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Over 4 years I developed a chronic case of patella femoral syndrome. I believe started with the way I pedal the bike. After I started jogging, the problem got chronic.

I have a pretty big muscle imbalance in my quads. I favor the outside quad muscles over the inside muscles, which is causing my kneecap to track off center. The muscles on the inside of my knee/thigh are so weak its a challenge just to get them to fire in PT sessions.

Are there specific things I can look at on my pedal/seat setup to help me not favor the outter quadraceps?
 

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Same thing happened to me...

First, a pedal system will not be a fix. When I had problems I looking into pedal systems but procrastination got the best of me and I am still on SPDs with very little float but am back to normal riding. That said many people have good results with Speedplay.

What made a big difference was seeing a PT and FOLLOWING THE TRAINING PLAN. It sounds like you have already seen a PT good move IMO. However, it took 2 months of training to even begin to see results. After that and using good cadence I have minimal problems (max 2 days rest needed).

Also rest days were important to keep inflammation under control. So good luck you have some hard work ahead of you.
 

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Kristin said:
Over 4 years I developed a chronic case of patella femoral syndrome. I believe started with the way I pedal the bike. After I started jogging, the problem got chronic.

I have a pretty big muscle imbalance in my quads. I favor the outside quad muscles over the inside muscles, which is causing my kneecap to track off center. The muscles on the inside of my knee/thigh are so weak its a challenge just to get them to fire in PT sessions.

Are there specific things I can look at on my pedal/seat setup to help me not favor the outter quadraceps?
You're paying good money for an actual professional to work with you in person .... ask him or her what they recommend. If they don't know, find a PT who is familiar with cycling.
 

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stretch your quads well before your work them. do straight leg raises while laying down. pick an exercise to strengthen your inner quads and gracillis. I know one but it's a lot harder to explain with words alone.
 

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I'm a PT and I have people do straight leg raises, terminal knee extensions and wall slides with their affected leg externally rotated. What ever you do, don't let a doctor perform a lateral release on you. I have been a PT for 11+ years and have never seen one work. By the way, don't bother with the gracilis, it' a hip rotator and will have nothing to do with the way your knee tracks.
 

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RICE (Rest, Ice, Compression, Elevation) worked well for me when I got Runner's knee (PFS) but it isn't permanent. You have to just be careful to not increase mileage too fast and intensity. Also stretching works pretty well for me. Along with a massive dose of Ibuprofen.
 

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jmrachek said:
I'm a PT and I have people do straight leg raises, terminal knee extensions and wall slides with their affected leg externally rotated. What ever you do, don't let a doctor perform a lateral release on you. I have been a PT for 11+ years and have never seen one work. By the way, don't bother with the gracilis, it' a hip rotator and will have nothing to do with the way your knee tracks.
True that it doesn't directly help any with kneecap tracking, but would it have no effect in promoting proper movement around the knee itself?

I was taught to do the following lets say for the right leg:
lay down on right side
bend left knee 90* and place foot on ground behind right knee
straighten right leg (bottom of foot pointed in opposite direction of top of head)
point great toe of right foor at 2 o'clock and hold position *critical*
raise right leg until the right knee is just under the level of the left (bent) knee

it's a good idea to avoid leg presses as well. I'm not saying this will necessarily work for you, but the idea is you are strengthening the muscles needed to center your patella over the knee joint and promote movement of the limb that is closer to normal than your body naturally tends to.

I didn't know a surgery is ever indicated for this issue. Sort of shocking.
 
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