Help Fibular head swelling

Conrad

Maximum Pace
Dec 8, 2014
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#1
This problem has been bugging me for ages - every time I go out for a decent ride I get swelling and pain in head of my fibula bone. I've done some research and narrowed it down to two or three possibilities.
livestrong.com has a pretty good basic summary of the situation:
" Fibular head pain can be caused by tearing or stretching of the lateral collateral ligament, which attaches the thighbone to the fibula. This injury causes pain, stiffness and swelling along the outside of the knee, as well as numbness in the foot. Pain in the outside of the knee can also be caused by a tearing of the lateral meniscus, which is a piece of cartilage located just over the fibular head, or by biceps femoris tendinitis."

I figured that other people had been through this before, so I'm keen to hear about your experiences with this and what you found to be effective in treating it. Recommendations for a good sports doctor would also be welcome.
 

D'Pioneer

Far beyond the black horizon
Oct 9, 2015
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#2
You are getting pain / swelling feeling on the front of the knee area, on the soft area below your knee cap?
 

D'Pioneer

Far beyond the black horizon
Oct 9, 2015
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#5
Obvious stuff;

-Are you stretching properly?
-Are you foam rolling your legs properly and thoroughly?
-Are you spinning with a high cadence and not pushing a massive gear at 70rpm?
-Are your cleats positioned laterally correct; too far in could cause stress on the outer knee area.
 

D'Pioneer

Far beyond the black horizon
Oct 9, 2015
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#7
Yes, the fibular head is swollen and the outer side is tender to the touch after rides.
Yeah, but it might not be. I thought I had cracked a Spinous Process, and it hurt to poke it, to the point where I was convinced it could not be anything else. Then I started properly stretching and mobilising the thoracolumbar fascia and the whole length of the trapezius muscle through FlowFit and ballet, and my definitely cracked Spinous Process suddenly didn't hurt anymore.
 

Conrad

Maximum Pace
Dec 8, 2014
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#8
Are you stretching properly?
I do stretch before rides, but I'm certainly open to recommendations for stretching routines.
Are you foam rolling your legs properly and thoroughly?
Haven't tried this, but will look into it.
Are you spinning with a high cadence and not pushing a massive gear at 70rpm?
Generally spinning at a decent cadence, could possibly make better use of the lower gears.
Are your cleats positioned laterally correct; too far in could cause stress on the outer knee area.
I'm using Shimano yellow cleats which allow a bit of leeway. I've experimented with this and don't think it's the source of the problem. By "too far in" I guess you mean the heal turned too far in?
 

D'Pioneer

Far beyond the black horizon
Oct 9, 2015
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#9
I do stretch before rides, but I'm certainly open to recommendations for stretching routines.

Haven't tried this, but will look into it.

Generally spinning at a decent cadence, could possibly make better use of the lower gears.

I'm using Shimano yellow cleats which allow a bit of leeway. I've experimented with this and don't think it's the source of the problem. By "too far in" I guess you mean the heal turned too far in?
1. FlowFit.

http://rmaxi.com/flowfit/fms/?page_id=303

2. Ahhhhh, I reckon this is your problem. Get a foam roller. You probably have a really really tight IT band, and very tight thigh muscles. Amazon yourself a foam roller. A few 1000 yen.

3. 90-100rpm. Stick to that and see how the knee feels.

4. No, lateral position. Not the angle, or heel in/out. The stance width, essentially. If it is too wide for you, this can cause pain on the inside face of the knee. Too narrow, and this can cause pain on the outer face of the knee.
 

Conrad

Maximum Pace
Dec 8, 2014
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#10
Thanks for your help, you've given me plenty to get started with. I'll look into it and report back :tup
 

D'Pioneer

Far beyond the black horizon
Oct 9, 2015
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#11
What leg is it? Is it your dominant leg (if you are right handed, this is usually your right leg)?
 

D'Pioneer

Far beyond the black horizon
Oct 9, 2015
458
229
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#13
Right, well do all the stretching and foam rolling, and get your cleats spot on first. If it still hurts after that, then start thinking about messing about with doctors.
 

GrantT

Maximum Pace
Oct 2, 2012
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Setagaya
#14
It could be biceps femoris tendinopathy/tendinosis/tendonitis (whatever they're calling it).

http://www.epainassist.com/sports-injuries/knee-injuries/biceps-femoris-tendinopathy
Symptoms of Biceps Femoris Tendinopathy
  • Tenderness at the site where the tendon enters the bone.
  • Swelling at the site where the tendon enters the bone.
  • If a person has biceps femoris tendinopathy, then he or she will have tenderness in the outer part or back portion of the knee. If the tendons apart from the biceps femoris are involved then tenderness is present medially.
  • There is pain with resisted flexion of the knee.
  • Stiffness of the knee after physical activity or exercise.
  • There is tightness of the hamstring muscles resulting in limitation of hip flexion.

This article has some ideas on changes you could try making to your position on the bike to see if that helps.
http://www.cptips.com/knee2.htm
The most relevant part:
"Cyclists who have biceps tendinosis report insidious onset of point tenderness at the tendinous attachment of the biceps femoris where it inserts on the fibular head.
Saddles that are too high or too far back can stress the biceps tendon. Excessive internal rotation of the cleats will also increase stress. Varus alignment of the knees or leg-length discrepancies may also contribute to posterior knee pain. If the saddle height is set for the longer leg, the shorter leg will be forced to stretch farther with each pedal stroke, increasing posterior knee stress."

I had problems at the insertion site of the IT band into Gerdy's tubercule for a while. Positional changes on the bike helped in the short term. In the long term, using myofascial release to loosen the muscles in the hip that are connected to the IT band helped. A similar approach is probably worth looking at.
 

D'Pioneer

Far beyond the black horizon
Oct 9, 2015
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#15
Yeah, getting mobility into your hips is key. Flowfit is all about this. Since starting that, I have progressed from having back pain every ride and knee pain, to being able to sit flat footed in a DQN squat for as long as I want, and have dropped my stem a couple of spacers. No more knee or back pain.

Scott Sonnon, who invented all that flowfit stuff reckons that the flat footed squat is key to the whole body being flexible and pain free. I am inclined to agree and since training myself to be able to do it, my whole body feels way better and is more balanced.
 
May 22, 2007
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Kawasaki
halffastcycling.com
#17
the flat footed squat is key to the whole body being flexible and pain free
This move also features in "Three Minutes to a Pain-Free Life" - many pages of self-absorbed waffle followed by a nice & quick stretch routine.

I'm sorry to hear you are having pain, @Conrad. Did you get a professional fit on your bike? That might be something else to look at.
 

D'Pioneer

Far beyond the black horizon
Oct 9, 2015
458
229
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#18
This move also features in "Three Minutes to a Pain-Free Life" - many pages of self-absorbed waffle followed by a nice & quick stretch routine.
Yeah those are the basics. I have gone through the whole FlowFit stuff, and found there are some other ones which are really good for riding, and the kind of specific tightness and inflexibility you get. Deep stretching the top and inside of the groin / hip is really good, as are the body weight one leg / one side balancing moves.