking that once shoes were connected to the pedal, they almost became one piece together. If the base of the shoe collapsed around the pedal, then yes, extra pressure would come onto wherever the shoe was connected to the pedal. But, with hard based shoes, shouldn't there not be extra pressure where the speed play pedal connects with the shoe? Since the shoe base is hard? Shouldn't pressure be distributed all the way around??? Does that make sense? Or, are you saying that speedplays create a propensity to distribute your pressure in your foot in strange ways---not that the connection itself is not the best? Sorry if that is confusing!

NadiaMac: Bummer you can only ride 20-25 mins at a time

NadiaMac, Catriana, Ny Biker: Thank you for your personal stories/experiences with taping. That is helpful.

Wahine: Thank you for the taping links. That is helpful. I haven't been taught by my PT yet, but I imagine I will need a refresher once I am.

Trek 420: I agree. Warmth does feel good on my knee too. I hope it isn't arthritis for me, but the warmth feels good nonetheless!

[Wahine]

Wahine: About the speed play having less of a connected base to push off compared to other pedals.... I was under the impression that the bases of cycling shoes were made of hard plastic/carbon to counteract that sort of effect. I was thinking that once shoes were connected to the pedal, they almost became one piece together. If the base of the shoe collapsed around the pedal, then yes, extra pressure would come onto wherever the shoe was connected to the pedal. But, with hard based shoes, shouldn't there not be extra pressure where the speed play pedal connects with the shoe? Since the shoe base is hard? Shouldn't pressure be distributed all the way around???

That's what the manufacturers would say and in theory I wouldn't disagree with that if the interface (transition points between parts of the shoe and pedal) was perfect. But it's not. At every interface you introduce a certain amount of play. It might be very small but it's there. The more play, the more the forces at the interface can affect contact surface etc. So speedplays have a double whammy here. The have more play at the cleat/pedal interface and they have more interfaces between the pedal and the shoe - pedal to cleat, engaging part of cleat to stabilizing part of cleat, stabilized part of cleat to triangular cleat base, triangular cleat base to shoe. My Looks go pedal to cleat (which is all one piece and has less play) cleat to cleat base in shoe. I'm sure that this is a great explanation but it is the best theory I have.

So really, I'm not positive what's going on here, I've noted the difference clinically and through my coaching experience and that's the best explanation I can come up with. All I can say for sure is that my clients with forefoot issues almost always do better with a larger cleat base/pedal, especially the ultra riders I work with.


Hope that helps.

[Onix]

That's what the manufacturers would say and in theory I wouldn't disagree with that if the interface (transition points between parts of the shoe and pedal) was perfect. But it's not. At every interface you introduce a certain amount of play. It might be very small but it's there. The more play, the more the forces at the interface can affect contact surface etc. So speedplays have a double whammy here. The have more play at the cleat/pedal interface and they have more interfaces between the pedal and the shoe - pedal to cleat, engaging part of cleat to stabilizing part of cleat, stabilized part of cleat to triangular cleat base, triangular cleat base to shoe. My Looks go pedal to cleat (which is all one piece and has less play) cleat to cleat base in shoe. I'm sure that this is a great explanation but it is the best theory I have.

So really, I'm not positive what's going on here, I've noted the difference clinically and through my coaching experience and that's the best explanation I can come up with. All I can say for sure is that my clients with forefoot issues almost always do better with a larger cleat base/pedal, especially the ultra riders I work with.


Hope that helps.

Gotcha. That does help. I can definitely feel more pressure in the ball of my foot...but couldn't make sense of it all Thank you for all of your help with this issue.

[Kathi]

I was diagnosed with patellofemoral pain many years ago. Cycling really helped and for many years I had no pain even though I used Speedplay pedals. I even used them on my trainer when I tore my ACL. Then I started having foot pain and progressed to knee pain which progressed to hip and back pain. My old knee exercises, leg lifts, etc did nothing to alleviate the pain. Because of the negative things I had been reading about Speedplays I really started to believe the they were causing the problem. After 4 months of PT I changed therapists and he looked beyond the site of pain and found my left SI joint was locked, whereas the 1st PT had been treating the site of the pain, my right side.

2,000 miles of riding this summer with Speedplays, X1's and Frogs and no pain with knee or foot.

BTW, the podiatrist said I had 2 neuromas in my foot. I now can walk barefoot with no issues, no burning in the morning, no pain while riding. I'm using my orthotics less and less.

For some reason this time I rejected the ortho's suggestion of surgery and braces, the podiatrist injections and decided to let things run its course. And for me, I can confidently say the Speedplays were not the issue.

[Onix]

I was diagnosed with patellofemoral pain many years ago. Cycling really helped and for many years I had no pain even though I used Speedplay pedals. I even used them on my trainer when I tore my ACL. Then I started having foot pain and progressed to knee pain which progressed to hip and back pain. My old knee exercises, leg lifts, etc did nothing to alleviate the pain. Because of the negative things I had been reading about Speedplays I really started to believe the they were causing the problem. After 4 months of PT I changed therapists and he looked beyond the site of pain and found my left SI joint was locked, whereas the 1st PT had been treating the site of the pain, my right side.

2,000 miles of riding this summer with Speedplays, X1's and Frogs and no pain with knee or foot.

BTW, the podiatrist said I had 2 neuromas in my foot. I now can walk barefoot with no issues, no burning in the morning, no pain while riding. I'm using my orthotics less and less.

For some reason this time I rejected the ortho's suggestion of surgery and braces, the podiatrist injections and decided to let things run its course. And for me, I can confidently say the Speedplays were not the issue.

Thank you for your post Kathi. I appreciate the perspective. So far, my knee exercises also don't seem to be changing anything. I keep getting told that it is a lengthy process of strengthening the muscles that over time will help with the pain. What is an SI Joint? Do you think that working on that issue is really what helped you with a lot of your pain?

[Wahine]

The SI joint is the joint between your sacrum and your ilium, parts of your pelvis. It's there to allow a little motion, (only about 12 deg each way at each joint if they are healthy), so that torsional forces during leg movements can be dissipated, especially when walking or running. Without them in combination with the pubic symphasis, our pelvis would be one solid bone constantly under torsional stress and getting microfractures. Not to mention the important role of the SI joints in childbirth.

Sometimes this joint can become dysfunctional by moving too much or too little. This can lead to all kinds of compensation during movement and will result in pain locally and/or elsewhere... knee included. So yes, if your PT hasn't looked at your low back-pelvis-hip mechanics. It's worth having them check it out. A messed up SI often goes right along with the "dumb butt" syndrome Knott mentioned earlier.

[Onix]

The SI joint is the joint between your sacrum and your ilium, parts of your pelvis. It's there to allow a little motion, (only about 12 deg each way at each joint if they are healthy), so that torsional forces during leg movements can be dissipated, especially when walking or running. Without them in combination with the pubic symphasis, our pelvis would be one solid bone constantly under torsional stress and getting microfractures. Not to mention the important role of the SI joints in childbirth.

Sometimes this joint can become dysfunctional by moving too much or too little. This can lead to all kinds of compensation during movement and will result in pain locally and/or elsewhere... knee included. So yes, if your PT hasn't looked at your low back-pelvis-hip mechanics. It's worth having them check it out. A messed up SI often goes right along with the "dumb butt" syndrome Knott mentioned earlier.

Awesome. Good to know. Thank you Wahine. My PT actually hasn't checked out my back-pelvis-hip mechanics. I will address this. Interesting.