Annoying chondromalacia patellae and then I tried...

Gearoidmuar
Posts: 2358
Joined: 29 Sep 2007, 7:35pm
Location: Cork, Ireland. Corcaigh, Éire má tá Gaeilge agat.

How I'm getting on.. well much better.

Post by Gearoidmuar »

I got a goniometer which is a very cheap angle measurer and found that on my touring bike, with pedals I use, my bottom knee flexion angle was spot on, 30 degrees. This is the sweet spot in a range of from 25 to maybe 40. So I've checked that on all my bikes.
My knee is very good now. I can get a slight niggle in it after cycling or occasionally during the day but what I've learnt to do by trial and error is just one gentle squat to full squat position and it's gone. I'm back cycling up to 35m at the moment including hills.. I stopped doing these recommended exercises. I suspect that a lot of these are just a substitute for easing back and that it's the easing back which is the solution.
Gearoidmuar
Posts: 2358
Joined: 29 Sep 2007, 7:35pm
Location: Cork, Ireland. Corcaigh, Éire má tá Gaeilge agat.

Re: Annoying chondromalacia patellae and then I tried...

Post by Gearoidmuar »

Knee definitely fine now. No symptoms. Up to 45 miles with good hills.
What worked (I think).
Precise saddle height using goniometer (30 degrees).
Easing up and starting from when going down stairs asymptomatic.
Doing one gentle squat going down fully but not pushing up, when slight symptoms occur.
Gradual build up of distance etc.

This affliction was on the opposite side with the torn meniscus, 7y ago.
Gearoidmuar
Posts: 2358
Joined: 29 Sep 2007, 7:35pm
Location: Cork, Ireland. Corcaigh, Éire má tá Gaeilge agat.

Re: Annoying chondromalacia patellae and then I tried...

Post by Gearoidmuar »

Fine now for a month. This injury lasted (I checked my first post) 8 months!
Jdsk
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Joined: 5 Mar 2019, 5:42pm

Re: Annoying chondromalacia patellae and then I tried...

Post by Jdsk »

It's good to hear of the improvement.

Did that approach come from any particular source?

Jonathan
Cyclothesist
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Joined: 7 Oct 2023, 11:34am
Location: Scotland

Re: Annoying chondromalacia patellae and then I tried...

Post by Cyclothesist »

As I've gotten older my knees have become less forgiving of cycling without due consideration of their biomechanics. I've had patellofemoral syndrome stop me cycling for a while. It's not fun. FWIW here's what has helped me...

🦵Shorter cranks (less of an angle for the knee joint to cycle through, 165mm works for me)
🦶Moving my SPD cleats back also helped a lot, possibly by stabilising the foot on the pedal more, reducing the amount of ankling that occurs and removing tension in the calf
🧘Stretching regularly is important, particularly quads, calfs and hamstrings.
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531colin
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Joined: 4 Dec 2009, 6:56pm
Location: North Yorkshire

Re: Annoying chondromalacia patellae and then I tried...

Post by 531colin »

Moving the cleats back (ie. the feet forward) will load the quads and spare the hamstrings.
Moving the saddle back will spare the quads and probably load the hamstrings and glutes.
I found this by trying it; I have no idea why it works like this!
Cyclothesist
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Joined: 7 Oct 2023, 11:34am
Location: Scotland

Re: Annoying chondromalacia patellae and then I tried...

Post by Cyclothesist »

There's a lot written about KOP (knee over pedal spindle) and whether it makes any difference. Sheldon wasn't a fan. When I had a flare up of PF syndrome amongst other changes I made I adjusted my saddles to ensure KOP was as accurately achieved as possible. I think it was no more than 5mm of movement for each. That too has helped. Knees are complicated.
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531colin
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Location: North Yorkshire

Re: Annoying chondromalacia patellae and then I tried...

Post by 531colin »

I’m a fan of KOPS, as it says in my DIY bike fit page.
It’s a rule of thumb which works for lots of people; and most people are pretty similar in overall shape.
Start with saddle height, then setback, and you won’t go far wrong.
Set saddle height so there is a bit of bend in your knee at the bottom……funny isn’t it, nobody asks you to justify that, where’s the science behind it, etc.
Cyclothesist
Posts: 318
Joined: 7 Oct 2023, 11:34am
Location: Scotland

Re: Annoying chondromalacia patellae and then I tried...

Post by Cyclothesist »

531colin wrote: 15 May 2024, 8:42am I’m a fan of KOPS, as it says in my DIY bike fit page.
It’s a rule of thumb which works for lots of people; and most people are pretty similar in overall shape.
Start with saddle height, then setback, and you won’t go far wrong.
Set saddle height so there is a bit of bend in your knee at the bottom……funny isn’t it, nobody asks you to justify that, where’s the science behind it, etc.
So am I now, and I used your bike fit guide as part of my painful knee remediation plan. Thank you for posting it. A well deserved place in the 'too good to lose' index thread.
I made quite a few changes so it's hard to know which made the biggest difference but the combination of shorter cranks, rearward placed cleats, quads and hamstring stretches, saddle height optimisation and KOPS have made a huge difference.
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