Stretching is a bad idea?

[Lanterne Rouge]

I have been reading this article about the muscle imbalance but following lines confused me to hell:

The other side of abnormal muscle inhibition is tightness (abnormal facilitation). It often occurs as the body compensates to an abnormal inhibition that recently occurred. This tight muscle is often noticeably uncomfortable and sometimes painful, and it can impair movement by restricting flexibility. Tight muscles are shortened, making them candidates for mild, slow stretching; however, in most cases this would be treating the secondary problem as the cause is usually the weak (inhibited) muscle. In addition, in attempting to loosen the tight muscles through stretching (which is not recommended), you risk weakening the inhibited muscle more (because it’s already over-stretched).

So, we shouldn't stretch the tightened muscles? I have been reading everywhere that foam rollers help to alleviate knee pains but according to this guy maybe it is a temporary relief and it could make the matter worse in long term. You can read the whole write up here:

http://www.philmaffetone.com/muscle-imbal

[vickster]

I prefer to discuss this stuff with my physio. Are you seeing one ?

[Lanterne Rouge]

No, i don't see a physio.

[vickster]

I'd suggest that as a next step as it is certainly possible to do more harm than good when embarking on knee rehab

[Lanterne Rouge]

I am sorry. I didn't get it. Stretching won't do any good? I have inflammation on my both knee atm. I ordered a foam roller yesterday and was planning to do some stretching tonight. Should i throw that idea out of the window? Should i only do strengthening exercises for my VMO?

[vickster]

I am suggesting you spend a few bucks and see a sports physio who understands cycling who can give you an exercise and stretching programme that is appropriate your personal knee situation.  No one on the internet can tell you what you should do or not do.  You need a trained professional who has seen your knee to do that.  So ideally not a doctor hundreds of miles away who has consulted by email either.

What country are you in? Is it not possible to access a physio? Get a referral from your doctor?

[Lanterne Rouge]

I'm in Turkey. It is almost impossible to find a sports physio. These specialists are working for professional athletes here. Besides, it is harder to find one who knows about cycling. That's why I registered to this forum and seeking help.

Anyway, i tried the foam roller just now but it is too hard on my bones. Maybe the material is a bit denser than it should be or it is due to the fact i am weaker than most people. It feels good on my hip muscles but IT band, no.

[vickster]

I would go back to your specialist for further advice.  I don't think anyone on the Internet will be able to tell you what to do.  On here, we are all patients with varying degree of knee issues and can share experience but give no medical advice which could be completely wrong

Are there no physios who work with people after operations, injury etc?  Perhaps that is your orthopaedist, in the UK they are surgeons and once they are done with their advice or treatment, they refer you to physio for exercises /rehab

With PFS and other knee issues, you will likely need to continue with the exercises for many months, there is rarely a quick fix.  Usually this will start with the basics, settle things for a while and then move on

Good luck

[Lanterne Rouge]

Ok Vickster. Actually i got an advice and "online examination" from a physio two weeks ago. I contacted her through e-mail and sent her my MRI images. She checked it out and told me i have both patellar tilt and malalignment. She also told me that i have "functional hyperextension loss" and this is the cause of patellar disfunction. She said that my knees weren't straightening. They look straight to me when i lay them down but maybe they don't extend as much as they should. She advised me to do this exercise with my legs straightened and a pillow under my heels i will press down with my knees for 5 secs. 200 reps a day. I had seen two orthopedists before but they never mentioned about patellar tilt or malalignment. They had just told me i have PFPS and advised quad strengthening exercises. I am confused because of that. I will follow this knee straightening exercise and see how it goes.

[allyd]

Like Vickster says – you need to get a hands on (not online assessment) from a physio (or another orthopedic professional). The biomechanics, muscle imbalances, and gate/form/technique of all individuals is unique; and can only be fully understood by being in the same room as the individual. They’ll be able to check your walking gate, how your knee cap tracks throughout an entire range of motion, and which muscles are/aren’t firing. MRI’s/Xrays are just a piece of the puzzle. While many here can offer pointers and good advice; The problem we still face is that no two knees are quite the same. What works for one may not be the solution for another.

When you go see the professional – make sure you recount everything you’ve been told/diagnosed about your knee to date. The more info they have, the better chance you’ll have at finding a solution.

As for the hyper extension loss. When you sit on the floor with your legs straight; does the back of your knee touch the floor? When you put a pillow or something of similar height under your heel… does the back of your knee still touch the floor? If the answer if “yes” to both of these, you likely do not have any functional hyper extension loss. If the answer is “no” then that is something you may need to look at closer. My understanding is that ‘normal knees’ have anywhere from 0 to -10 degree hyper extension.

[Lanterne Rouge]

Like Vickster says – you need to get a hands on (not online assessment) from a physio (or another orthopedic professional). The biomechanics, muscle imbalances, and gate/form/technique of all individuals is unique; and can only be fully understood by being in the same room as the individual. They’ll be able to check your walking gate, how your knee cap tracks throughout an entire range of motion, and which muscles are/aren’t firing. MRI’s/Xrays are just a piece of the puzzle. While many here can offer pointers and good advice; The problem we still face is that no two knees are quite the same. What works for one may not be the solution for another.

When you go see the professional – make sure you recount everything you’ve been told/diagnosed about your knee to date. The more info they have, the better chance you’ll have at finding a solution.

As for the hyper extension loss. When you sit on the floor with your legs straight; does the back of your knee touch the floor? When you put a pillow or something of similar height under your heel… does the back of your knee still touch the floor? If the answer if “yes” to both of these, you likely do not have any functional hyper extension loss. If the answer is “no” then that is something you may need to look at closer. My understanding is that ‘normal knees’ have anywhere from 0 to -10 degree hyper extension.

Thanks a lot. I'll check my knee extension when i got back to home. But when i look at my knees from the above when they are bended i can see my kneecaps look really weird, they are pointing outwards. I don't know if they were like that since i was a child because i didn't pay attention to it before.

[Lanterne Rouge]

I checked my knee extension this morning and my answer to your questions is yes or almost to the first one and no to the second one. So what does that mean?