Hamstring and Physio concern

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RitchieJoe

Active Member
I have recently being having pain behind my left knee. I went to the physio provided by bupa and I was informed I have weak glutes and tight hamstrings. I was examined for 40 mins before being given three glute strengthening exercises and a hamstring stretch and a quad stretch. This was on thursday, after performing them for the last few days the pain behind my left knee is just as bad and I now have it behind my right :/

is this just bad luck or do you think I need another physio? I'm based in south yorkshire if somebody could recommend one if need be. Maybe I am being a bit hasty but bupa will only cover for me for another four sessions before requesting a medical report for more sessions.
 

screenman

Squire
I would say you are being a bit hasty, if the bike is causing the problem does it fit?
 

vickster

Legendary Member
@screenman I don't think the OP has a bike, he runs

Sounds like you have the same issues as me, just have to persevere I'm afraid. However, if the exercises hurt, do fewer reps. If they really hurt, stop, go back to the physio and see if you are doing them right. It may be that they are simply too much if your calves and glutes are really weak. Any new way of using muscles will likely make those muscles sore to start with until they adapt to the exercise :smile:

I would say you are being too hasty, I was told my issues would take months to resolve. Indeed, 3 months on, I have no more calf length. That said, my knee specialist has told me not to overstretch my calves as it exacerbates another issue (muscle irritation caused by a bone spur in my fibula).

You have 4 sessions to get diagnosed and to get an exercise programme, Bupa then expect you to carry on your rehab at home. They pay for the treatment of acute issues, not chronic ones (regardless of whether the policy is unlimited). Muscle tightness is likely a chronic issue that has developed over many months if not years, and will likely take months and not days to resolve. Unfortunately any knee issues require an enormous amount of patience and can be extremely frustrating!

Have you seen a knee specialist, had scans etc (I can't recall)? If things really are getting worse with more time, your physio should refer you to the appropriate doctor.

When do you see the physio again? Can you not call him if concerned, this is a better strategy than asking on an Internet forum, he's seen you :smile:

If you really want a new physio (I would say it's far too soon), see one who is attached to a specialist sports medicine clinic, see what your local private hospital offers.

Do you run in a club, see if any of your running buddies can recommend a physio and then see if Bupa will cover. But I'd use the 4 sessions, then if needed see a specialist. If they then recommend more physio, Bupa will sign off more sessions. They need to see either progress, or that you are trying other treatment avenues (I have at least 3 or 4 years of dealing with them) even if those avenues come with bigger bills, which is a bit mad, but understandable, consultant appointment is £200, physio £50. Bupa aren't there to keep you in condition for your chosen sport, but to be able to learn how to function in daily life. If you need ongoing physio, sports massage, conditioning training etc, you'll have to pay yourself
 

PK99

Legendary Member
Location
SW19
I have recently being having pain behind my left knee. .

Does it appear during/after cycling?

I had the same problem some time ago and a bit of googling suggested that posterior knee pain is most often associated with hyperextension of the knee joint. Prompted by that I checked my cycling action and realise that I had got into the bad habit of freewheeling with my left leg fully extended and the knee joint ever so slightly hyperextended and under pressure in that position.

A conscious change of cycling action so as to keep the knee slightly bent and hey presto the pain behind the knee went away.
 

vickster

Legendary Member
@PK99 i don't think the OP has a bike from previous posts, but does that weird running thing!

Perhaps orthotics are needed, ask the physio to check pronation, walking and running gait etc
 
OP
OP
RitchieJoe

RitchieJoe

Active Member
lol I was due to order my bike last month but I had to have an emergency endoscopy done last month and I was unsure how long I would be off work so I held off on my bank balance taking a £999 hit. But I am ordering it at the end of this month for sure.I need to switch between running and cycling to ensure I am not engaging in high impact exercise 4-5 times a week.

I see the podiatrist this morning vick, I did see him three weeks ago but when my inserts came my right one didn't seem to fit properly......
 

vickster

Legendary Member
Hopefully those will help but you still need to persevere with the exercises :smile: you should talk to the podiatrist about whether you might need different inserts for cycling
 

vickster

Legendary Member
When you do get your bike, pay for a proper fit, preferably by someone with a physio background. Cycling is not the best exercise for glutes and hamstrings, you need to learn how to ride in a way that does activate them, for me cycling probably compounds the issue and is likely what has damaged my kneecaps. Also get your core stability assessed :smile:
 

Tail End Charlie

Well, write it down boy ......
Hamstring stretches are very important to a cyclist as they are very underused. It's easy to cycle a lot, think you're fit and then be unable to walk a few hundred yards.
 
OP
OP
RitchieJoe

RitchieJoe

Active Member
Even when I have finished my course of physio I will continue to spend an hour a day working on my legs with stretching, strengthening and foam rolling. So @vickster if you were in my position would you have the bike fit carried out by planet x or the sports physio?
 

vickster

Legendary Member
Physio, but it needs to be a physio expert in cycling and bike fitting. Most physios aren't, you need to find one with a turbo trainer for starters. Someone here might be able to point you in the right direction. I expect you might need to travel, for example to the team at the Manchester velodrome.

I've had both done, although the retul fitter got the fit ok according to the cycling physio who did a recent assessment, he didn't formally take my position and riding needs into account. He was focused on efficiency for speed. I think it was more a coincidence the two more or less agreed!

From what I've heard, most bike fitters do a course to use the kit and software and then get some experience fitting. They don't have years of medical training. I'm assuming PX fitters fall into the non medic group, I could be wrong. They should I hope be able to get the bike set up initially so it doesn't do any further damage. They use retul, I'd ask what the background and experience is of the fitters, particular in dealing with customers with multiple musculoskeletal issues

This doesn't really mean a lot IMO, just that they've done a course

Planet X fitters are highly experienced and trained to the highest industry standards. When combined with the unique advantages of the Retül system, this makes for the very highest standard of fit available.

Did you say you are seeing a knee specialist at some point? Personally I'd wait for that before shelling out on a bike. See what he says about treatment, management, exercise etc
 
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