Vastus Medialus pain, anyone else?

Nurse Ben · 2012-07-11, 01:32 AM

http://en.wikipedia.org/wiki/Vastus_mediali

It started hurting a little last year during the Black Bear Rampage, now it's popping up a little more often, mostly the left leg, a little on the right, hurts the most when resisting on the downhills.

I'm stretching, trying to give my legs breaks,not riding hard every day, but unless I ride flats it's really tough to ride trails without straining it.

Anyways, I guess it's the old age thing, so more slack time, more spin time, more brake time, if only I could have my twenty something knees and back...

MadFurai · 2012-07-11, 11:46 AM

Not yet. Are you using those disc brakes enough?

Verbyl · 2012-07-11, 03:31 PM

I'm not a doctor nor a unicycling nurse but I had great pains in my knees after riding for an hour or so. Once I lowered the seat the pain has not re-appeared.

knoxuni · 2012-07-11, 04:17 PM

rest is the second best thing for it but the first best is riding!

4umfreak · 2012-07-11, 06:10 PM

I had something like that when starting out but never anymore. I don't ride nearly as often as 'every day' so perhaps I'm getting enough rest between rides.

Kram Costello · 2012-07-12, 12:04 PM

The vastus medialis on my left leg is definitely the muscle I feel/notice the most during and after rides. I started unicycling in March, and I guess it was underused before then.

blueharmony · 2012-07-12, 04:05 PM

Where is the vastus medialis? I have some trouble with my right knee sometimes, but if I stand up while riding the pain goes away.

Nurse Ben · 2012-07-12, 04:41 PM

Check out the link I posted.

The Vastus Medialus is the tear drop shapped muscle you can feel/see just above you knee on the inside, it helps with leg extension. Pain in the VM is often associated with walking/hiking/running/biking up and down hills.

Mine hurts more when I use resistance pedaling on downhills, likely due to overuse. I am doing some specialized stretching. It is suggested that lings are good for VM problems...

jbtilley · 2012-07-12, 05:17 PM

Solution that works for me... mine are small so there's less to hurt.

Don't want to steal the thread by any means, but I don't feel like this merits it's own thread.

My problem is that I always get excruciating pain not in the vastus medialis but in that gap area that's in roughly the same location but immediately opposite of the knee. In fact I got a stabbing pain about halfway through the one ride I was able to get in at Douthat. Luckily I was able to stretch a bit and take some of the pressure off that day but the last time it truly acted up I thought I was done, done with unicycling. It was that bad. Took about two weeks for the constant pain to stop. If it comes as a sudden stab I have a quicker recovery. If it starts hurting several hours after a ride I know I'm toast.

I sure would love to know how to avoid that one... I've had a minor flareup of that early this week. Just a dull pain now as opposed to the sharp pain before. If it happens again I figure I'll just end up at a knee specialist.

Your issue is the muscle colored in red, mine whatever it is that is colored in blue.

Nurse Ben · 2012-07-12, 05:34 PM

Take a look at this picture:

Quote:

http://en.wikipedia.org/wiki/File:Knee_diagram.svg

Is your pain directly above the knee cap or on the outside of the knee?

jbtilley · 2012-07-12, 05:48 PM

I must have extra chunks, I don't see something definitive to compare to in that picture.

It's slightly above the kneecap on the outside edge. When it gets really bad it feels like a loose, narrow tendon about the width of a finger that slides back and forth when the femur pushes up on it from behind; even pops as it slides over the femur. To guess I'd say it's not that quad tendon that connects right down the middle, it's just on the outside of it down in that recess.

I've heard it may be the iliotibial band but I always second guess because I thought that would be more toward the outside of the knee.

bungeejoe · 2012-07-12, 06:15 PM

Don't just ride the brake. Power through the brake to change which muscles are taking the strain. If you are still applying back pressure on the downhills the knees get shock loading during pedaling similar to walking downhill.

A higher speed while in high gear also smoothes out the pedal loading on downhill riding. I find it hard to get in a rhythm in direct drive on descents.

Nurse Ben · 2012-07-12, 06:55 PM

Quote:

Don't just ride the brake. Power through the brake to change which muscles are taking the strain. If you are still applying back pressure on the downhills the knees get shock loading during pedaling similar to walking downhill.

Oh yeah, when it's possible, that's a good way to ride, I call it "gliding" the brake. But for technical downhills it really isn't possible to coast and let the brake be your primary source of control, which is where my leg pain becomes an issue.

When climbing, for the most part I can get up out of the saddle and find a comfortable position.

Running a high seat helps keep the pain down as well, but that doesn't work as well for technical downhills or for highly variable terrain.

bungeejoe · 2012-07-12, 08:37 PM

I do what I think you would call "technical downhills" in high gear with the brake on hard enough my hands will start to cramp while pushing the pedals harder than if it were a 3 or 4 % incline. Changes the knee loading so vastus medialus don't start to hurt and allows a lower seat height. Control comes from powering through the brake (not coasting on the brake).

If it gets real steep, rough, or drops I'll do the same using low gear.

Nurse Ben · 2012-07-12, 09:12 PM

Hey Joe, I think we're talking about the same thing, and when I can I do pedal into the brake, but it's just not possible to power through some of the stuff I'm riding without using backpressure to maintain control, so then the only alternative is to walk them, which I'm loath to do.

Right now I'm riding shorter distances, stopping when it hurts, trying to reduce the amount of steep climbs/descents, just until it stops hurting.

My guess is that I have a strain/tear, not bad enough to keep from riding, but enough to keep me from riding hard.

2012-07-11, 01:32 AM	#1
Nurse Ben XC Muni Join Date: Jul 2008 Location: Southeast USA Age: 47 Posts: 3,952	Vastus Medialus pain, anyone else? http://en.wikipedia.org/wiki/Vastus_mediali It started hurting a little last year during the Black Bear Rampage, now it's popping up a little more often, mostly the left leg, a little on the right, hurts the most when resisting on the downhills. I'm stretching, trying to give my legs breaks,not riding hard every day, but unless I ride flats it's really tough to ride trails without straining it. Anyways, I guess it's the old age thing, so more slack time, more spin time, more brake time, if only I could have my twenty something knees and back... __________________ I dream of hamsters and elderberries

2012-07-11, 11:46 AM	#2
MadFurai Skateboarder to Marine to Unicycler Join Date: Aug 2011 Location: Central Virginia Age: 42 Posts: 536	Not yet. Are you using those disc brakes enough? __________________ MadFurai's YouTube channel

2012-07-11, 04:17 PM	#4
knoxuni wes style!! Join Date: Jun 2010 Location: central ohio Age: 18 Posts: 4,664	rest is the second best thing for it but the first best is riding! __________________ Be a dumbass experience dumbass consequences its full circle of dumbass And then, do it again. That makes it an infinite loop!

2012-07-11, 06:10 PM	#5
4umfreak Registered User Join Date: May 2009 Location: Victoria, BC, Canada Age: 41 Posts: 644	I had something like that when starting out but never anymore. I don't ride nearly as often as 'every day' so perhaps I'm getting enough rest between rides. __________________ - 4umfreak █ 4u2c.it █ a simple, fun and free Url shortener with publishing to Facebook and Twitter. █ Geagle Search Engine █ a unicyclist.com inspired search engine. (kh longneak vs shortbeak)

2012-07-12, 04:05 PM	#7
blueharmony Kenny Cason Join Date: Feb 2008 Location: Snoqualmie, WA USA Age: 53 Posts: 471	Where is the vastus medialis? I have some trouble with my right knee sometimes, but if I stand up while riding the pain goes away. __________________ - Kenny

2012-07-11, 03:31 PM	#3
Verbyl Registered User Join Date: Aug 2010 Posts: 5	I'm not a doctor nor a unicycling nurse but I had great pains in my knees after riding for an hour or so. Once I lowered the seat the pain has not re-appeared.

2012-07-12, 12:04 PM	#6
Kram Costello Ranger Rec Join Date: Apr 2012 Location: Salisbury, Md., USA Age: 47 Posts: 81	The vastus medialis on my left leg is definitely the muscle I feel/notice the most during and after rides. I started unicycling in March, and I guess it was underused before then.

2012-07-12, 04:41 PM	#8
Nurse Ben XC Muni Join Date: Jul 2008 Location: Southeast USA Age: 47 Posts: 3,952	Check out the link I posted. The Vastus Medialus is the tear drop shapped muscle you can feel/see just above you knee on the inside, it helps with leg extension. Pain in the VM is often associated with walking/hiking/running/biking up and down hills. Mine hurts more when I use resistance pedaling on downhills, likely due to overuse. I am doing some specialized stretching. It is suggested that lings are good for VM problems... __________________ I dream of hamsters and elderberries

2012-07-12, 05:17 PM	#9
jbtilley Muni Foot Join Date: Jul 2011 Location: North Carolina Posts: 555	Solution that works for me... mine are small so there's less to hurt. Don't want to steal the thread by any means, but I don't feel like this merits it's own thread. My problem is that I always get excruciating pain not in the vastus medialis but in that gap area that's in roughly the same location but immediately opposite of the knee. In fact I got a stabbing pain about halfway through the one ride I was able to get in at Douthat. Luckily I was able to stretch a bit and take some of the pressure off that day but the last time it truly acted up I thought I was done, done with unicycling. It was that bad. Took about two weeks for the constant pain to stop. If it comes as a sudden stab I have a quicker recovery. If it starts hurting several hours after a ride I know I'm toast. I sure would love to know how to avoid that one... I've had a minor flareup of that early this week. Just a dull pain now as opposed to the sharp pain before. If it happens again I figure I'll just end up at a knee specialist. Your issue is the muscle colored in red, mine whatever it is that is colored in blue. Last edited by jbtilley; 2012-07-12 at 05:19 PM.

2012-07-12, 05:48 PM	#11
jbtilley Muni Foot Join Date: Jul 2011 Location: North Carolina Posts: 555	I must have extra chunks, I don't see something definitive to compare to in that picture. It's slightly above the kneecap on the outside edge. When it gets really bad it feels like a loose, narrow tendon about the width of a finger that slides back and forth when the femur pushes up on it from behind; even pops as it slides over the femur. To guess I'd say it's not that quad tendon that connects right down the middle, it's just on the outside of it down in that recess. I've heard it may be the iliotibial band but I always second guess because I thought that would be more toward the outside of the knee. Last edited by jbtilley; 2012-07-12 at 05:49 PM.

2012-07-12, 06:15 PM	#12
bungeejoe J Myers Join Date: Feb 2006 Location: Bellingham, WA Age: 56 Posts: 487	Increase brake usage… Don't just ride the brake. Power through the brake to change which muscles are taking the strain. If you are still applying back pressure on the downhills the knees get shock loading during pedaling similar to walking downhill. A higher speed while in high gear also smoothes out the pedal loading on downhill riding. I find it hard to get in a rhythm in direct drive on descents.

2012-07-12, 08:37 PM	#14
bungeejoe J Myers Join Date: Feb 2006 Location: Bellingham, WA Age: 56 Posts: 487	Powering is not "coasting" I do what I think you would call "technical downhills" in high gear with the brake on hard enough my hands will start to cramp while pushing the pedals harder than if it were a 3 or 4 % incline. Changes the knee loading so vastus medialus don't start to hurt and allows a lower seat height. Control comes from powering through the brake (not coasting on the brake). If it gets real steep, rough, or drops I'll do the same using low gear.

2012-07-12, 09:12 PM	#15
Nurse Ben XC Muni Join Date: Jul 2008 Location: Southeast USA Age: 47 Posts: 3,952	Hey Joe, I think we're talking about the same thing, and when I can I do pedal into the brake, but it's just not possible to power through some of the stuff I'm riding without using backpressure to maintain control, so then the only alternative is to walk them, which I'm loath to do. Right now I'm riding shorter distances, stopping when it hurts, trying to reduce the amount of steep climbs/descents, just until it stops hurting. My guess is that I have a strain/tear, not bad enough to keep from riding, but enough to keep me from riding hard. __________________ I dream of hamsters and elderberries

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