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Tanasi wrote:I have not read the entire thread, but a few years back when I was doing mountain bike many stage races I started having a problem with ITB. This started out of no where - no new bike or setup. I also saw doctors physio etc. Eventually, on the advice of a fellow rider, I went to see someone about the setup of my bike. Turned out the entire setup was wrong, seat to high and too far back, stem to long, cleats in the wrong position etc.

I had the who setup adjusted and have not had a problem since.

can back this one up 100%.
have had pain in knees for a few years ,went to a few doctors with letters after thier names,xrays,physio all sorts of quack stuff then a guy rang me said he heard through a mutual friend i was having knee probs so offered to help.
end result a cure.
canned Shimano pedals and cleats.moved seat forward and lowered few riding tips and well on the road to a cure.

The Patella Femoral Syndrome is most of the time the result of muscles being too tight pressing the patella (knee cap) on the knee joint and causing irritation. It could also be due to a more serious injury in which the patella has been damaged on the back side (but scans/further examination should show this) or it could be that there is too much tension on the muscles by your bike being set up in the wrong way (see comment above, most of the time seat just a little too low).
You said you had an injury on your back and achilles prior to the PFS issue. That explains a lot to me: the balance between the tension on the muscles on the backside (calfs, hamstrings, back) and the tension on the muscles on the frontside (quads) is likely to be severly disturbed when injured. In this case I believe too much tension on the quads and especially when doing static exercises even the more. The answer: regular massages for a couple of weeks! Get rid of the tension on the quads.

hans_w wrote:The answer: regular massages for a couple of weeks! Get rid of the tension on the quads.

that mentality is no different to thinking taking panadol will cure migraine causes...


My partner is a practising sports massage therapist - She will massage the common tight muscles in cyclists, but they all keep coming back with the same issues unless they work on resolving causes....set-up, technique, muscle imbalance, knee tracking, poor neuro firing-patterns forcing the less muscles to do more work, over-training, range of motion, anthropometrical flaws, diet, injuries, joint degeneration, cycling....

point is: you can't give an answer over the net

cruiser wrote:

hans_w wrote:The answer: regular massages for a couple of weeks! Get rid of the tension on the quads.

that mentality is no different to thinking taking panadol will cure migraine causes...


My partner is a practising sports massage therapist - She will massage the common tight muscles in cyclists, but they all keep coming back with the same issues unless they work on resolving causes....set-up, technique, muscle imbalance, knee tracking, poor neuro firing-patterns forcing the less muscles to do more work, over-training, range of motion, anthropometrical flaws, diet, injuries, joint degeneration, cycling....

point is: you can't give an answer over the net

I reckn wot he said is much mor rite that wot the guy above said.

Especially the last line - go see a real person who knows about it

I'd suggest a multi-pronged approach.

Get your setup checked by somebody who understands cycling biomechanics like a physio who specialises in this stuff to eliminate any causes from that angle. I'd also recommend going to see a qualified massage therapist to get some specialist soft tissue treatment. Look for somebody who is diploma or degree trained and accredited with Massage New Zealand as a remedial massage therapist (http://massagenewzealand.org.nz/find-a-therapist/
). There may be some reason for the muscular imbalance in your quads such as trigger points (commonly known as "knots") which will cause ongoing muscular weakness and dysfunction until they are treated no matter how many squats you do.

I'm a massage therapy student in Chch so can't recommend anyone in Wellington, you could also try the New Zealand College of Massage (http://www.massagecollege.ac.nz/about/s ... linic.aspx) who run a student clinic in Wellington and would also be able to point you in the direction of a good therapist.

Good luck with the rehab!! cheers, Megan

I know a good therapist in wellington area

...also registered on MNZ, and through NZCM Kay Cruise

she's got marvellous hands if I must say so myself