Training & Nutrition - Its Back!

I have had this nagging knee/hamstring since early decmeber, and I ended up taking lots of time off, then finally returning to light riding at the beginning of january...I thought I was doing everything right, I was pain-free. then, friday, I started my intensity. by saturday, my hamstring/knee is messed up again. this sucks so bad. my first race of the season is saturday, I'm signed up, money is paid, travel arrangements made. If I have to drop out of this race, I'm gonna be so pissed. so pissed.

anyway, I just wanted to vent, since I'm mad. I know theres not a whole lot I can do but take time off. It pisses me off, because I went to the PT, and they're not really doing anything, just stretching and massage. It seems like I could do that **** at home, and not waste my money (copay) or the insurance companyies money and most importantly, my time. I asked if a leg-length discrepancy might be the prob...and the guy goes...nope, its all that running you've been doing. he didn't measure anything...and I RAN 3 TIMES IN THE PAST MONTH!

wow, this thread has really helped me cement things. I'm cancelleing all of my appointments. stupid PTs.

that sucks.. I feel for ya man.. have you rechecked your position on the bike, or changed anything about it just before all your trouble started? Is it tendon pain where it connects to knee or deeper in knee? how are you treating it now, ice/heat/ice? just curious...

. . . because I went to the PT, and they're not really doing anything, just stretching and massage. It seems like I could do that **** at home, and not waste my money (copay) or the insurance companyies money and most importantly, my time. I asked if a leg-length discrepancy might be the prob...and the guy goes...nope, its all that running you've been doing. he didn't measure anything...and I RAN 3 TIMES IN THE PAST MONTH! . . .



1. You can and should be doing all the stuff the PTs are doing at home. You could and probably should be stretching what the PTs are stretching (or having you stretch) and if you can reach it, you could massage it. You can ask them to show you exactly what they are doing and have them show you exactly how you can best do it yourself. Stretching at home everyday can be better than 2 times a week at the PT appointment.

2. Insist on measurement to check that leg discrepancy thing. If they refuse to, ask for the person in charge--and ask them to measure/check this out for you.

3. Ok, you're not running. Maybe it is due to "all that riding you've been doing?"

4. Did your doctor order an x-ray of your knees to check for osteoarthritis before ordering the PT? If not, go to your doc and ask to have your knees x-rayed. My osteo-arthritic knees feel great at time and at other times give me wierd pains, especially if I haven't warmed up sufficiently.

1. You can and should be doing all the stuff the PTs are doing at home. You could and probably should be stretching what the PTs are stretching (or having you stretch) and if you can reach it, you could massage it. You can ask them to show you exactly what they are doing and have them show you exactly how you can best do it yourself. Stretching at home everyday can be better than 2 times a week at the PT appointment.

Yea, thats what I was thinking of doing. basically, its just hamstring stretches, nothing fancy...and the massage didn't seem to complicated, I think I could replicate the effect by myself, its not like its my back...its just on the outside of my knee


2. Insist on measurement to check that leg discrepancy thing. If they refuse to, ask for the person in charge--and ask them to measure/check this out for you.
yea, I definitly asked...and they were like, yea...well sometimes [the PT] does that and you dont even know it...he's pretty experienced with that stuff...Please...if that's not bull****, I dont know what is.


3. Ok, you're not running. Maybe it is due to "all that riding you've been doing?"
Yea, well I know that my riding had something to do with it, the pain reappeared after I started my intensity...but still, I had 3-4 weeks of gradually working back up to riding before starting. I THOUGHT I did everything right...


4. Did your doctor order an x-ray of your knees to check for osteoarthritis before ordering the PT? If not, go to your doc and ask to have your knees x-rayed. My osteo-arthritic knees feel great at time and at other times give me wierd pains, especially if I haven't warmed up sufficiently.

I'm 18...I doubt that I have arthritis...and its DEFINITLY a muscle/tendon thing...the pain is right where the semitendinosis attaches to the knee joint.

This is propably related to bike fit. Streching combined with excercise is in my opinion the mainstay of coming back to normal function, but bikefit issues should of course be resolved to prevent further stress, basically PT´s and MD´s in general wan´t know the first thing about bikefit or related stress issues.
A short leg will get stretched more if the bike is set up for the long leg, but I personally got issues in my long leg (ITB) after setting the bike up for the short leg. The stress on the medial side of your leg could be related to toes pointing to much to the outside or active supination during pedaling. What shoes/pedals do you use? How does your feet point on the bike (inwards /outwards)? Do you get saddlesores /discomfort mainly in one side?

My cousin was 18yo, when she found out she had arthritis in her knees, and couldn't play tennis anymore.

It is rare in young people, but does occur. Might want to havce your doctor check just to be sure. Ya never know.

a discrepency in leg length can SOMETIMES be helped by chiropractic care...could be that your pelvis is tilted (held there by uneven muscles) causing the diff in lenght

This is propably related to bike fit. Streching combined with excercise is in my opinion the mainstay of coming back to normal function, but bikefit issues should of course be resolved to prevent further stress, basically PT´s and MD´s in general wan´t know the first thing about bikefit or related stress issues.
A short leg will get stretched more if the bike is set up for the long leg, but I personally got issues in my long leg (ITB) after setting the bike up for the short leg. The stress on the medial side of your leg could be related to toes pointing to much to the outside or active supination during pedaling. What shoes/pedals do you use? How does your feet point on the bike (inwards /outwards)? Do you get saddlesores /discomfort mainly in one side?

thats exactly what I was thinking, my short leg is getting hyperextended when its at the bottom of the stroke. as for the way my toes point, I dont really have a way. they sort of move around. when Im hammering, mashing a big gear, my toes tend to point out, when I'm spinning a small gear, my toes point inwards. anybody else have that sort of change? I've got speedplays BTW...I'm think that the extra float might be hurting me?

a discrepency in leg length can SOMETIMES be helped by chiropractic care...could be that your pelvis is tilted (held there by uneven muscles) causing the diff in lenght

I've heard that, actually. I have minor scoliosis, so possibly thats the prob? chiros aren't paid by insurance, though, which is a bit of a bummer, so the treatment would come right out of my pocket.

When your toes point very much outwards it can actually be a result of active pronation (imagine you step hard and to compensate for the natural tendency to step of the outside of the foot your foot turns toe out to let the inside of the foot contact the pedal). I got ITB (lateral knee pain) from trying to force a toe in position, then I got myself the speedplays, but they potentially allow you to get to much toe out, which will strain your medial knee. I instead turned to the root of the foot alignment issue and got the Lemond wedges, best money I ever spent, they prevent the pronation and thus limits my toe out need! Sort of the same effect can be gotten with specialized shoes.

When your toes point very much outwards it can actually be a result of active pronation (imagine you step hard and to compensate for the natural tendency to step of the outside of the foot your foot turns toe out to let the inside of the foot contact the pedal). I got ITB (lateral knee pain) from trying to force a toe in position, then I got myself the speedplays, but they potentially allow you to get to much toe out, which will strain your medial knee. I instead turned to the root of the foot alignment issue and got the Lemond wedges, best money I ever spent, they prevent the pronation and thus limits my toe out need! Sort of the same effect can be gotten with specialized shoes.

I'm intrigued. so the wedges kept you from rotating your foot out?

I'm intrigued. so the wedges kept you from rotating your foot out?

Not absolutely but about 70%, I found that a lot of toe out occurred when I tried to contact the pedal with the medial part of my foot, which will cause a slight rotation of the lower leg when it´s fixed in the pedal.