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Anyone had quad/patella tendonosis issues with any advice? Mine’s not been right since partial knee replacement 2.5 years back. Well it's been right-ish, then bad and right and back and forth as is the way with such things it would seem!
Two weeks back after steady 50k road ride it really flared up and so did my knee overall.
Currently stretching quads, hams and calf’s and doing slant board eccentrics and wall sits.
Been trying an easy 30min spin on the turbo occasionally, but not sure if that’s a good thing to do, but I am keeping the cadence up (85-90) and watts low (150-60w, ftp~ 260w). And some 20-30min flat walks on pavements around the block sort of thing.
Trying not to over do it on the rehab exercises too though, which is hard given its about all I’m doing!
I did see a physio initially for assessment btw, but can't afford repeat 'check ups' now I've had it assessed and some exercises.
Sorry to hear that longdog, I'm just getting over a wee flare up of my own, brought on by two heavy turbo sessions on consecutive days and pushing lower cadences than normal on the second one.
Can't offer much advice, mine has taken 2 weeks and is just about OK again, but I did remember that older dumb turbos in particular might not be great for knee issues, the smaller flywheel have less inertia so require to be accelerated again with every pedal stroke! Might be better doing your easy spins on the road?
Cheers 13thfloormonk, good to hear yours is easing off.
I have a smart trainer, directo elite, so assume that's not an issie. I'll not get an easy road ride here though, and definitely not at the moment with the gales and snow we've had 😂.
At least on the turbo I can stop as soon as I think I'm doing too much. I probably need to drop the power on the turbo though, but I was trying to at least have it high enough for some cardio benefit.
I had this a few years back (but no knee replacement complications).
Its back to normal now and I don't get any flare ups.
What 'may' have fixed it is getting a variety of other exercises in and also stretches and core training.
I think my issue was being caused because my body had become unbalanced from just cycling.
After a recommendation on here I follow this a couple of times a week.
I also do additional lower back stretching and foam rollering of quads and calfs.
3/4 30 minute sessions of weights a week (wendler 531 program)
A bit of running. Maybe 3 days a week in winter, 25km total ish. but this drops to once or not at all in spring/summer as cycling takes over.
Hope you get it sorted, it's horrible.
Cheers El-boufador, good to hear you got on top of it. The annoying thing is last year before lockdown I'd got up to doing a hilly century. I think too much, and too intense turbo originally set it off again over this winter.
Yeh got those stretches or variations on my programme and been looking at Martin Koban videos and the currently popular knees over toes guy stuff.
Running isn't an option with my knee anyway, but normally as well as cycling I do a lot of walking/rough hiking which has been cut down to local wanders at the moment.
I had a pretty bad case of patellofemoral pain syndrome and went to a few different physios about it. Got a good bike fit and then after that what has actually helped is doing glute activation exercises along with stretching quads, hams, hips, and IT bands, and then foam rolling them afterwards. Doing this every day without fail helps.
Definitely look up glute activation exercises. The physio basically told me my left glute was asleep and not really being used like my right one, I didn't even realise until he showed me. It has helped a lot.
I gave my self patella tendonitis from too much bar well squatting. Took over a year of rehab but eventually back better than it was before. I saw a sports physio who gave me lots of eccentric loading exercises which I did pretty much every day for 12 months. Long old slog, but got there eventually.
As a general rule tendons need mild exercise to heal, rest doesn't make much difference.
I'm currently rehabbing a mild hamstring tear (over use) which I did last December. That has healed much better, still not 100% but I can ride 100km as long as I don't push too hard, so can't really complain.
As a general rule tendons need mild exercise to heal, rest doesn’t make much difference.
I'd read this too, instead of 'RICE' (REST ice compression elevation) it's now POLice (PROTECT, OPTIMAL LOADING, ice compression elevation). I rode through a sore tendon on a 3 day gravel tour, just meant smaller gears and twiddling hills with heels dropped instead of monstering everything, by day 3 it was OK again.
I wonder if my current flare up was actually related to my low back flare up, all brought on by too flat a saddle, tilted too far back, meant I was using core to flex back unnaturally to take weight off front of saddle, which I've since learned also 'dis-engages' glutes to a degree...
OPTIMAL LOADING
My physio says that pain in the range 1-2 (out of 10) whilst doing rehab is OK.
However, if the rehab is making it worse day by day eg first thing in the morning then you need to back off.
With my patella, it was always painful first thing in the morning walking downstairs to make tea, which apparently is normal. Once you warm it up a bit, the pain gets masked and it feels better but isn't any different. NB Walking down stairs first thing in the morning should be 100% pain free in all joints!
Cheers all.
Yeh I seem to have the right things at hand in terms of exercises and stretches etc. but maybe the wrong balance of trying to do too much of them. I did read about pain level not been more 24 hours later, the stairs thing is a good guide! Aching just as I'm sat right now .
Sounds like I need to hold off even the easy turbo spins and just do what walking as required for now, but to find just the right amount of the eccentric and stretches that allows it to progress healing.
Did any of you totally cut out the cycling, even gentle? Obviously hilly cycling or hiking isn't a good idea, but a few 30 min light spins a week for some semblance cardio/blood flow?
Did any of you totally cut out the cycling, even gentle?
I cut it out for 7 days. I'm obviously on a slippery slope into being an exercise junky as it was really difficult to stay off the bike for the full 7 days, kept thinking I could sneak out and do a gentle turbo spin or something!
Seems to have helped, spent the seven days doing a lot of low back mobility stuff and on/off painkillers (for back, not knee) and a couple of brisk walks with wife at lunch. Also gave knees a wee rub with some deep heat every morning just because (more for the massage/blood flow than any faux medical benefits of deep heat).
I'm discovering my new local area and it seems impossible to avoid hills, so no ride is truly easy enough I think.
Cut it out for 7 days?!😂 I may not have mentioned that I managed to get on the turbo and at least turn the pedals over 7 days after my knee replacement.
My name is Kevin and I am an addict 🤣 I'm not joking really 😣
But yeh, seems like I need to do as you've done.
Paton, thanks for that video,but it's not a fit issue. I know what the issue is, it's unresolved trauma to my quad tendon from the knee replacement
Unresolved as, unlike 13thfloormonk, I've been too stupid to stop, rehab it properly and then build up cycling again, so it's got bad and I've eased off a while,and then built up again until it gets too bad, and I'm back to square one.
At this stage I guess I'm asking, in others experience, do I really need to stop doing any cycling/hiking all together and just balance the physio exercises and stretches, and how to gauge how long that needs to be?
It would seem I probably do need to and to be be patient, and not over do the physio to make up for the lack of other exercise. But that doesn't help with my mental health or the demands of Chub Club!
At this stage I guess I’m asking, in others experience, do I really need to stop doing any cycling/hiking all together and just balance the physio exercises and stretches, and how to gauge how long that needs to be?
There are no hard rules, you just need to use trial and error to slowly introduce activities back in at low intensity and low duration eg 1km walk on pavement. Next day, is your knee worse or the same. If the same then after a few days try 2km etc. Slowly figure out what you can get away with. Bear in mind that every time you over cook it you set your recovery back a bit and need more rest, so err on the side of caution. As for hill walking, use poles to take some load of your knee.
Cheers Footflaps, a lot more conservative than is my nature as I feared then really 😔
Other than some ice massage it's just been a slow flat couple of km wander with my wife today as it's been pretty achy after over doing it yesterday with eccentrics, stretches and 30min Z2 zwift. So that's me one step back already 🙄
I have poles I use for rough walking.
Must do better and rest up this weekend!
Cheers Footflaps, a lot more conservative than is my nature as I feared then really
You may get away with a lot more, but the worst thing you can do is start a 20 mile hike, get half way and your knee swells up like a balloon, realise you've totally screwed up and still have another 10 miles to go.
You'll probably find your recovery is two fold, you'll get 80% there in half the time and the last 20% takes ages. However, once you get 80% there as long as you're careful not to overcook it, you can still do an awful lot.