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  1. #1
    Join Date
    Nov 2005
    Location
    Chi-town
    Posts
    3,265
    Sorry to hear about it, beta. I think SK has the same thing, and had a number of surgeries for it.
    Run like a dachshund! Ride like a superhero! Swim like a three-legged cat!
    TE Bianchi Girls Rock

  2. #2
    Join Date
    Sep 2001
    Location
    Lakewood, Co
    Posts
    1,061
    I have it too. My x-rays are showing signs of cartiledge wear.

    It's the reason I started cycling.

    Correct crankarm length is very important as well as saddle height. I spin my gears, no mashing. I use Speedplay pedals, my ortho recommends them and they keep my knees happy.

    I was also told by my PT not to do the same activity the same day in a row, ie. riding the bike. I do not jog or do high impact activities. My drs. told me not to do lunges and squats. One told me, this was in 1994, to quit exercising.

    Fast forward to today. I tore my ACL in Jan. and had surgery in late Feb. Just about everything I've been told is out the window!

    I do lunges and squats almost on a daily basis, I'm working on muscle endurance and will eventually back off. I do leg raises and bridging on my fit ball. I'm now doing plyometrics.

    My physical therapy exercises incorporate quad, glute, hip, hamstring and core strength. Many things I do for strength are on the Pilates reformer.

    Currently, I'm riding 100+ miles a week and have 3 tours scheduled for later this summer.

    Before I tore my ACL I did a weight routine that included lunges, squats or leg press, leg lifts, step ups and calf raises with 12-20 weights.

    Anyway, I recommend that you find a PT that knows how to work with this issue and get on a good program for strengthening the quads so the pain doesn't get worse.

  3. #3
    Join Date
    Jul 2005
    Location
    WA, Australia
    Posts
    3,292
    Ooohh we have quite the club going. I have Chondromalacia in both knees and have just finished PT. Make sure you ice your knee after riding. I recommend you buy Andy Pruitt's Complete Medical Guide for Cyclists. I know Im always raving over this book but it really is jammed full of great info. It has a section on Chondromalacia and a section of stretches to help the condition especially strengthening the Vastus Medialis.

    Avoid pushing big gears and until you get the condition under control avoid lots of climbing.

    Hope this helps and GET ANDY'S BOOK.
    The most effective way to do it, is to do it.
    Amelia Earhart

    2005 Trek 5000 road/Avocet 02 40W
    2006 Colnago C50 road/SSM Atola
    2005 SC Juliana SL mtb/WTB Laser V

  4. #4
    Join Date
    Sep 2001
    Location
    Lakewood, Co
    Posts
    1,061
    For me, the Vastus Medialus is the one muscle that has not come back yet. My therapist says its the last muscle to come back and it takes a long time.

    The uninjured leg looks great but the injured one, I shouldn't complain, it's come a long way since March.

  5. #5
    Join Date
    Apr 2006
    Location
    I'm the only one allowed to whine
    Posts
    10,557
    A good PT can teach you to strenthen your hip external rotators (to stabilize the femur) and the vastus medialis obliquus (to keep the kneecap tracking properly). They can also get you stretching the tight stuff and teach you how to do myofascial release to your ITB and the retinaculum around your knee. And will be able to tell if insoles/orthotics will help on the bike or walking.

    Tibial tubercle transfers and lateral releases are really last resorts. And you do have time before RAGBRAI to make a difference. PT could tell you how to keep things happier on the ride, too.
    "If Americans want to live the American Dream, they should go to Denmark." - Richard Wilkinson

  6. #6
    Join Date
    Dec 2005
    Location
    Cypress, TX
    Posts
    32
    I'm cursed with bad knees as well. Same thing - chronic dislocations and I agree, some of the worst pain you have ever experienced. I had surgery on the right knee for the first time while in college (tried the conservative routes up until then) and ended up having it repeated about 5 years later when it started dislocating again (last time at work - how embarassing!). Fortunately, the left one never went out as often, so I've been able to avoid surgery on it. However, not sure if I overcompensate with it, but I experience problems with the IT Band from time to time.

    For me, the dislocations occurred primarily when I was kneeling/squatting down or sitting with my leg(s) folded beneath me, so I've learned to be careful when doing either. And, I also got to where I could tell when it was going to happen ... I'd feel that pull and immediately I'd try to straighten it back out to prevent it from happening. Didn't always work, but certainly kept it from happening more often.

    I second the opinions others have expressed ... find a knowledgeable PT that can help you strengthen the quad muscles and try to avoid that surgery for as long as possible. I do appreciate the fact that it has given me another 6 years without too much constant fear of dislocations, but I also know that I gave up some strength in that leg as well as some stability.

  7. #7
    Join Date
    Aug 2003
    Location
    Bendemonium
    Posts
    9,673
    Yikes! Lunges and squats! No way, Jose. Not for me. Let me say that again.

    Prescription orthotics. Worn them since 1976 for chronic chondromalacia and I don't leave home without 'em.

    In 1980, I managed to fall straight through a snowbank with a fully loaded backpack and my right knee had nowhere to go. What was chronic was now acute with a big, old gigantic tear. Fortunately, I could walk out of the backcountry and I have a strong as an ox brother who doubled-packed everything out. I carried the fishing rods.

    After an arthroscopic scraping didn't work because the gouge was just too big(I got to watch the little lawn mower rotor rooter around in there!), my right knee was re-aligned with a Macquet Maneuver (tibial tubercle elevation) which I understand is no longer performed. The Los Angeles Rams' orthopod did mine which may have been why it has been successful for me (he had lots of really big knees to practice on first). The lower attachment point for the patellar tendon is actually excised from your tibia and bolted to another spot. Bye-bye competitive volleyball (I'm too short anyway); hello, cycling (and a handsome hubby/riding partner).

    My chronic chondromalacia is caused by a number of things, pronation being part of it. The orthotic rolls my foot outward so that my tibia tracks in a straight line in the patellar groove as I bend my knee. So, it does solve my chronic issues but, of course, couldn't protect against acute injury.

    I'm hoping one of these days to get some new prescription insoles as mine are not as low volume as are used for cyclists these days. I've been very interested in eSoles which TsPoet bought. http://www.esoles.com

    I did short arc extensions until I was blue in the face when I was recuperating. Yoga, cycling and orthotics for me. And, no hiking downhill. Let me add a few more on that one.

    Adding one last thing: no extra weight. Easier said than done or I would be the indulgent dorky dough girl, but somebody has to keep those peppermint mochas from escaping.
    Last edited by SadieKate; 06-29-2006 at 08:33 PM.
    Frends know gud humors when dey is hear it. ~ Da Crockydiles of ZZE.

  8. #8
    Join Date
    Jan 2006
    Location
    Pacific Northwest
    Posts
    3,436
    Andy Pruitt's book IS great, and I got it on Trekhawk's recommendation.

    My understanding is that anyone with anterior knee pain should avoid squats, lunges, and any weight-bearing knee bend that places your kneecap beyond your toes. And, by the way, I changed my crank arms to 165 mm.--the ones that came with my first bike were 175s!

  9. #9
    Join Date
    Aug 2003
    Location
    Bendemonium
    Posts
    9,673
    Ditto on Pruitt.

    BTW, TrekHawk, what's up with the mtb cranks?
    Frends know gud humors when dey is hear it. ~ Da Crockydiles of ZZE.

  10. #10
    Join Date
    Feb 2006
    Location
    The Red Stick
    Posts
    1,439
    I had knee problems in both knees from my ballet days as well. I had my right knee dislocate 5 times in one afternoon of riding horses when I was 15. That was pretty much the end of my ballet days. I had surgery (lateral release) on both knees when I was an undergrad and it cured me. I have had no problems since. My knees will "talk" to me a bit when I start running, but by 5-10 minutes into it, they are fine. I haven't run into any problems on the bike. Strengthing the quads is not always the solution - that is what caused my problems. It's the other muscle on the inside of your leg (name escapes me at the moment). In women, the quad wraps across your leg above the knee. Over-strengthening of that will cause improper tracking. The jumping and other movements done in ballet accentuate this. Hence, the problem in women, especially dancers. When they did my lateral release, the doc said that he could see the patella pop back to where it was supposed to be.
    *******************
    Elizabee (age 5) at the doctor's office: "I can smell sickness in here...I smell the germs"

  11. #11
    Join Date
    Sep 2001
    Location
    Lakewood, Co
    Posts
    1,061
    [QUOTE=SadieKate]Yikes! Lunges and squats! No way, Jose. Not for me. Let me say that again.

    Prescription orthotics. Worn them since 1976 for chronic chondromalacia and I don't leave home without 'em.


    I also wear prescription orthotics, shoes, ski boots, cycling.

    And yes, squats and lunges. My first bout (when the ortho told me to quit exercising) with this the therapy was mostly straight leg raises with ankle weights. I did them until I was "blue in the face". But, I still had pain. I had been doing step aerobics, which I gave up, but had an instructor who was very strict about proper form (knee over toe) when doing squats and lunges.

    One day, I decided my knees were going to hurt anyway so I started doing squats and lunges again. My knees felt so much better! A year or 2 later I tore my rotator cuff and for some reason got off the leg training. During that time I went hiking and jumped down an embankment and that started the right knee off again.

    The ortho I saw said "no lunges or squats" but my therapist disagreed, most of my therapy was straight leg raises, again to ad nausum, weight machines and lunges and squats. To make a long story short I ended up working with an athletic trainer at my gym who set up a program using the weight machines. I followed her program for quite a long time.

    When I moved here to the Denver area I didn't have a gym membership so, for ski conditioning, I started doing lunges and squats again. No problems. After I joined a gym I mixed the weight machines with lunges and squats.

    Then every skiers fear, the dreaded ACL tear. Before my 1st therapy session for my torn acl/mcl I thought I was so smart because I just knew I'd have to do zillions of straight leg raises. Initially there were leg raises but the protocol is so different from what I did before. Strengthening was done on the pilates reformer, all leg muscles ( hip, core, etc.) were included. Many floor exercises were pilates based. Around 4 weeks I started doing single leg squats. Then I had acl surgery and started the protocol all over again. Around 6 weeks post op I began lunges, walking, sumo and side to side,l squats against a wall or fit ball. I also do the step down in front of a mirror that knottedyet spoke of.

    The therapy this time around is much more "whole body" based and functional. Every exercise I do incorporates a variety of muscles, including my upper body. When I finish formal PT next week, I will start a "maintance program" at the physical therapist office, so there will be continual guidance with the knees.

    I still have a lot of work to do to bring back the muscles in the injured leg but I've learned so much about keeping my knees strong. I guess that's the positive side of this acl tear.

  12. #12
    Join Date
    Jul 2006
    Location
    Ontario
    Posts
    178
    Oh boy, so I crashed my bike early Sunday morning. Aside from a monstrous black bruise on my thigh, I was fine--I did 75 minutes on the elliptical at its highest ramp setting later that day, and spent a good ten minutes crouched down brushing mud off my horse's legs after that. No problem.

    Skip to Monday afternoon; my right knee is tracking a little funny. Monday night, if I try to straighten it after it's been bent more than ninety degrees it sticks, sticks, sticks, CRACKS into place and sets me off cursing in pain.

    Tuesday morning, the whole inside of the knee is tender where I must have hit it in the crash, and any un-bending procedure involves me relaxing the leg completely and carefully manually manipulating the patella to minimize that jolt of pain.

    I have bad knee genetics--shallow patellofemoral grooves, pronation. I took an impact to the other knee when I was fourteen and it never recovered. I've seen every sort of specialist and heard everything from "patellofemoral syndrome" to "bone bruise" to "huh.. pretty crunchy cartiledge there, eh? (to the nurse) FEEL this!" to "it would have happened on its own later anyway." I was advised to use orthotics in all my shoes (not just my running trainers), and to wear a brace for any activity.

    Of course, the brace didn't last long. I preferred to build up my muscle and NOT have a weaker, more dependent leg. When it gets sore, rather than favour it I push it harder, push it through, and most of the time I work through the pain. I've managed the injury well, but its unpredictable incapacitating moments are what ultimately ended my running career and got me into cycling.

    Well, now my old injury seems a walk in the park compared to what my right knee is up to! I just tossed the ole brace on it and already feel a difference, but UGH, what an awful feeling when it grinds out of place.

    In less than an hour I have an opportunity to go mountain biking for the first time EVER. I can scarcely walk on my right leg, but I'm brought back to track races where I was too injured to walk and still got the adrenaline up enough for something resembling a dynamic warmup, staggered to the line and waited for the gun not knowing if my legs would support me. They miraculously worked every time.

    So um... here's hoping that technique works again! I've got the ice pack handy, and the guy taking me on this trip has already insisted we're not going to do more than a few roots given the state I'm in (says he just can't stand the thought of the extra weight of the spatula he'd have to bring along to scrape me off the trail otherwise). YAY MTBING!

  13. #13
    Join Date
    Jul 2006
    Location
    Ontario
    Posts
    178
    w00 still in one piece! Knee started tracking fine once I was on the bike. I have switched over to the dark side and am in love with MTBing.

 

 

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