On going knee problems

[Robert Shillito]

Hi,

I am just writing this to see if anyone else has had the same problem or knows about it?

I have had a problem with my knee for nearly two years now, which I think was brought on by riding my mountain bike too much. I have had an mri scan and its all clear and been to a physio. He said that I had a problem with my iliotibial band. He said my glutes on one side had become lazy and needed stretching and strengthening. This all sounded great as I had found the problem, but I don't seem to be getting a lot of relief whenever I stepped up my exercise a bit. Two or three times now I have backed right off again, which is no good as I need to keep in shape. Whenever I do any exercise the glute tightens right up and I start to get the dull ache back deep inside my knee.

I guess the question I'm asking is should I push through the dull ache and keep up with the stretching and strengthening? Will it sort itself out? Does it take a while to reset the muscle? The physio seemed to think that it wouldn't damage my knee, but just cause an annoyance if I don't do the exercises.

The exercises I do at the moment are:

Stretching - go on all fours (crawl position) and bring my left leg (problem knee) around in front of the other leg. I then arch the back to pull the glute. This seems to work for me as I am quite limber so other stretches didn't seem to pull the muscle at all. BTW - if I do the exercise the other way I can hardly feel anything so I guess one side is a lot tighter than the other.

Strengthening - lay on my side and bring the left leg up and down. The leg is arched backwards so I can feel it working the glutes.

Any help or advice on this would be great

Cheers

Rob

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[physiobob]

You might find you need to sort out your bike setup a little. It took me a lot of tweaking to minimise my knee pain. I ended up putting some orthotics in my MTB shoes as well as I noticed on my weaker site I was excessively rotating my leg inwards during the push down on the crank. That was causing a torsion in my knee and then result was FAB.

It could also be an issue arising from the back that is causing a dysfunction in your gluteals and there the knee is a secondary problem. The popint here it to get your physio to check the mobility in your low back. The ITB is just a fascial component from the glutes and TFL so stretching/releasing them might be useful.

Are you using SPD's/clips or are you more of a downhiller?

[Robert Shillito]

Thanks for the reply.

I just use flat pedals. Had the bike setup properly about 8 months ago.

I get the problem from other activities too so hopefully the bike is ok now. To be honest, its better than when I try to do running. My problem is that I live in NZ Wellington, where the tracks are either flat (boring) or very steep. Doesn't give my legs much chance to warm up.

I guess its not going to magically get better, but wonder if its normal to continue training with a bit of discomfort while the glutes on the left side go back to normal. It's not very painful, just an annoying dull ache that's mainly there when I have finished doing the activity i.e. the next day.

Cheers

Rob

[physiobob]

OK, that rules out a few things. Maybe it is a strength thing and also perhaps lumbar spine related. Can you try going to a few spin classes a week. That will really help getting a good position for climbing the steeps. Best of luck

[namratasnv]

It is important that you need to take proper medication if there is such a problem with our knees like it is important for you if you better go with some exercises that are necessary for your knees otherwise it will become a big problem for you.

I do have on going knee problems that are really painful and it really puts me down so many times, so, I do some stretching and I got relaxed.

Thanks
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