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Old 01-05-08, 03:07 PM   #1
Distantfellow
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Extreme case of Patellar Femoral Pain

Howdy,

I've been struggling with Patellar Femoral Pain Syndrome for over a year now, and consequently off the bike for about a year. As you all could probably imagine, it sucks. It really sucks. I went from being an avid mountain biker and bicycle commuter to a depressed, car driving, *******. I've been doing physical therapy for the past nine months, I've done accupuncture, rested and took anti-inflamitory drugs for over two months, cortisone injections, had an MRI, had custom orthotics made, custom bicycle fitting, shims put under my cleats, and I still can't ride my bike! The injury gradually got worse as I continued to ride last year and finally cut my cycling career short after a century ride just destroyed it. I haven't ridden my bike more than a few hundred feet in several months. I'm only nineteen and invested so much into cycling. It's just heartbreaking. Now even cross-country skiing's hurting it. I've seen several different doctors and the story's always the same. "I'll have you back on the bike within a month!" Bull****. Is anyone else outthere struggling with patellor femoral pain to this extent? Has anyone on this forum had a "lateral release" surgery?

DistantFellow
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Old 01-05-08, 05:01 PM   #2
BikeManDan
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Same thing is happening to me and I'm 22. No solution unfortunately, just like you.
I've been told mine is patellar femoral by one doctor and been told its quad tendinitis by several others.
Your story is eerily similar to mine, I feel your pain and am currently living in the same torment.
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Old 01-05-08, 05:52 PM   #3
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My patello-femoral pain syndrome flares up in the winter. I was told it is caused by one or both of two things:

1) When you cycle your quads don't develop evenly. Three of the four quad muscles develop really well, but one doesn't. This imbalance causes your knees to track "funny" which causes problems. Therefore, as bad as fitness experts will have you believe they are, leg extensions can help develop that fourth quad. When I do leg extensions, my patello-femoral acts up, I do leg extensions and a short time later, I'm fine again.

2) Pressure on the knee from things like clothing ... like tights or long pants that are too tight and restrict free movement of the knee. This is why mine flares up in the winter ... it's when I'm wearing tights. I also experience some problems on rainy days in the summer when I have to wear rain pants.

Just some ideas that you might experiment with if you have not already.
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Old 01-06-08, 03:03 PM   #4
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While it may not be the most popular,or hi tech, solution why
not try a pair of platform pedals & Knee Saver pedal extensions.

This combo work wonders for me now that I have knee implants to
let my legs "self align" thoughout the entire pedal stroke. This
combo is my ortho docs standard method to help cyclist heal
tendon or mucuel tears/strains.

You may have to chill back on how much/fast you ride but ride
you can. All this means is that , at least for a while, you'll hav
to skip any sort of clip ins that lock your feet/legs in rigid postions.

At the end of the day your feet & legs are gonna hafta "float" or they
won't heal.

http://www.bikescor.com/product/knee.htm
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Old 01-06-08, 03:38 PM   #5
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Hey,

I feel your pain. I was in the same position, not quite as long though, just shy of a year. Tried all kinds of things, physio, accu, drugs....etc, etc.

What ended up working for me was using a styrofoam roller on my IT band. But i'm cheap so I used an old nalgene water bottle. (I found a firmer object worked better)

I would place the bottle on the ground and then lie on my side with my IT band on the bottle using my body weight for pressure. Then I would then roll back and forth on the bottle making sure to go from my knee to my hip. It was initially painful, but the good kind of pain. It would almost instantly feel better after a minute or two of rolling. I would do this 2-3 times a day and before/after a ride.

I hope that made sense, good luck!
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Old 01-07-08, 12:30 PM   #6
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I had my first bout of this a few years ago during the Rosarita-Ensenada ride down in Mexico.

I had to give up moutain biking but have managed to continue riding road (my first love) as long as I remember to spin rather than crank.

I've even had my knees give out on me while helping a friend move; too many stairs under load.

It sucks.
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Old 01-07-08, 07:37 PM   #7
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Thanks for your comments. Tightwad, the knee-saver pedal stuff looks promising. I'm goint to order a pair in the near future. PCS2, I do have a foam roller and have never used it regularly, so I'll have to start spending more time on it. Thanks again.
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Old 01-11-08, 01:20 AM   #8
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What I know about lateral release surgery is that it used to be done often and with little hesitation on the doctor's part but now, the indications for it are pretty narrow including your almost having to have patellar tilt on the Sunrise View of the patella. These days most doctors want to exhaust non-operative measures first.

..The thing about using the foam roller or other means of combatting trigger points, as well as with physical therapy, is that you have to keep doing it, usually several times a day. At times I've gotten sick of doing it and I've had my own lapses in discipline but.. staying at it will bring the best results.

I've had patellofemoral pain and I don't think mine was ever as bad as yours but mine has changed over time; I had my initial inflammatory bouts a few years ago and following that was grating sensations on the lateral (back)sides of my kneecaps, where my cartilage is presumably fibrillated. I haven't had either pains or discomforts in some time and I've been riding (short) hills as well as sprinting on my road bike and I've had nary a symptom. Damn, I hope I didn't just jinx myself!

I think that in time your knees won't feel so bad and you'll be able to do at least much of what you want to.
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Old 01-11-08, 06:02 AM   #9
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I feel your pain, I have bad knee problems stemming from soccer injuries and its beginning to affect my cycling.

PF issues are normally caused by the kneecap rubbing too much in the groove it slides up and down in.
Lateral release is supposed to "slacken" the tension it rubs in the groove with, checkout the kneetalk forums, there are lots of people there who have done this.
http://www.kneeguru.co.uk/KNEEtalk/index.php

Also you could try videoing yourself pedalling from infront on a trainer to see how your knee track when going around the pedals, if they move excessively side to side it could be a possible cause of more unnecessary rubbing in the pf groove
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Old 01-11-08, 03:14 PM   #10
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Quote:
Originally Posted by Distantfellow View Post
Howdy,

I've been struggling with Patellar Femoral Pain Syndrome for over a year now, and consequently off the bike for about a year. As you all could probably imagine, it sucks. It really sucks. I went from being an avid mountain biker and bicycle commuter to a depressed, car driving, *******. I've been doing physical therapy for the past nine months, I've done accupuncture, rested and took anti-inflamitory drugs for over two months, cortisone injections, had an MRI, had custom orthotics made, custom bicycle fitting, shims put under my cleats, and I still can't ride my bike! The injury gradually got worse as I continued to ride last year and finally cut my cycling career short after a century ride just destroyed it. I haven't ridden my bike more than a few hundred feet in several months. I'm only nineteen and invested so much into cycling. It's just heartbreaking. Now even cross-country skiing's hurting it. I've seen several different doctors and the story's always the same. "I'll have you back on the bike within a month!" Bull****. Is anyone else outthere struggling with patellor femoral pain to this extent? Has anyone on this forum had a "lateral release" surgery?

DistantFellow
A Chiropractor who does the Zindler technique helped me with my knee pains, and I did less than you have before going to see him. You might have to ask around to find one - it was worth the effort for me.
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