Strengthening the VMO muscles

[vickster]

It's a sports physiotherapist that I was referring to. Preferably one into cycling if there's anyone local

My cycling physio also did an on bike assessment after a few session once she had assessed my myriad knee / leg issues. Cost £80. Much better than the £150 I'd spent previously on Retul as she actually considered my history unlike Retul guy who wasn't v interested. Although to be fair, the physio didn't change the Retul set up

If you really only have minor knee issues and only cycling, the bike set up should be the starting point. If there are broader anatomical issues, then physio would be the way to go imo. I have leg pain at least rest, which is neither better not worse when cycling

 

[Wolf616]

It's a sports physiotherapist that I was referring to. Preferably one into cycling if there's anyone local

My cycling physio also did an on bike assessment after a few session once she had assessed my myriad knee / leg issues. Cost £80. Much better than the £150 I'd spent previously on Retul as she actually considered my history unlike Retul guy who wasn't v interested. Although to be fair, the physio didn't change the Retul set up

If you really only have minor knee issues and only cycling, the bike set up should be the starting point. If there are broader anatomical issues, then physio would be the way to go imo. I have leg pain at least rest, which is neither better not worse when cycling

How much did you end up spending on initial assessment and then some physio? Also did you do it in London and, if so, where?

My main problem is I don't have very much money. And I know prevention is cheaper than cure, but I really can't afford to be spending £100s on physiotherapy

 

[vickster]

How much did you end up spending on initial assessment and then some physio? Also did you do it in London and, if so, where?

My main problem is I don't have very much money. And I know prevention is cheaper than cure, but I really can't afford to be spending £100s on physiotherapy

Physio charges £45-65 a session from memory (bupa kindly paid). The on bike assessment was £80. Which was done after a few physio sessions, I was recovering from knee surgery
In Putney

http://www.pelotonphysiotherapy.co.uk/prices/

I had the original retul fit done at Cadence in Crystal Palace, think it was £150

Take some time off the bike, see if it improves?

 

[Wolf616]

Yeah rest is looking like the only option now

 

[vickster]

Do you actually have a diagnosis? Seen a Dr or preferably physio

Worked on bike fit?

 

[Wolf616]

Do you actually have a diagnosis? Seen a Dr or preferably physio

Worked on bike fit?

Not seen a doctor or physio yet due to lack of money (physio)/complete lack of faith (GP). If it's still irking me after a week of rest then I might consider biting the bullet and going for an assessment.

As for bike fit, I know KOPS isn't that great but is better than nowt and I've sorted that out by moving my seat back slightly. Weirdly the pain (mainly lateral/anterior, although it's hard to tell which sometimes) only started, I think, after I raised my seat. So I've now put it down a bit (and worked out inseam * 0.883, which also told me to lower it), even though most internet advice suggests too low seat = anterior pain and too high seat = back of knee pain.

I guess the only other fit problem could be foot positioning, but as I can't yet afford cleats I'm using the cages that came with my bike and normal walking shoes so I can't actually change the foot positioning in any way at the moment.


Ironically I've been fine up until the point I started messing around with it, I even did a ridiculously hilly week long tour in Wales without any problems whatsoever. So either I've finally knackered my cartilage or I've somehow managed to mess up the admittedly half-arsed fit Decathlon did for me when I bought the bike (that I changed anyway).

 

[vickster]

Sounds like patellofemoral syndrome if anterior and lateral

Are you stretching and foam rolling daily? And icing

 

[Crackle]

I can't stress this enough: Don't ignore it won't go away. Well, it might but not by the sounds of things. Also don't get frustrated, this might take time and experimentation but you need to be proactive and with no money, I'd be bothering your GP for an onward referral. Multiple approaches required. It took me over 6 months to sort my knee out.

 

[Wolf616]

Sounds like patellofemoral syndrome if anterior and lateral

Are you stretching and foam rolling daily? And icing

Yep I am stretching and foam rolling. Not icing yet though, and now I'm going to stop cycling for a bit probably no need as there's no swelling anyway.

I can't stress this enough: Don't ignore it won't go away. Well, it might but not by the sounds of things. Also don't get frustrated, this might take time and experimentation but you need to be proactive and with no money, I'd be bothering your GP for an onward referral. Multiple approaches required. It took me over 6 months to sort my knee out.

Thanks for the advice (both of you). Hard not to be frustrated, particularly as I am moving house at the end of the month and my whole commuting plan is entirely farked up by this injury. I'm going to be destitute, fat and depressed by the end of this!

 

[vickster]

Don't know where you are in London, but in sutton, there's an 8-12 week wait for NHS physio if not post op etc

Can you really not cycle at all? I've been riding with sore knees for 6+ years. Just take it easy, find flatter routes etc

 

[Wolf616]

Don't know where you are in London, but in sutton, there's an 8-12 week wait for NHS physio if not post op etc

Can you really not cycle at all? I've been riding with sore knees for 6+ years. Just take it easy, find flatter routes etc

I can cycle, it's not even that painful. Nor is it that painful off the bicycle. There's definitely a pain though, and I've always been taught that pain (not the good pain you get from cycling up a hill or something, obviously) is a sign to stop what you are doing.

Plus, if it really is patellfemoral syndrome then that means continued cycling will destroy my cartilage which will take ages to heal due to a lack of blood supply. My new commute is going to be 22 miles round trip, which is definitely not suitable for my newly knackered knees!

 

[vickster]

How does your kneecap track?

If that concerned and if it doesn't improve, it certainly is worth investing in physio IMO

I assume you don't get private healthcare through work?

Certainly no physio nor orthopaedic surgeon I have seen has ever told me to stop cycling, just consider how. No standing on the pedals for starters. A mildly inflamed patella tendon or fat pad, also part of PFS won't wreck articular nor meniscus cartilage (depending on which you refer to)

Running on the other hand a no no

 

[Wolf616]

How does your kneecap track?

If that concerned and if it doesn't improve, it certainly is worth investing in physio IMO

I assume you don't get private healthcare through work?

Certainly no physio nor orthopaedic surgeon I have seen has ever told me to stop cycling, just consider how. No standing on the pedals for starters

Running on the other hand a no no

Not a clue how it tracks, to be honest, as I've never paid any attention to my knees before so I don't know what's normal and what's not! I didn't realise, for instance, that you can wobble your knee caps when your leg is almost straight - that scared the hell out of me for a minute or two. My knees do click when they didn't used to (and my hips for that matter)

No private healthcare through work, unfortunately, one of the joys of working in the charity sector!

I might get an initial assessment somewhere, at the very least I'll know what I'm dealing with then and I assume physios aren't out to rip you off...

I also know it's an investment, but the money freed up by not taking the tube would no longer be there and that's the only wiggle room in my budget, to be honest.

 

[vickster]

If it's PFS, the kneecap almost always tracks laterally towards the outside, bend your knee with your feet up and you should be able to see. You should be able to see how the kneecap tracks. Also, with PFS you get pain at St and also going down stairs or slopes

http://www.kneeguru.co.uk/KNEEnotes/primers/patella-primer/patellofemoral-syndrome-pfs

Physios won't rip you off, but if money is so tight, ask the GP for an NHS referral, you may get seen more quickly, depends on the area. You do seem pretty concerned about this so get it looked at

 

[Wolf616]

If it's PFS, the kneecap almost always tracks laterally towards the outside, bend your knee with your feet up and you should be able to see. You should be able to see how the kneecap tracks. Also, with PFS you get pain at St and also going down stairs or slopes

http://www.kneeguru.co.uk/KNEEnotes/primers/patella-primer/patellofemoral-syndrome-pfs

Physios won't rip you off, but if money is so tight, ask the GP for an NHS referral, you may get seen more quickly, depends on the area. You do seem pretty concerned about this so get it looked at

Thanks again for the information. I will go and see my GP but the reason I am sceptical is last year I went about RSI in my wrist (from playing piano, the last hobby I had to quit due to injury, something I do not want to repeat here) and they were absolutely useless. Just told me to splint it and rest, with no strategy for overcoming it and no option to see a physio.

Looking at my knees they don't seem to track obviously one way or the other, so maybe it's just overuse. I do tend to be overzealous with how far and regularly I cycle as it's my main (read: only) form of transport these days. Plus I do get an occasional twinge on stairs so it does sound like PFS, regardless of what my untrained observations suggest