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Oldguyonabike
07-09-2007, 09:16 AM
Patellar tendonitis.....
The good and ironic news is that I did not get this new, acute pain on the inner, upper aspect of my knee from riding. I spent 2 days crouched under my porch replacing dry-rot and woke up unable to go down stairs.
I've been icing it and taking massive quantities of ibuprofen with steady, progress. Made it through the "Night Ride" last Saturday with the help of a knee-brace.
The question: all the medical & bike links on patellar tendonitis say to stretch well before and after use. Specifically, what stretches the inner tendon to the knee? I'm nervous about anything involving deep knee bends or extreme flexion as I think that's what got me into trouble.
Any therapists out there with specific stretching suggestions?

29"er
07-09-2007, 03:50 PM
Typically PT manifests itself in sharp pain at the bottom of the kneecap and will resolve itself only with rest, although a PT brace will ease the pain dramatically. If the pain is the upper, inner kneecap area you may be experiencing Illio-tibial band syndrome which us cyclists are even more prone to, because of inflexibility of the IT band. Either way, rest in the short-term and an increase in your flexibility will help keep it away. I hear there is a yoga instructor affiliated with River City Bicycles.

mizake
07-09-2007, 07:47 PM
i've had positive results in alleviating knee pain with a combination of a knee brace and glucosomine tablets.

fetishridr
07-11-2007, 07:51 PM
i would massage the knee before use, heat it up, rub it and get blood flowing in it. after the ride, ice ice ice. anti inflammatorys are just that, anti inflammatories. however, this inflammation is good to a point because it is increased blood flow to the joint. it repairs the tissue damage. too much inflammation is bad however.

when you're riding, keep the rpms above 90 and be sure to ice religiously. a cold bath works well too, or just a cube for ice massage.

russell@herriottsports
07-11-2007, 08:13 PM
First, you might consider seeing a specialist to make sure your diagnosis is correct. It doesn't sound like a definitive case of patellar tendonitis. Without seeing you in person and obtaining a complete objective and subjective evaluation, I won't speculate an exact diagnosis but while it could be patellar tendonitis, it could also be exacerbation of chondromalacia/patellofemoral-stress-syndrome, quad tendon strain, among other possibilities. If the tissue is inflamed then that may be addressed as needed. After aggravating the tissue, it may be necessary to address any irritating stresses that may continue to irritate your knee. This can be especially important with cycling biomechanics. Make sure your fit and position, cleats, etc, are in the correct placement. As for stretching, some gentle stretching might help. Again, a physical evaluation would help determine what stretches should be prescribed for you. If you have any questions, feel free to contact me directly. I also know some good resources in Portland to help you get checked out in person. Best of luck with your knee.

Russell Cree, DPT, CSCS
www.herriottsportsperformance.com

SpeedRacer
07-11-2007, 10:05 PM
Patellar tendonitis.....
The good and ironic news is that I did not get this new, acute pain on the inner, upper aspect of my knee from riding. I spent 2 days crouched under my porch replacing dry-rot and woke up unable to go down stairs.
I've been icing it and taking massive quantities of ibuprofen with steady, progress. Made it through the "Night Ride" last Saturday with the help of a knee-brace.
The question: all the medical & bike links on patellar tendonitis say to stretch well before and after use. Specifically, what stretches the inner tendon to the knee? I'm nervous about anything involving deep knee bends or extreme flexion as I think that's what got me into trouble.
Any therapists out there with specific stretching suggestions?

There's no free medical advice here 8 ) I recommend knee extension exercises in meantime. Truth told though Knees just go bad (poor design) just take it as more proof that God does not exist (or if God does exist, is a moron for an engineer 8) ) xD

Oldguyonabike
07-12-2007, 06:39 AM
Thanks all.
Rode in today and now sitting with an ice pack on the knee. Not so much painful as that back-in-the-mind fear of painful. Its true that knees are horribly designed and a wonder they work at all. A friend also gave me some Biofreeze to try and I like it. It seems to penetrate better and the menthol smell goes away quickly. I'm using it along with the massage advice.
Happy trails!

russell@herriottsports
07-12-2007, 07:15 AM
FYI. Knee extension exercises are the most stressful exercises on the patellarfemoral joint. Be careful. Knee joints don't just go bad. They age like the rest of our bodies, but they will keep working for years and years if treated correctly. Especially for cycling! Of course, you hurt yours kneeling not cycling, which isn't surprising. Gentle stretch and ice, if the pain is there then see someone to find out what's going on. If in Portland, I'd see Anna Vaughn, a Physical Therapist in N. Portland. Anyway, hope you feel better and better and are riding painfree soon.

RC

Haven_kd7yct
07-12-2007, 07:52 AM
Thanks for all the free advice, Russell!

I've also got knee problems, but I got them from being too aggressive in co-ed soccer-- which I can't play any more. Not my fault I kept getting run into, I always got to the ball first.

My doc said I had patello-femoral syndrome, and gave me some knee extension and strengthening exercises. They seem to help, but what also helps is gentle stretching, glucosamine, and the pain reliever of your choice.

I'll add massage to my routine!

Kt

russell@herriottsports
07-12-2007, 09:24 AM
Soccer is the worst! Actually, soccer is the number one sport for knee injuries even though people most often think of skiing and football. Like you said, it's often the other players you have to watch out for. I think recreational leagues are worse than college or professional, as well, because the players charge at each other but aren't as agile and tend to run into each other even more. But... it's better than sitting at home on the couch, so if you love doing it then continue to do it. The worst thing for your body is to be sedentary.

RC

Oldguyonabike
07-12-2007, 09:32 AM
Thanks Russell. I think 29"er has it right. Makes more sense to be the illio-tibial band.
There's been some back/forth about the idea of extension as an appropriate stretch. Seems like extension (e.g straight legs with the extended foot on a window sill, say) stretches biceps femoris and hamstrings. Seems like if you want to loosen up the knee it would involve the vastus and illio-tibial tract and that would require knee flexion. I don't get how extension (advised or ill-advised) affects the knee. ???

fetishridr
07-12-2007, 10:42 AM
as well intentioned as all of us posters are, we dont have a PHD or DPT in front of our names and its irresponsible to prescribe strenghthening exercises. i had my ACL reconstructed 7 years ago and the one exercise forever banned by my PT was knee extensions due to the high amount of stress on the knee joint.
for everyone else reading this without knee pain remember that an ounce of prevention goes a long ways. its my feeling that a majority of joint "issues" are self inflicted by lack of exercise and or strength. strengthen the muscles surrounding the joint capusle and the connective tissue experiences less stress.
one awesome exercise for those who have doctor's permission is a one legged leg press. it mimics natural cycling motion, requires the use of stabilizing adductor and abductor muscles, and it isolates the legs so that you can strengthen the quadriceps equally and avoid overcompensation.
good luck with the knee injury. remember that ice massage only goes so far, and if it continues to hurt see a DPT. you'll save money by cutting out the osteopathic middleman unless you have done significant damage that requires surgery.

Todd Cruz at Therapuetic Associates Inc. in NW besides running an excellent PT clinic, does an excellent job with bike fits. check him out.