VMO tendinitis? HELP!
01-28-06, 12:06 PM
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VMO tendinitis? HELP!
About two weeks ago I started getting a tight pain in my right knee (occurs right where the vastus medialis, tear drop muscle on inside front of leg on top of knee) after I did three consecutive days of 3+ hr base rides. After I started getting the pain I took a few days off. Since I've done 2 rides and the pain comes back within 20-30 min even though I'm spinning light gears. The pain is only there when I ride and only occurs at the top of my downstroke. It still aches a few hours after riding but is usually gone the next morning. It doesn't hurt to do any other activity (walk, run, or lift weights). Anyone ever experience this? If so, what did you do to treat it? I've tried rasing my saddle and adjusting my cleats but to no avail. And yes, I've got an appointment with a doc but I prefer to be as self-educated about what may be wrong before I go see the doc.
01-28-06, 12:57 PM
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Could be tendinitis. If it isn't, it may lead to tendinitis at some point.
I experienced the exact same pain recovering from knee surgery and it was due to a atrophied quad. I would suggest some resistance training...squats, leg press, get that quad built up and it took care of my problem (for the most part). If you've recently gotten back on the bike, it could be your base miles have aggravated your tendons due to winter inactivity.
Perhaps a slower base mile buildup? 3 days of 3+ base rides at this time of year is perhaps overdoing it.
I experienced the exact same pain recovering from knee surgery and it was due to a atrophied quad. I would suggest some resistance training...squats, leg press, get that quad built up and it took care of my problem (for the most part). If you've recently gotten back on the bike, it could be your base miles have aggravated your tendons due to winter inactivity.
Perhaps a slower base mile buildup? 3 days of 3+ base rides at this time of year is perhaps overdoing it.
01-28-06, 01:04 PM
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I'm experiencing something similar right now in my left knee but I think mine is the hamstring tendon. This is a first for me. It occured right after my first Century ride this year. Like you, it only hurts when I'm pedaling and more noticeable on inclines. I'm not sure how to treat something like this. I just hope the answer isn't to stay off the bike. 
report back on what the doctor tells you. I hope its nothing too serious.
Edit: I found this explanation on how to strengthen your problem muscle. https://www.merck.com/mmhe/sec05/ch075/ch075f.html
report back on what the doctor tells you. I hope its nothing too serious.
Edit: I found this explanation on how to strengthen your problem muscle. https://www.merck.com/mmhe/sec05/ch075/ch075f.html
Last edited by reneuend; 01-28-06 at 01:12 PM.
01-28-06, 02:48 PM
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I'm sure it's not from an undeveloped quas muscle. It's in my dominant leg and I've been in the gym 1-2 per week since October. As far as weight trainin, my quads are the strongest they've ever been. I was in base 2 when the pain hit and I don't my hours more than 10-15% one week to the next. But the 3 days in a row of 3+ hour rides may have been a bit more than body could handle.
01-28-06, 02:57 PM
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I experience this from time to time. It's more common during the cold weather or after I've taken some time time off due to snow or bad weather. I usally ice down my knees for fifteen minutes after riding and if the pain is real bad I also take an anti inflammatory like advil, then when I get back on the bike again I spin lower gears till I'm loosened up. it usally goes away after a while. I think it just an over use kind of thing but its a good idea to have a doc check it out to make sure it is not something bio mechanical , torn tendon or the like.
01-28-06, 03:44 PM
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From the way you describe this doesn't seem serious to me. Must be quad or patellar tendinitis. I've effectively eliminated mild pains around the knee area with ice therapy and rest alone. Apply icepad for 15mins 4-5 times or more a day and DO NO exercise of any kind for a week at least! Don't be carried away, light pedaling is no way to recover it only prolongs the inflammation...Drugs don't have a place here unless the pain hampers usual everyday activities like walking
01-28-06, 04:06 PM
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Originally Posted by mimis
From the way you describe this doesn't seem serious to me. Must be quad or patellar tendinitis. I've effectively eliminated mild pains around the knee area with ice therapy and rest alone. Apply icepad for 15mins 4-5 times or more a day and DO NO exercise of any kind for a week at least! Don't be carried away, light pedaling is no way to recover it only prolongs the inflammation...Drugs don't have a place here unless the pain hampers usual everyday activities like walking
I've had this aggrevation on and off since January 16th, but I just ignored it. (The weather has been too nice!).If I've been riding 20 miles each day all summer on hilly terrain with no problems, and then have an injury after the 80 mile mark on a 100 mile ride could this still be a setup problem? or was it because of the other factors (temperature in the 30's, lack of water/food, last incline at 80 mile mark was a beast w/o a granny gear....)?
01-28-06, 09:51 PM
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Aluminium Crusader :-)
I've had some VMO problems which were somewhat relieved when I supinated my feet with LeMond wedges
01-28-06, 10:19 PM
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Stretc.............h....before and after rides.
I have also found that weight trainging has significantly helped, especially during the off season.
I have also found that weight trainging has significantly helped, especially during the off season.
07-05-10, 02:58 PM
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About two weeks ago I started getting a tight pain in my right knee (occurs right where the vastus medialis, tear drop muscle on inside front of leg on top of knee) after I did three consecutive days of 3+ hr base rides. After I started getting the pain I took a few days off. Since I've done 2 rides and the pain comes back within 20-30 min even though I'm spinning light gears. The pain is only there when I ride and only occurs at the top of my downstroke. It still aches a few hours after riding but is usually gone the next morning. It doesn't hurt to do any other activity (walk, run, or lift weights). Anyone ever experience this? If so, what did you do to treat it? I've tried rasing my saddle and adjusting my cleats but to no avail. And yes, I've got an appointment with a doc but I prefer to be as self-educated about what may be wrong before I go see the doc.
Wow! I have the EXACT same issue. Were you able to cure this issue? I am desperately searching for help as I am 3 weeks out from an Ironman and can't ride due to the pain in the VMO at the top of each downstroke. Light gears make it a bit easier but its still almost unbearable to ride. Any help would be greatly appreciated!
07-05-10, 05:13 PM
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I have been basically off the bike for 7 months now due to patellar tendonosis issues. It has been one of the wrost things I have ever had to deal with. Mentally more than anything because I was so ready to kick ass this season. I am not even sure if I will be able to race next yr at this rate.
I have done everything possible to get it better from Graston/Astym technique, electro therapy, ultrasound, stretching, all through my physical therapist twice a week. Plus everything I do on my own, like muscle building exersises, ice, full stretching routines and very light riding (under 200 watts for under an hour).
Heavy overuse is the dianosis. It is not tendinitis but tendonosis at this point.
Ironic my job is to prevent people from getting these types of issues.
I have done everything possible to get it better from Graston/Astym technique, electro therapy, ultrasound, stretching, all through my physical therapist twice a week. Plus everything I do on my own, like muscle building exersises, ice, full stretching routines and very light riding (under 200 watts for under an hour).
Heavy overuse is the dianosis. It is not tendinitis but tendonosis at this point.
Ironic my job is to prevent people from getting these types of issues.
07-05-10, 09:08 PM
#12
Aluminium Crusader :-)
One possibility for medialis pain (in the muscle, not near the knee) is kinking of the external iliac artery. When effort is intense in the flexed position, the artery can be kinked, temporarily (i think) reducing blood flow to the inner areas, causing an almost cramp-type pain, especially in the medialis. It's not uncommon for cyclists.
The impeded flow doesn't show up on normal 'pulse' tests, where the regular doc detects the pulse around the ankles.
The impeded flow doesn't show up on normal 'pulse' tests, where the regular doc detects the pulse around the ankles.
Last edited by 531Aussie; 07-05-10 at 09:51 PM.
07-05-10, 09:21 PM
#13
Aluminium Crusader :-)
I had some chondromalacia about 15 years ago, and after 2 physiotherapists misdiagnosed it as patella tendonitis, the subsequent rest, stretching and icing for a month did nothing. A 3rd physiotherapist diagnosed chondromalacia, and the pain was gone in about 4 days after doing straight-legged kicking exercises with light weights.
Only a few lbs was enough for me -- 10, absoloute max. In fact, I started off with a heavy boot with a 2.5lb plate taped to it.
The way my physiotherapist explained it to me is that during normal quad contraction (knee extension) the middle quads (both?) pull the knee cap up and out of the way of the end on the femur, but when fatigue, overuse, or imabalances develop (or whatever) the firing order of the quads stuffs up, and the rectus femoris doesn't pull the knee cap up quickly enough, therefore, causing the cap to grind on the femur and the subsequent pain. As far as I know, it's somewhat common for this to occur amongst cyclist, coz the middle quads don't get worked as hard as the mediali and laterali
The straight-leg exercise somewhat islolates the middle quads (rectus femoris and vastus intermedius) and corrects the tone imbalance. The leg doesn't have to be dead straight, just so long as the dominant movement is hip flexion, and not knee extension -- and try point the toe in such a way as to affect upper quads, and not the groin
Only a few lbs was enough for me -- 10, absoloute max. In fact, I started off with a heavy boot with a 2.5lb plate taped to it.
The way my physiotherapist explained it to me is that during normal quad contraction (knee extension) the middle quads (both?) pull the knee cap up and out of the way of the end on the femur, but when fatigue, overuse, or imabalances develop (or whatever) the firing order of the quads stuffs up, and the rectus femoris doesn't pull the knee cap up quickly enough, therefore, causing the cap to grind on the femur and the subsequent pain. As far as I know, it's somewhat common for this to occur amongst cyclist, coz the middle quads don't get worked as hard as the mediali and laterali
The straight-leg exercise somewhat islolates the middle quads (rectus femoris and vastus intermedius) and corrects the tone imbalance. The leg doesn't have to be dead straight, just so long as the dominant movement is hip flexion, and not knee extension -- and try point the toe in such a way as to affect upper quads, and not the groin
Last edited by 531Aussie; 07-06-10 at 09:42 PM.
07-06-10, 08:20 AM
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About two weeks ago I started getting a tight pain in my right knee (occurs right where the vastus medialis, tear drop muscle on inside front of leg on top of knee) after I did three consecutive days of 3+ hr base rides. After I started getting the pain I took a few days off. Since I've done 2 rides and the pain comes back within 20-30 min even though I'm spinning light gears. The pain is only there when I ride and only occurs at the top of my downstroke. It still aches a few hours after riding but is usually gone the next morning. It doesn't hurt to do any other activity (walk, run, or lift weights). Anyone ever experience this? If so, what did you do to treat it? I've tried rasing my saddle and adjusting my cleats but to no avail. And yes, I've got an appointment with a doc but I prefer to be as self-educated about what may be wrong before I go see the doc.
07-06-10, 11:27 AM
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Heck i'll join in on this. After my third knee surgery in december i started having this very problem about a month ago. Happened during a 30 mile ride, I ended up having the wifey come get me.
Im 2x physical therapy right now as well and doing some of my own exercises at home that dont involve load bearing on the join. Like the SL Lifts.
Though, I am having additional symptoms not mentioned here. Popping and clicking!
Im 2x physical therapy right now as well and doing some of my own exercises at home that dont involve load bearing on the join. Like the SL Lifts.
Though, I am having additional symptoms not mentioned here. Popping and clicking!
07-06-10, 02:22 PM
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Patella tendonitis is sometimes, actually, misdiagnosed chondromalacia, which is what happened to me. Here's an old post on mine below. My dogs is cute, hey?! My 'old' physio guy told me that the following diagnosis and treatment has become slightly untrendy, and the more favoured and typcial PNF treatment is usually used, which isn't always appropriate.
LOL, I have had chondromalacia for a long time. It just has never really caused any issues. Thanks for the idea though. You never know! I am going to really bump up this particular exercise you posted tonight!!!!!!!! I will let you know how it goes.
Great drawing by the way. Looks like the dog/cat thingy is going in for a sniff though!! LOL.
07-06-10, 09:42 PM
#17
Aluminium Crusader :-)
Hey! It's CLEARLY a dog!!! 
I still do that exercise once in a while, when I get a bit suss' that my chondro is playing up.
I now use an old rollerblade, onto which I bolted two tiny (1.25lb) weights
I still do that exercise once in a while, when I get a bit suss' that my chondro is playing up.
I now use an old rollerblade, onto which I bolted two tiny (1.25lb) weights
07-06-10, 10:39 PM
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Well ive heard a story where someone got knee pain and when he got a BG fit from specialized it allowed him to ride with minimal pain.... might be worth a try
07-10-10, 09:44 PM
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I have been basically off the bike for 7 months now due to patellar tendonosis issues. It has been one of the wrost things I have ever had to deal with. Mentally more than anything because I was so ready to kick ass this season. I am not even sure if I will be able to race next yr at this rate.
I have done everything possible to get it better from Graston/Astym technique, electro therapy, ultrasound, stretching, all through my physical therapist twice a week. Plus everything I do on my own, like muscle building exersises, ice, full stretching routines and very light riding (under 200 watts for under an hour).
Heavy overuse is the dianosis. It is not tendinitis but tendonosis at this point.
Ironic my job is to prevent people from getting these types of issues.
I have done everything possible to get it better from Graston/Astym technique, electro therapy, ultrasound, stretching, all through my physical therapist twice a week. Plus everything I do on my own, like muscle building exersises, ice, full stretching routines and very light riding (under 200 watts for under an hour).
Heavy overuse is the dianosis. It is not tendinitis but tendonosis at this point.
Ironic my job is to prevent people from getting these types of issues.
Did you or anyone else watching this thread try cortisone injections for the VMO/tendon pain? I hate to do it, but I am looking for a quick fix to get me through an Ironman in 2.5 weeks that I have been training 8 months for.
07-11-10, 10:06 AM
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I'll pipe up, especially since I just posted my own post. I currently have Patellofemoral syndrome, and it sucks major ass. One ride with a too low seat and BAM, major overload. I would go see an orthopedist and get an exact diagnosis/gameplan, then take it from there. I wish I was riding horses again, the treatment for anything was half a bute tab and suck it up and get back on the horse! I've ridden with a broken back, toe, collar bone, etc. One silly kneecap goes awry and here I am completely down for the count!
01-02-11, 10:28 PM
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About two weeks ago I started getting a tight pain in my right knee (occurs right where the vastus medialis, tear drop muscle on inside front of leg on top of knee) after I did three consecutive days of 3+ hr base rides. After I started getting the pain I took a few days off. Since I've done 2 rides and the pain comes back within 20-30 min even though I'm spinning light gears. The pain is only there when I ride and only occurs at the top of my downstroke. It still aches a few hours after riding but is usually gone the next morning. It doesn't hurt to do any other activity (walk, run, or lift weights). Anyone ever experience this? If so, what did you do to treat it? I've tried rasing my saddle and adjusting my cleats but to no avail. And yes, I've got an appointment with a doc but I prefer to be as self-educated about what may be wrong before I go see the doc.
