Date: May 22
Mileage: 21.6
May Mileage: 102.7
Temperature upon departure: 57
Some time on the road today gave me a chance to watch my legs do their pedal thing. It was not pretty.
My left leg holds straight and strong over the pedal, but my right knee pulls rather dramatically to the left. How far left? It’s centimeters away from crashing into the top tube, that’s how far left. Continued effort to straighten my leg felt tight and unnatural - like I was purposely trying to pedal bowlegged. But my natural inclination is to pedal like I’m overcome by an urge to pee. Ugly, ineffective and definitely detrimental.
An effect of knee injury ... or the cause? Probably both. There seems to be some knee-cap tracking that is causing the joint to collapse toward the inside. There also is the issue of my wimpy quad muscles that are probably disproportionately wimpy to one another.
Either way, the damage has been done. My concern is what I can do about it. I realize quad strengthening is the best road, but I’m not sure what the best exercises are. Wall sits are OK. Squats make me wish I were poking myself with a sharp pencils instead. Any suggestions?
Also, does anyone know of a brace or maybe a taping technique that might correct such a thing? I have been doing some Internet research, but almost all of it leads me in the direction of changing one's running habits. Tracking is common in cycling, but there doesn’t seem to be much readily available information about how to fix it on a bike.
Probably time to call my physical therapist again. I am definitely not thrilled about all of the medical bills that have been rolling in lately. I think if I knew three months ago what I know now, I would cash in all those copays and sell my bikes and take one of those Alaska cruises.
On second thought ... scrap that. Better to go to Antarctica.
You'll obviously want to check with your therapist and/or doctor, but here is what has helped my knee:
ReplyDeletePatellar tracking problems are most often caused by an atrophied VMO muscle, which I'm sure you know. The best exercise that any therapist will suggest is leg curls (don't confuse w/ hamstring curls), focusing on the last 15 degrees or so of the lift. Isolate the leg, don't do both at once. On the last 15 degrees of the lift, go real slow. Put enough weight on that you feel a strain, but not so much that it's going to make you stiff/sore for days afterwards. I do reps until exhaustion, then work the good leg, then do another set.
Other "exercises" that I found worked well for me were balance exercises. You know those spongy half-ball-like things at the gym? Stand on that w/ your bad leg, and toss a weighted ball from one hand to the other. Do that for a minute or two, then switch to the other leg (so you maintain muscular symmetry). Do this a few times. This really helped me a lot, as the work you put into maintaining balance on that wobbly thing really strengthens the muscles around your kneecap, including the VMO.
There's another thing at my gym that basically looks like a big wooden plate, w/ a little half ball mounted on the bottom of it, another balance tool. I put both feet on opposite sides of the "plate", and then try to get it to balance up on that little point for as long as I can, which usually isn't very long. I do that for several minutes though, and it's a great addition to the previous exercise I mentioned. Make sure you stand on it w/ both legs though. If you do just one leg on this thing, you risk falling off and potentially injuring yourself worse.
Also, after a good bike ride or weight session, I wear my ACE knee brace (w/ the patellar locator/isolater hole) for the rest of the evening, so as to retain that muscle memory that I just worked on building. I don't know if that really helps or not, but seems to have done so. Could just be coincidence though, I suppose.
Hope that helps...
Good luck!
-Ryan
My brace has the patellar hole and metal reinforcement on each side of the kneecap. It really ensures my knee tracks properly and I wear it riding, running, lifting, etc., and I'm looking for one I can wear in the pool. I'm looking to get an even sturdier one, as the drugstore variety I bought is starting to unravel, though it's done it's job well so far.
ReplyDeletetake it easy, take it slow. the body has it's own way of healing... keep smiling!
ReplyDeletepeace out, yo!
You would be wise to get good therapy and advice despite the cost. Get yourself totally well so you can really enjoy the sport. Don't be penny wise and pound foolish.
ReplyDeleteFront squats, back squats, overhead squats, one-legged squats, hack squats...hmm, I sound like Bubba from Forrest Gump. (Check out some of the instructional videos at crossfit.com; you might hate them less with a bit of form adjustment. Are there any olympic weightlifting coaches in Juneau?)
ReplyDeleteAlso, deadlifts, lunges, the snatch and clean and jerk (and all their variations, i.e., clean pulls, push presses, etc.). All of the big, basic, whole-body lifts will help a lot more in the long run than the isolation exercises.
Jill: Whenever my legs get really fried near the end of a long race my knees always start to come in toward the top tube. In the old days of top-tube cable clamps, I used to cut the inside of my quads sometimes on the little bolt that held the cable clamp onto the top tube. It always seemed to happen around 80 miles into a 100 mile road race when I was fully bonked and nicely dehydrated. I suspect that quad and associated muscles are just weak because you've naturally been limiting their use and your neuromuscular system will need to get used to firing them properly again. It's probably just a matter of time and repetition. I think you are on the right track. "Patience, young Grasshopper."
ReplyDeleteGiven enough time; nature heals thy self. I've been dealing with knee problems forever. You need to rest (i.e., active rest - swim) and lots of ice (3 - 4 x a day). Once on the bike, spin a light gear. Good Luck. Great Blog.
ReplyDeletehttp://keepitstreetlevel.blogspot.com/
Jill,
ReplyDeleteI e-mailed some stuff you can do in your living room (sans weights) to your biketoshine address. I'm sure your PT will have better recommendations than I'm giving, but you never know.
Do you have a pool nearby? You could probably do some stuff in the water as well. (They tell me only tough people do water aerobics).
Best of luck,
Caloi