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stress fracture and sprained quadriceps muscle (whoops)(6 posts)

stress fracture and sprained quadriceps muscle (whoops)JS Haiku Shop
Jan 26, 2004 5:28 PM
ok so after 2 weeks of going back and forth with the doc, since i couldn't put a finger on the pain, i finally tweaked it well enough this weekend to draw a sharpie marker circle on the inside of my left knee, but more on the leg and surrounding tissue, interior of the knee itself. limped into the sports med doc this afternoon and said "ouch" repeatedly as he pushed there. he re-looked at the knee xrays and said i've both sprained whatever quad muscle joins the end of the thigh bone (ok so i wasn't really listening after he said fracture, i know there must be a buncha bones in there), and his guess is that i've managed a stress fracture at the tip of said bone. he thinks it's a combination of sudden big-gear (fixed, mostly, LOL) big-miles at the start of the year, and the stresses from cross-country running and cyclocross racing.

damned thing doesn't hurt too bad on the bike, but when i get off to walk from shop to garage door, it's like pulling teeth without any whiskey. and running is completely out of the question.

he's signed me up for my fair share of physical therapy, where i look forward to being bent like a pretzel, deep-iced to a new level of soreness, and kneeded until it's not fun anymore. says it's ok to keep riding, albiet "easy".

aside from all this fun stuff, what can you guys suggest as far as hastening recovery? i have a couple big rides coming up in april and may, and would like to be back on my game by then.


re: stress fracture and sprained quadriceps muscle (whoops)paa
Jan 26, 2004 6:05 PM
HEY!!! Finally someone else with knee problems so early in the year. The pain on the inside tip of my left knee cap has been increasing with each ride. I'm just the opposite, hurts while riding and not a damn thing off it. A doctor friend of mine said, after I first mentioned it 3 weeks ago, it is just a case of tendinitis. And to ice it after each ride, take Motrin before and such. But I been doing all tempo riding since October and all of a sudden this "discomfort" comes out of nowhere. Also, I should mention that there is zero swelling whatsoever! The next thing was, I asked an MRI friend of mine what he thought. After a quick examination, he asked if I had bumped my knee on something solid or sharp. I told him I bump it all the time at my desk at work. He said I have a bonebruise and that they take at least a month to heal. A classic case. So I decided to rest it completely off the bike for a week. Went on the club ride last Saturday with no pain during the warm-up ride to the start. After the intensity picked up, I could feel the same twinge I've felt for the past 3 weeks. As a matter of fact, it was to a point I couldn't even soft pedal. Even took 400 mg of Ibuprofen when I woke up. I thought for sure something was broken or torn during the painful journey home. Now, with a month before my club's first target race of the season, I'm not sure what I should be doing. I tried the trainer today after work, and the pain was so excruciating after such a pain-free day walking around all day. As a matter of fact, I'm doing this century Feb. 8 with the club as a tune up for the upcoming season. If I can't even turn a few pedal strokes, how am I supposed to do a 100+ miles? I'm going to make an appointment with an Orthopedist tomorrow to get an official diagnosis. In the meantime, I'll ice it and rub it down with some sports cream before bed...take the rest of the week off the bike. Good luck J. I hope you recover quickly. Sounds like we both have completely different injuries, but I feel your pain.---paa
Jan 27, 2004 9:19 AM
Yours could be a variety of things, worst case scenario being a potential scope of the knee. You might have a small tear or free floating mass that when in a particular position (ie on the bike) it gets pinched or rolled, causing said pain. Plus, 400 mg of Ibuprofen isn't gonna touch that. When fastidiously running in high school as the token miler, 2 miler and 4x8 relay member... I got chondromalatia, which is a thinning of cartiledge, or roughening of the back of the kneecap which causes all kinds of pain and odd popping. My primary concern for you, if you aren't a runner is your positioning. I think there are some slight positioning modifications you can make to reduce the stressors on that portion of your kneecap and off the cuff, Im thinking you may be able to bring down that saddle a bit and perhaps bring it forward a tad, or you may go to shorter cranks... or, Im wondering if the knee in question may have the toe pointed excessively inward which would exacerbate the situation, but again... its JUST my opinion, and Im NOT a doctor nor do I even play one on tv.

As a somewhat of a local "prodigy" of a runner at a young age (ran 4:52 mile in grade 7).... I was abused by every coach I had, so that my body was basically falling apart by the time I was a senior in HS due to overtraining, and a lot of those problems have followed I am a avid reader and researcher on sports-related knee issues, especially those potentially caused by overuse and positioning. So, take what I say with a grain of salt, but might offer some tips or ideas for you to try and or float to your physicians as they may not be familiar with specific cycling-type malidies.

sorry dawg!!!funknuggets
Jan 27, 2004 9:45 AM
You are gonna be fine.

Hastening recovery, the standard ice and elevation, stretching, massage, and ibuprofen for the pain should be sufficient. I might even consider some supplementation of glucosamine chondritin, but just something to consider.

End of the bone stress fractures are pretty common, albiet not in the knee. However if you minimize the weight bearing running, lifting and standing out of the saddle, I think you will probably be back in action (in the small ring) in about 3-4 weeks if you dont press it.

The quad strain is actually in a good spot that will heal pretty quickly if you recover like a good boy. Its the deep quad injuries you have to worry about. I would avoid leg extensions at all costs, and would suggest some time in the pool, either doing running (with vest), or swimming. And sorry, no cannonballs....

And I realize that positioning is a bit different on cross/mtn/road, but check that cleat/saddle/fore-aft position to make sure you dont toe in on that side... or slide up a bit. The diagnosis about big gears is a fair theory but it would be difficult to pinpoint that as the only cause. Perhaps it was lingering from your brevet training stuff, but who knows.

I would think that in a week or two, you could hop back on the trainer, light to no resistance and focus on medium cadence spinning, mostly do one leg drills to work on the hams and hip flexors over the top of the pedal stroke and not the downstroke to keep your motion, and you will soon be back to your nefarious ways.

See my caveat in the post below... haha.

Best of luck, my man. Take a break

thanks, yoJS Haiku Shop
Jan 27, 2004 5:20 PM
good info. was on glucosamine/chondroitin before, stopped for awhile, and now am back on it. funny thing: the last ortho prescribed vioxx for the rest of my life, and this one didn't bother. from what i've read, though, vioxx et al. only prolong the healing process.

i'll re-check the cleat position on left knee per your descripiton. the **only** change this year on these shoes was cleat set. and the bikes are all the same, and no problems 'til 1/1, when i was riding a totally different set of shoes, cleats, pedals, and bike (steamroller, mtb/spd, etc.). come to think of it, that seems a common thread / a precursor to injury.

i'll take it light and spin easy. your "out of saddle" comments were right on, as i'm consistently more sore / incapacitated after more out-of-saddle efforts. and i'll stick to the geared bikes and look pedals/cleats, for now.

thanks again!!!!

Hey JS, I hate to hear this!Mike P
Jan 28, 2004 4:57 AM
What is the injury going to do to your spring schedule? Seems like you and a few others had plans to ride in some insane, long, painful, fun thing??? And what about 3St3Mtn?

Anyway, I hate to hear this. I have a couple of good friends in the PT business. One of the things you should find out from your Doc and the PT working you over is if they are using an aggressive program or a more conservative one. If aggressive, you might not want to over do it in your own out-of-PT recovery plan. If they want you to follow a more conservative plan, you might consider asking for a more aggressive one or ask what you can be doing in your out-of-PT work. Sounds like it boils down to the don't over do it rule with the addition of do not under do it either.

Best wishes for a speedy recovery!