Vinnie B

For those who don't know, a tens machine is an electro nerve stimulator. Tens stands for transcutaneous electrical nerve stimulation.

The 'gadgets' I've seen in drugstores look somewhat pricey for what they are, they usually run on two AAA batteries, and have things like "pain relief" and "massage" written on the box, not "to increase muscle strength", or "tone"

I've been told that my vastus medialis is weak (common in cyclists), which causes some petallofemoral issues due to off-center knee cap tracking. From what I've read on some sites, despite common belief, it's impossible to isolate the medialis, because the knee is a basic hinge joint moving on one plane.
Therefore, if the knee extends, all the quads contract, no matter where the toe points, how far the knee extends, or where the "focus" goes, or doing eccentric one-leg squats on a decline.

So, I'd like to try electric simulation on the medialis to see if isolating it does anything. Are basic tens devices like this good enough for this? If not, where are stronger ones sold? I've got no idea.

I've been doing most of the other PTF stretching and exercises.

Products similar to this is what I've seen.

no1mad 

I've used the tens unit at the Chiropractor and I also have a portable unit another Chiropractor sold me (which I could've gotten off of Amazon for almost 1/4 the price). The portable (9v) just doesn't have the oomph.

Vinnie B

Thank you. That's what I was thinking.

The ones I've seen are 1200 milliamps, if that means anything. Does that sound right?

Carbonfiberboy 

I have a 9v Slendertone unit from Amazon and it's plenty strong. OTOH, the VMO isn't only about strength, it's also about getting the firing timed right. I've found the most effective exercise to be the leg extension machine but only going between ~150° and 180°, so only a 30° leg arc before fully straight. I do 3-4 sets of 10-12, working up to as much weight as I can manage. Squats, then leg extensions, then one-legged presses. They'll notice that.

Vinnie B

Thank you. I've also read an opinion recently that many knee problems are "all" about correcting internal hip rotation by strengthening the all the glute muscles, etc

Rollfast

Fix your foot support and the rest is supposed to follow. As for your knees, pain is trying to tell you more than your muscles aren't strong. Also arthritis, and a few other things. It might be damaged.

denvertrout

When I was in PT school and were learning about the stim units all the guys in class, about 9 of us of 60, set up the pads on our quads and cranked it up as high as we could tolerate. Full on contraction like nothing you could ever create on your own power. Each one of use had one leg that was beat to hell the next day. Never did that again!!

Carbonfiberboy 

If you haven't already, you might read this old post of mine: https://www.bikeforums.net/training-n...l#post16081392

Vinnie B

Thank you again, Carbonfiberboy

bikebreak

I had a diagnosis of patellofemoral syndrome with weak VMO, years ago
They did a TENS on it at PT, and I don't think there was any difference.
Squats and riding more and harder did make a positive difference


If you are starting riding remember your muscles will adapt (grow) quickly, but tendons and ligaments take longer and bone much longer to strengthen.

Vinnie B

Thanks. I've been riding for a long time.

My main symptom is a painless twinge in the patella (or at least in that spot) when I ride hard off the saddle.
The one time I pushed it, I had some pain in the inner side region next to the petalla, but I think it's more in the pes anserine vicinity.

I've also had a little inner shin soreness in different spots, and I get a fair bit off clicking, not just in the knee cap, but in other spots, especially when I get out of bed.

Doing straight leg raises doesn't seem to have done much.

Incidentally, I'm very suspicious that a combination of doing hanging leg raises and having weak glutes (and other external hip rotators) might have altered my leg biomechanics, because I think hanging leg raises have caused medial knee pain in previous years.

About 6 years ago I had some acid reflux, so I had to stop doing crunches and other ab exercises, and replaced them with hanging leg raises.

Carbonfiberboy 

Do you do the hanging raises straight or bent legged? Stopping doing crunches is always a good idea.

For the pes anserine bursitis, try these stretches every day: https://www.bikeforums.net/road-cycli...l#post15372967

For the weak glutes, do one-legged leg presses with your foot well up on the plate. One legged pedaling on rollers or trainer is also good for the glutes and leg development in general.

Try doing leg extensions only through the last 30° before the leg is straight.

I click too, but it doesn't seem to be a problem for me. It goes away after I warm up.