UniTrac,
I just re read your post more carefully and see the issue you are talking about WRT to the leg extension. My own study has taken me to look at the Q-angle side of the physiology world.
So is working the vastus medialis pointless? If I full contract the vastus medialis while weight bearing would that then be a closed chain exercise?
How about leg abduction and leg adduction? Good/Bad, right or wrong way to do them?
Knee Grinding Sound
I have developed grinding sound in my left knee. I can only hear it it when I slightly bent my leg while putting pressure on itā¦It doesnāt hurt but concerns me. It started doing it after one morning, intense Muni rideā¦There was no impact on the knee however. Itās been few months, still no pain. I also make sure that my hamstring are strong; Iām pretty well educated in that area. I have to say that my quads are getting lot of stress from ridding though. Just wonder if somebody has similar issue?
Some info expanding on what UniTrac said about VMO and some suggestions for exercises (and some mention of closed/open chain exercises)
Some links at the bottom as well.
Iām trying to find some good info about reducing Q factor, the radial angle of the leg.
Read along we are trying to figure some of this stuff out. What we have in common is problems with the knee while pushing down.
Like you Iām pretty educated on the topic but my knowledge keeps growing such as the links I just posted above, and UniTracās input.
Hi
hereās a link to some stuff on ITB.
The modern thinking seems to be that we need to find the weak link and strengthen that as much as just stretching the affected muscles.
I have achilles problems and do the Alfredson eccentric weight bearing stretching exercise which seems to work as long as I donāt get lost on the Ultra coursesā¦
Have a look;
http://www.sportsinjurybulletin.com/archive/0168-knee-injuries.htm
Cheers all
Youāre probably doing the leg exercises slower than when you ride the uni, where youāre spinning the wheel a lot faster than anything you could do on an exercise machine. Like you mentioned, you didnāt have pain when you did the exercises slower.
The exercises are also a lot smoother and less jerky than the unicycle riding. When the back pedal rises on a downhill, you have to quickly put more pressure on it. With the leg extensions and presses, thereās mostly constant pressure on the leg and knee.
Maybe your knee can handle the constant pressure OK, just not the ājerkinessā associated with the pedal suddenly rising and slamming into your knee via your leg. Perhaps concentrating on your technique, and making your pedalling smoother, would help ease the pain.
I noticed that you put the ball of your foot over the pedal. Do most people ride this way? I always put my arch directly over the pedal; it seems more stable to me that way.
(Another difference between the exercise machine and the uni: your foot has more support on the machine, a wider platform, and the ankle is probably not bent as much).
More info on VMO isolation (More than most people would care about, but posted for few who might like to read)
www.gastonrehabassociates.com/files/uploads/1040.pdf
Short version: trying to isolate the VMO is pretty much waste of time. it will get worked in a more general quad strengthening routine. For reference recall the cyclist picture I posted where I noted that the VMO was seriously engaged even though the leg was not near full extension.
Krjames: Lot of good info on ITBS, but other good info beyond ITBS.
The cool thing about knowledge is it can keep growing.
Thanks again UniTrac for putting me on to more current physio research. I think its going, no I know its going to be a help.
Just goes to show what works for one . . .
I found less knee irritation when riding on the ball of my foot. I think it allowed my leg to rotate to an more advantageous position for me. My feet really stick out to the sides so what works for me might not be best for everyone.
Hey Guys,
If you can identify the source, a possible solution may be possible. With patella femoral syndrome (PFS), the pain is felt posterior to (toward the rear) the knee cap (underneath). With patellar tendonitis, the pain is usually JUST inferior (toward foot) to the border of the patella. Both of these are very common for cyclist. They also have very different rehab programs. Patellar tendonitis can respond to a program of eccentric quad strengthening (emphasis on the lowering phase). For PFS hip strength is the emphasis. Where is your pain? Sorry if I missed it in previous posts!
Hi Unitrac,
My pain is in the middle to the inside part of the patella. Somtimes I have pain on the interior part of the knee on the joint itself(Sometimes the pain is not directly on the patella). When the pain is real bad the entire knee hurts.
Thank you for sharing your PT experience and information. It is great having you on these forums.
Unibabyguy made an interseting observation about my pain happening from quick jerky movement and how putting my arch directly over the pedal could help. I could try this for a few rides to see if my leg feels more stable. Do lot of people ride with the arch of the foot over the center of the pedal?
How do I improve my technique? My legs are usually very relaxed at the bottom of a pedal stroke at around the location where I sometime need to tense up immediately to apply negative pressure to slow the unicyle. Should I ride with more weight on my pedals?
Another thought is to improve balance skills to the point where you these
micro adjustments become fewer and fewer. What skills can help this? Idoling?
I found that tilting my foot down a bit at the front helped me. But that went along with learning to ride on the balls of my feet.
This allowed my feet to be part of the micro-adjustments and my pedaling got smoother.
YMMV
My pain is closer to top of the Patella and doesnāt feel very deep. Sometime it actually feels more like the insertion point of the quads.
I have had that pain just below the knee cap and slightly to the outside but it seems to have taken care of itself.
I havenāt been doing a lot of rehab the last couple of days. But I do stretch the front of my hips and groin every day. What little exercise Iāve been doing is more straight leg lifting and lower abs. Iām really concentrating on leveling my hips in everything I do.
I wasnāt necessarily claiming that putting your arch on the pedal would lessen the pain; that was just an observation from your picture. Iām far from an expert and you probably shouldnāt be making changes based on my comments because you could make it worse. I just thought Iād toss out some random observations.
Riding smoother comes with more practice; Iām not sure thereās anything specific you can do to speed that process along. How long have you been riding?
If you experience more pain (or irritation) on deacceleration than acceleration and you have either quad tendinitis or patella tendonitis, you may benefit from eccentric quad strengthening. Eccentric is when the muscle is Elongating (E). For example a bicep Ecc is the lowering phase only. A good example of a ecc only quad exercise is to take an elevator up and then descend the stairs in the following manner: Descend VERY SLOW and CONTROLLED, landing SILENTLY on the heel, not on the toe as in normal stairs. So controlled that you cant hear the heel touch down. Do not allow the hips to drop and most importantly do not allow the knee to āVā inward. The knee should continuously be aligned with the center of the shoe. Slow, Quiet, controlled. Every other day, start with maybe 3 or 4 flights and slowly, progressivly increase. Of course if you dont have an elevator you can walk up, doing the concentric phase, but there is some advantage to doing eccentric only.
Trying to do this irritated my knee. By the 2nd step I felt that familiar feeling and stopped right there. On the other hand walking up stairs flat footed does not irritate my knee.
One full week off from riding and still getting the occasional ping in my left knee. Iām hoping for 3 weeks of not riding and avoiding things that irritate will be enough.
I continue to rehab and change things around as I read more and discard things that have not helped or I feel I have maxed out on.
My legs are responding well to this advice.
> UniTrac, I understand that tendinitis is sorta like a tear in the ligaments.
Correct?
Should I feel pain when apply pressure to the ligaments around the knee?
This seems to be the right place to post this.
Itās been about 12 weeks since I decided to take some complete time off from riding and I havenāt posted much since then.
Itās not looking good for me and riding unicycles.
Itās quadriceps tendinitis. As other knee pain/irritation fell away the real issue became apparent.
I took 10 complete weeks off from Unicycling. NO riding, not one foot.
I have done enough stretches and exercise to write a small book. Some of it I devised myself as I learned more about what works for me and what doesnāt. Some of those things have been the most helpful.
I made mistakes along the way but learned from them. I adapted, I added, abandoned things that had lost their usefulness, brought things back when needed.
I do some type of rehab work just about everyday. Lately there is no real rest day. A rest day is a light day. My life is rehab. There is almost no daily task I have not worked some kind of stretch or exercise into.
There is not a body-area below my nipples that has not been the target for stretching and strengthening. From the Extensor Digitorium Longus in the foot (yes, really) to the Obliques in the torso.
Iāve also lost 30lbs since March and have Super Feet footbeds in the two pairs of shoes I wear most which includes my riding shoes.
No stone left unturned.
About two weeks ago (at the end of the 10 weeks) I rode twice a couple of days apart on my 20". Only 1/2 a mile on level ground. Things seemed Ok but I was proceeding carefully. A couple of days later I rode my 29" with short cranks for 1/2 mile on level ground. I mean dead level, its an airport.
A couple of days later I went a little further but less than a mile, I felt a super slight twinge so hopped off.
After these 4 rides I detected some irritation so I laid off riding for 5 days. The irritation was almost gone the next day and completely gone after 2 days.I gave it 3 more days with no riding.
I did some web searching to review things Iād forgotten and from that made some changes based on some advice for cyclists.
I put longer cranks (165ās) on my 29" and raised my seat to adjust for the crank length and just a bit more to make it right for pedaling on the balls of my feet.
A couple of days ago I rode one mile on flat ground with the new 29" setup. The knees felt good. Felt strong, like they were well lubed, working in the middle of their range, etc. (as Iāve advanced my knees rarely complain while Iām doing something, itās later they speak up)
Then yesterday I did the same ride with no sense of irritation. During those rides I did not try to ride slow or fast, just focused on being smooth and minimize what I call micro-braking.
Today my left (always been the worst) AND the right knee are a little tweaked out. The right knee hasnāt complained in weeks.
Itās small but itās there. I feel it when I push back from my desk in my chair and when I walk down the few step in front of my house.
F*! F*! F*! Excuse my French. Itās a blow after 12 weeks of works. Untold hours of work, only possible because Iām unemployed and single. Most days approach 2 hours and that does not include icing/massage or more research.
Iām going to give it two more weeks and at that point take a hard look at my progress.
I have a few advance stretches that Iām still waiting for benefits from. Here is one just to show you the level Iām getting to: http://0.tqn.com/d/sportsmedicine/1/0/t/7/Noe_Montes_Getty.jpg
I wish I had her for a stretching partner.
I could also be doing more ab/core work (side plank especially) and pick up my quad stretching again.
Iām also not out of ideas about riding.
One is to come back and stick with the 20" for awhile and/or just work on riding backwards for awhile. I mean just backwards. Find something to push off of and keep trying. Walking/running backward (called retro walking) has been helpful. Maybe pedaling backwards will be possible and maybe even beneficial.
But Iām not optimistic. It took so little to cause irritation again.
Maybe I will be wrong with this fitness/bio-mechanic base iām putting down. I keep learning more and more. As as one muscle lengthens, other tight muscles are revealed, but iām running out of muscles.
If you read this far, thanks.
Wish me luck.
No one replies to this inquiry?
In case Scha is still watching this thread. I would say if you feel like you are in recovery phase those are candidates for massage/myo fasicial release.
While iām driving I look for those sore spots and work on them with my thumbs. Itās been helpful for me.
Did you just do stretching for those 12 weeks?
Do you own a bicycle? If so, ride that instead for a while (with clipless pedals) , and stay off the unicycle for a longer time. I found that the best things for reducing knee pain were bicycling and using the leg press at the gym with my feet slightly pointed outward \ / to work my inner quads, and making sure that my feet are high up on the leg press so I press with my heels not my toes. Also, dead lifts have really helped out balancing my legs by working my hamstrings.
So yeah, look into bicycling and leg workouts at the gym. Stay off the unicycle for now.
