Chronic Knee Tendinitis- Rehab Exercises?

[Juan Pelota]

Anyone have any rehab exercises for Chronic knee tendonitis? Preferably ones i can do at home, since I don't have a gym membership?

My pain only occurs while riding, only in my right knee, and only after about 20 minutes. I've tried different saddle positions, different bikes, to no avail. This has gone on for about two years. Pretty sure I need to rehab it. The pain starts on the outside of the knee,just beyond maybe even a little under the knee cap, but after a long ride can spread to other parts of the knee.

 

[FrankDay]

Anyone have any rehab exercises for Chronic knee tendonitis? Preferably ones i can do at home, since I don't have a gym membership?

My pain only occurs while riding, only in my right knee, and only after about 20 minutes. I've tried different saddle positions, different bikes, to no avail. This has gone on for about two years. Pretty sure I need to rehab it. The pain starts on the outside of the knee,just beyond maybe even a little under the knee cap, but after a long ride can spread to other parts of the knee.

Try shorter cranks.

 

[JayKosta]

If you wear cycling shoes, maybe the toe-in angle is wrong, or maybe your pedals & clips need more 'float' so your foot can do small angle changes as you ride.
Also perhaps your shoe needs a 'wedge' to adjust the angle of your foot.

If you wear regular 'street shoes', maybe the sole to too soft or flexible, and that can affect the angle of your foot on the pedal.

A simple exercise that has helped me is every morning I do this quick routine.
Stand on one foot and raise the other knee to about waist level.
Then rotate the foot (and also the ankle joint) 10 time clockwise and then 10 ccw.
Switch feet and repeat.
Don't try to go fast or hard, just easy motion.
If this causes any pain or it seems that something is 'wrong' with your knee then stop, and seek medical help.

Jay Kosta
Endwell NY USA

 

[Flux Capacity]

My chondromalacia (pain around the front of the knee, just under the cap) was misdiagnosed as patella tendonitis by 2 physiotherapists before a third one got it right. A month of rest, icing and stretching did nothing, but the third guy had me doing straight leg raises/kicks (knee slightly bent) with very light weights, and I was riding pain free in less than a week.

I'm not saying this is what you've got, but straight leg raises have worked wonders for me over the years.

I use an old roller blade with about 3 pounds bolted on where the wheels used to be, and I do 2 or 3 sets of about 15 to 20 reps.

They test for chondro (wear under the cap from it incorrectly rubbing on the femur during knee extension) by rubbing the cap from side to while the leg flat, then feel for any grinding, which indicates roughness (it's meant to be very smooth).

Cycling doesn't work the middle quads much, and the outer (lateralis) does more than the inner (medialis), so, after a while, the quad firing order can sometimes get screwed up, which effects the tracking of the cap during knee extension.

Then there's working on loosening all the outer stuff (to reduce tension on the outer knee) with stretching and roller work (with a foam roller, rolling pin and/or a tennis ball), such as the lateralis, IT band (especially, in my opinion), glutes and the tensor fascia latae, which is a small muscle just below the outside of the hip

 

[Alpechraxler]

When i ride lot's i also get some knee pain on my right side. it's more on the medial (inner side) of the knee just behind the kneecap where the quadrizeps femoris tendon is inserting and i'm almost 100 % sure that it is a hypertrophied plica that causes my symptoms. There is no cure except let a surgeon perform an arthroscopy and cut the plica.

 

[hiero2]

Knee pain - as you see from the above posts - causes, and cures, are multiple. It can be caused by too much cycling stress, or too little strength. It can be caused by riding position, or foot position, or crank length.

However, you can step through a series of different "cures" to find what works.

1. First rule is, if it hurts, rest it. Couple weeks, try again. In your case, I think we can say you've tried this.
2. Foot position: if you are using cleats, get a good bike fitter to check your bike and shoe position. This alone could fix your issues.
3. Third thing I would say is spin. Get a computer that gives you cadence, and never go below 85. Never. If you are going up a hill and go below 85, walk. If, after a month to 6 weeks, you see improvement, you can slide the cadence down occasionally, but not less than 75. After 6 months, you might have enough soft tissue strength improvement to go outside this. The key here is light pedaling, and plenty of it. I've seen people rehabilitate trashed knees this way. You could be causing the pain by pushing too hard (low cadence, pushing hard) on the pedals. That is a sure way to hurt yourself.
4. You might actually benefit from a weight routine. If you go this route, high reps/low weight is usually the correct path, not low reps/high weight.
5. This might be higher, but I don't think knee pain is often related to flexibility. However, yoga and similar stretching exercises are very important. Flexibility strengthens the soft tissues. Yoga and other "core" exercises can help balance muscle groups as well. Unbalanced muscle groups are more likely to cause back pain or muscle stress, but you can see it manifest in odd ways. Atypical, but possible.

The knee is a complicated joint, with a lot of stuff going on. Be cautious until you find things that help. If it hurts, stop doing it. It could be as simple as you overstressing the joint on that first hill outside your house, and not resting it enough to recover. Spinning and light weight reps will help to strengthen connecting tissue for a long term solution.

 

[Parrot23]

When you say "The pain starts on the outside of the knee, just beyond maybe even a little under the knee cap", that's exactly what I had episodically but with the left knee.

You're gonna laugh at how simple my solution was.

Quit riding knock-kneed. Don't laugh! Resist all temptation to move your knees inwards, even slightly at all, towards the top tube at any part of the pedal stroke. What cured me was trying to ride just a bit bandylegged, a bit like a cowboy whose been on a horse. On the upstroke think of aiming your knees outward toward the drops or break levers, type thing. Doesn't have to be much. Cured me totally.

I definitely have different leg lengths, with my left leg a little shorter. It did in my running (was landing asymetrically, or dipping on the left side). I'm guessing your right leg may be shorter.

In laymen's terms, what I think happens on the bike when you turn your knees in is that the femur then on every down pedal stroke (after you've rotated the knee inwards on the up pedal stroke) starts rotating back outward, grinding the kneecap in a type of figure of eight, lateral movement on every pedal stroke. When you push down in the power phase the knee starts rotating out, esp. at the bottom of the pedal stroke. Grind, grind, grinding the kneecap laterally every time.

I'm cured of all knee problems on the bike now. (Per the above poster, I'm also a spinner: climb at 90-95 rpm, never lower. If I do go lower, though, I don't have problems now, even when doing low 60 rpm power drills on an indoor trainer, if I keep my knees aimed outward just slightly.)

 

[my username is flish]

My own experience on this was:

1. knee pain
2. rest it....no improvement
3. rest it some more...no improvement (several months at this stage)
4. leg extensions with weights (careful, these are a dodgy exercise), single leg squats...some improvement
5. back on bike...still some pain
6. more strengthening etc
7. back on bike...still some pain
8. more strengthening in conjunction with intensive icing throughout the day....95% pain free but load of hassle icing the damn thing, plus still didn't feel right.
9. start stretching the outer quads several times per day...PAIN FREE

In my case I had changed my non-bike training over the years and as a result lost flexibility on the outer quad area, over time it pulled the kneecap sideways until it went bang one day. So rest, icing and strengthening would only do some much in my case, they were really just masking the flexibility problem. Hindsight is great...

If you're struggling to self-diagnose and have given enough time for your injury to calm down first, I'd advise trying a bit of:
-stretching
-strengthening
-icing
and then gradually eliminate the icing and strengthening but keep up the stretching.

 

[Frank222]

Just simple moving exercises and not more to avoid any further issues. You can include simply walking in exercise plan after you feel better enough for that and when you don't feel pain during walking..
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Cary Fitness