My winter/early spring training is being derailed by pain in my vastus medialis muscle of my left quad only. I don’t run. The muscle is sore almost all the time (unless I take mega doses of advil) and gets really sore biking (road) especially as the wattage and duration goes up. I have searched and read all I could, and have found rare reports here and there of similar pain issues and reports, but no solutions or suggestions. I have asked some of the bike fitters in town and the LBS and no one I asked had heard of it, or knew of a solution. I am sure the muscle is strained now (pain is in the muscle, not knee), but the question is what kind of position problem predisposes you to get this unilateral injury? Seat too high, too low, leg length, pronation etc? Thanks for any advice!
This is a difficult one. The immediate idea that comes to mind could be a limb length discrepancy. The negative effects this can have on training/performance is much more common with running, haven’t heard many cases with cycling.
I would consult a PT experienced working with endurance athletes.
Check the symmetry (or lack thereof) of your cleat set up in order to assess if something is way different. One cleat could be further forward or all the way in or twisted or something.
The VM in theory activates towards the bottom of your pedal stroke, so I would experiment with lowering your seat to see if that seems to help.
Have you tried massage on the VM?
I use speedplay zero’s, and have checked the cleats, I’ll double check to make sure nothing has moved. I am wondering if it is a limb length issue. I’ve tried massage with a roller and the stick. I feel the quad the most around the 3 o’clock position in the pedal stroke when the left foot is forward.
One other thing, which may be a longshot…rule out a saphenous nerve entrapment (google it). The pain from this will be a little more localized and more on the inner thigh but cycling can contribute to entrapping the nerve and cause some pretty bad pain at the entrapment site or in other places.
I’ve had a pain inbetween my VMO and knee cap(right at the junction) which has been treated as PFS for about a year. I’ve tried most of the conventional PFS treatments, as well as some less conventional without a certain resolution.
I might suggest checking for any variance in your knee tracking during the pedal stroke. I have seen several Medialis problems arise from tight hip angles causing legs/knees to differ. Q-Factor could also be worth considering (for instance if the problem arisen after switching pedal brand, or you have wide/narrow pelvis).
Hi, I have had exactly the same problem for 6/7 months now. But can not find a solution anywhere.
How are you getting on?
Have you found any solution?
Many thanks
I tried lots of things. Ended up lowering Saddle a few mm (3-5), taking it easy for a month or two, stopped getting out of saddle unless necessary, avoided sprints, and over time it got better. That muscle is only engaged in the last few degrees of knee extension. (out of saddle, or higher saddle would engage it more). Avoiding that extension seemed to help.
I also did straight leg isometric contraction of the quads as part of PT. contract for 10 sec each, (ten times a night). Same exercise for biker’s knee/patellar tracking issues.
Whatever bike fitters you are talking to do not know of issues with the VM, or have never heard of it, they are not bike fitters.
If you’re in Portland, go see Mike Sylvester http://bicyclefittingservices.com
I tried lots of things. Ended up lowering Saddle a few mm (3-5), taking it easy for a month or two, stopped getting out of saddle unless necessary, avoided sprints, and over time it got better. That muscle is only engaged in the last few degrees of knee extension. (out of saddle, or higher saddle would engage it more). Avoiding that extension seemed to help.
I also did straight leg isometric contraction of the quads as part of PT. contract for 10 sec each, (ten times a night). Same exercise for biker’s knee/patellar tracking issues.
Hope some of that helps!
Jeff
VM and quad tendon pain isn’t that rare…you really need to find a PT that understands bikes. About 98-99% of the bike fitters on this planet likely won’t know what to do with you.
There is no “ghost in the machine”; something is causing this, so you need to have it examined by someone who knows what they’re doing. I second the idea of at least finding a PT that deals with endurance athletes.
No one will be able to diagnose you remotely, so go out there and find that person you need to see.