Obviously cleat adjustment is a super individualized endeavor, and I know that bike-fitment over the internet can be...problematic. That being said, I wont hold any idea against anyone and I am just trying to reach a broader audience.
The question: Any advice on how to adjust cleats/bike to have greater emphasis on medial quad recruitment? heel/out heel in toe/out toe in? Lots of talk about IT band or medial knee pain, less about this particular issue, but not a too uncommon problem. It seems the only thing I can reliably find in the literature is to raise saddle enough to have enough extension to bias the VMO more, but I am at the limit in that regard now.
The longer story - I have a bum left knee with significant hyper-mobility and PFS lateral with patellar maltracking which has bothered me for the better part of 5 years now. Other leg is bullet-proof. Both road bike and tri bike are comfortable excepting this knee. Fallen into the same cycle over and over again, After letting things settle down pain wise, I get back on the bike, it feels good for a couple rides, and then I think my lateral quads gain more strength and shortly later I start to recurrently dislocate my kneecap(pops out over the lateral part of the knee) going from flexion to extension. More of a problem on the trainer.
I have and continue to foam roll the shit out of the lateral quad, I have had 2 formal bike fitments and 2 cleat alignments, I have used speed play historically, but have experimented with shimano yellow to try to restrict movement (mostly gave more pain). Have tried down 155mm cranks (im 5'7''). Have tried cleat forward and way back, have tried arch inserts, have tried wedges to 3 degrees, have tried shorter pedal spindles, have tried pedal extensions, have raised saddle to the point of getting bilateral back of knee pain and numb junk, I have tried saddle way back. Earlier this year I had a an arthroscopy with lateral lengthening (weaker version of lateral release but better for hypermobility, apparently). Lots of VMO exercise, done 20+ weeks of formal physiotherapy before and after surgery all this to to try to get my dang leg to pull the kneecap in the right direction. Surgeon thinking about something more drastic (tibial tubercle osteotomy) but since this seems to be isolated to riding and that is a dramatic surgery, I'm wondering if anyone has experience with fitting as a solution. Its possible I didn't give any one adjustment enough of a chance before changing it up.
thanks for reading.
The question: Any advice on how to adjust cleats/bike to have greater emphasis on medial quad recruitment? heel/out heel in toe/out toe in? Lots of talk about IT band or medial knee pain, less about this particular issue, but not a too uncommon problem. It seems the only thing I can reliably find in the literature is to raise saddle enough to have enough extension to bias the VMO more, but I am at the limit in that regard now.
The longer story - I have a bum left knee with significant hyper-mobility and PFS lateral with patellar maltracking which has bothered me for the better part of 5 years now. Other leg is bullet-proof. Both road bike and tri bike are comfortable excepting this knee. Fallen into the same cycle over and over again, After letting things settle down pain wise, I get back on the bike, it feels good for a couple rides, and then I think my lateral quads gain more strength and shortly later I start to recurrently dislocate my kneecap(pops out over the lateral part of the knee) going from flexion to extension. More of a problem on the trainer.
I have and continue to foam roll the shit out of the lateral quad, I have had 2 formal bike fitments and 2 cleat alignments, I have used speed play historically, but have experimented with shimano yellow to try to restrict movement (mostly gave more pain). Have tried down 155mm cranks (im 5'7''). Have tried cleat forward and way back, have tried arch inserts, have tried wedges to 3 degrees, have tried shorter pedal spindles, have tried pedal extensions, have raised saddle to the point of getting bilateral back of knee pain and numb junk, I have tried saddle way back. Earlier this year I had a an arthroscopy with lateral lengthening (weaker version of lateral release but better for hypermobility, apparently). Lots of VMO exercise, done 20+ weeks of formal physiotherapy before and after surgery all this to to try to get my dang leg to pull the kneecap in the right direction. Surgeon thinking about something more drastic (tibial tubercle osteotomy) but since this seems to be isolated to riding and that is a dramatic surgery, I'm wondering if anyone has experience with fitting as a solution. Its possible I didn't give any one adjustment enough of a chance before changing it up.
thanks for reading.