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Discussion Starter · #1 ·
I've been struggling with a bad case of Patellar Femoral Pain Syndrome for several years (believed to be caused by a muscle imbalance) and I have a question. Theoretically, would it be possible to power through it? I mean just keep cycling hard for years untill the damned knee gets the idea? And yes, I do pt exercises daily, use a foam roller, spend lots of time stretching, have a professionally fitted bike, etc... What would most likely happen if I just went for it and forgot the pain?


Let's hear it! Thanks.
 

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PF pain syndrome is really just a garbage can diagnosis for pain behind the patella. It is not very specific. Lateral tracking problems are not common for bikers, since the pedal stroke puts them in the same range of motion as the PT exercises for the same problem. Usually tracking patients are told to ride a bike. You may have something else going on. Have you had an MRI?
 

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I have PF pain on and off also, on my left knee. I comes and goes, and seems to come on strong during mid-season (i.e. now), but later in the season it seems to go away on its own. Maybe I am increasing my mileage too quickly and my tendons/muscles around the knee eventually catch up? I had a professional fit (Wobble Naught) done on my bikes a few weeks ago and the fitter moved my cleats forward on my shoes. He said my saddle was about the right height on my mtn bike, but too high on my road bike. We lowered my road saddle but after one ride I raised back up a bit since it seemed way too low.

Ironically, it also seems to hurt more at the beginning of a ride, and as I warm up it tends to get less. Then the next day it hurts when I am sitting at work.

Anyway, it now seems to be going away as the season progresses. Maybe the fitting helped. I've found that a handful of ibuprofen before I ride and gradual warm-ups tend to help also. So maybe you can power through it? It scared me nearly to death when it started hurting for the first time last season but it never seems to get any worse past a certain point. So I am just riding through it for now until it gets worse.
 

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Nothing too crazy; about 80-120 miles/week when doing a lot of road rides, or maybe 30 or so trail miles if the weather and trail conditions permit. I did a lot of leg work (presses, squats etc.) in the spring but haven't been back in the weight room for at least a month (which lately has been more a function of limited available time -- i.e. if I had the time I'd do more weights but lately have been on the bike more.)
 

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I have a damaged right knee, and I found my PFS pain was less with my seat a little lower. I think it causes the patella to track a bit differently, so you can try that.

I just had ACLR 2 months ago and a little more meniscus removed and so far no PFS. I'm not pushing really hard as my muscles are a bit atrophied but I think maybe the problem is fixed. Perhaps the lack of ACL caused the knee to track wrong? I don't know.

I definitely had PFS; the doctor had me contract my quads while he had his hand above my knee cap. Wowie, the pain was intense when he did that.
 
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