I've been dealing with pattelofemoral pain syndrome for a couple of months. Lots of PT and time off the bike. I can ride the trainer at home 30-45 minutes in relative comfort, but I'm not by any stretch "cured". I decided that today is the day to get back on the bike. A commute is a the best way the try out riding on the road again, IMO, because I can always get on the subway (work in Brooklyn) if the knee acts-up, plus the plan was to ride the ~10 miles to 14th St and take the subway the rest of the way anyway (I work in Brooklyn and want to avoid bridges aka hills for a while).

The ride was slow as I soft-pedaled the whole way but it sure felt great to ride instead of look at my bikes. I coasted once in a while to check on my knee by flexing the VMO muscle, looking for lateral patella tracking, the source of my problems. I hope that the ride home is equally successful!

You picked a wonderful early spring day to ride. May your recovery be steady and complete.

Here's to the great Physical Therapists out there.
Best of luck with the recovery.

Jeff, still fat

Can't you get into a super low gear and spin?

I could also walk the ~14-15 miles to work but it'd take too long.

So the ride back was less comfortable than the ride out but hey I was in shorts, can't complain about that. I suppose I'll have to ride to be able to ride, so to speak, teaching my left how to do it right.

Congrats, oboe!

What's the VMO, though? I know a lot about muscles...but don't know VMO...

https://www.bfeweb.com/protocol/pro01eng.htm (second paragraph) "inner quad" to me.

Interesting! Thanks!

How's the VMO strengthening going?

It's going, but the problem is that the VMO shuts down (PT's words, my perception confirms) after riding a while and "the old familiar sting" comes back. Taping is supposed to make it easier and I've had someone show me how to do it but I'm pretty hopeless at it. The PT is pretty much anti-taping, seeing it as a crutch that will inhibit long-term improvement.

Wow, I'm glad I saw this, kind of!

I'm going through this exact same experience right now! I've been dealing with it for about 2 weeks now, and I don't see an end in sight. The doc told me it would be months until I was 100%, but that just seems ridiculous, atleast it did until I read this. I start physical therapy next friday, so we'll go from there. This is such a weird pain, it almost feels like if I were to straighten my leg and flex my quad, my knee would just rip apart. It never truly hurts, like an OMFG I want to cut my leg off, but it drives me crazy. I'm tired of walking like I'm 80 when I'm only 25!

On a side note, I did get my new Brooks B-17 Special Edition in today and I put it on the bike. I actually rode it around the parking lot for about 3-5 minutes and it's the best I've felt in the past two weeks, kind of weird.

Why does your VMO shut down? How do you mean it "shuts down?" Do you mean that it just stops responding, or it fatigues easily, or it spasms, or what?

I think he is saying that it fatigues easy.

Here's my understanding. The VMO is inadequate compared to whatever the outer quad section (don't know name...) and therefore fatigues much quicker. Once it fatigues, the outer section takes over and actually pulls the patella crooked across the femur. This causes the underside of the patella to rub on the "ball" of the femur and not the "groove."

That's my understanding, too Jacobi. I just want some clarification because sometimes my assumptions are wrong .

It's something like that, yes. It's a bit of a vicious cycle too in that it only gets weaker over time from the shutting down.

Thank you for the posting. I have been off the bike for six weeks with knee pain. I went to the doctor after two weeks and got a month's worth of prescription anti-inflammatory drugs, plus a sheet of daily exercises, but he did not offer a name for the condition. I used your name for it, with google, and found all sorts of information. I am not so worried now, since all this information does say that it takes a long time for knees to get better.

My sister-in-law, a physical therapist, stressed the importance of hamstring stretching, always a problem area for me personally.

Get well soon.

Oboe, your condition baffles me!

When something baffles me, I suggest acupuncture...

I find acupuncture baffling!

I find the most baffling thing about acupuncture is that it's worked every time I've had it.

Do go on. I'm not panning it, you know. Heck I chose a sports med doc based on the fact that he's a DO not just an MD.

That's about all I can say. I understand the whole meridian line thing, have no idea how it could possibly correspond with real anatomy & physiology, and have had enough western science training to be highly skeptical. And yet, each time I've had acupuncture done, it has worked with powerful results. I guess I'll just have to live with the mystery until they can explain it. I'm sure it's perfectly reasonable and logical, we just don't know what it is yet.

I have read that acupuncture can help with hypertension.

+1

I have no idea how, but it severely reduced my exzema. Also helped with a ton of tension in my calves.

Sorry to hijack! I just think it's a good thing to look in to!

No worries about the hijack. Anyway for all who are wondering, great weather is on tap for NYC this week and my knee has felt exceptionally good this weekend (very limited "movie goers syndrome", i.e. pain / discomfort from sitting for extended periods of time) so I expect I'll be commuting or part-commuting (subway part of the way) a lot this week. Updates to follow!