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  1. #1
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    Tendon Flicking over Fibular Head

    Hi everyone

    Back in October I did a 210km road ride on my mountain bike. I did fine except for some fairly severe cramping in both legs towards the end of the ride. The next week I decided to buy a road bike. Every time I road it I would suffer pain where the large outer tendon down the back of my right leg contacted with the top of my fibular. After many adjustments to the bike the pain just got worse every time I road. I then also got the pain on my mountain bike. I did 2 months without touching either bike, went to a physio who gave me some stretches to do. The pain has since gone away but comes back on either bike if I don't strap my leg. The pain is caused by the tendon flicking over the head of my fibular near the top of every pedal stroke. The same flick occurs when I squat or sit down on a chair. If I tape around my leg just below my knee, it stops the tendon flicking out and therefore prevents any pain. Obviously not ideal but at least I can ride.

    I'm wondering if anyone out there has had this problem and what they had done to fix it. I've had physio, acupuncture, osteo without results. I'm really hoping to not have to see a surgeon but it isn't looking good.

  2. #2
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    That sounds bad. What does your therapist say? Is s/he an M.D.? If not do you have a doctor's opinion? I've never had that so I can't help, but no bike should do that to you, and I'm sorry you're having trouble. It sounds like you've got it in hand with the brace (strap). Do you have trouble riding with it?
    To the troll mobile, away...

  3. #3
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    My doctor had no idea and sent me to physiotherapist. The physio gave me stretches which I did for 2 months straight without any effect. Acupuncturist had a go but wasn't confident she could fix it. Had 1 session with an Osteopath so far. I don't really understand their treatment but I'm open minded. He says it shouldn't need surgery and just needs realigning. I just don't understand how pocking me with his fingures will do that though. If the osteo has no success then the only other person I can think of is an orthopaedic surgeon.

    The strap works fine and I forget it's there after a while. Thanks for your concern California.

    Thanks Ray for the advise. I learn't the horse thing years ago when I did karate as a young tacker. I'll give it a go.

  4. #4
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    Quote Originally Posted by sime1810
    My doctor had no idea and sent me to physiotherapist. The physio gave me stretches which I did for 2 months straight without any effect. Acupuncturist had a go but wasn't confident she could fix it. Had 1 session with an Osteopath so far. I don't really understand their treatment but I'm open minded. He says it shouldn't need surgery and just needs realigning. I just don't understand how pocking me with his fingures will do that though. If the osteo has no success then the only other person I can think of is an orthopaedic surgeon.

    The strap works fine and I forget it's there after a while. Thanks for your concern California.

    Thanks Ray for the advise. I learn't the horse thing years ago when I did karate as a young tacker. I'll give it a go.
    I'm glad the strap works, but maybe it's time to seek a sports medicine M.D. if your M.D. is baffled.
    To the troll mobile, away...

  5. #5
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    im a student trainer at my high school and it sounds kind of like I.T. band friction syndrome all that is, is when your iliotibial band (tendon) rubs over the head like yours. there is not much you can do for it but may be try different saddle heights and heating witha pad before you ride and really stretching.

  6. #6
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    I originally thought it was IT Band syndrome but I'm told and was shown on my leg that it is a little further around the leg on the side.

  7. #7
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    don't know the answer, may have the problem?

    I wonder if I have the same issue, not sure. Here's my story: 15+ yrs ago I had 1st generation clipless pedals. The first winter I didn't know to lube when it got muddy and one day I kept trying a steep section. I never fell, but kept yanking my foot out of the pedal which was jammed with mud. Since then I have a pain in the back of my left knee where the calf meets the knee. It also feels weak and very sore if I do toe raisers. It has become this chronic injury. I'm so glad I can ride, but it is always sore and I have wondered if there is a ligament or some other injury and if there is some treatment. I've tried rest/time off the bike for 6 months, 13 yrs ago "exploratory" surgery that was inconclusive. The sports med MD said he took a little scar tissue out, but that the knee itself was sound. He speculated about a 'bakers cyst', and popliteal sp cyst, but he didn't see anything. That has never seemed right since it seemed directly connected to that one injury and has never been ok since.

    After every ride, especially when I climb hard, afterwards for days there is a dull pain. I wear a knee sleeve to keep it warm, ice and aspirin have helped. I use a foam roller to try to do my self help version of friction massage. Does this seem like a similar injury?

  8. #8
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    Gee! 15 years! I hope mine doesn't last that long. Hard to say whether mine is the same thing or not. You'd know if your tendon keeps poping out though as you can see it and feel it. I don't get any weakness either.

  9. #9
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    it sounds like the IT band symdrome but you should consult a sports med M.D. or try the heating and stretching
    hope i could help

  10. #10
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    Yeah, it's been a long time. Actually after the surgery years ago, I was so glad just to be able to walk, not to mention even riding, that I decided that the cure was worse than the injury and have just lived with it. But when I read your post it made me wonder if it was a similar injury. I don't think I ever felt or heard the tendon. In fact I don't even know the anatomy...is there a tendon that connects the calf to the back of the knee? anyway, good luck and I hope it heals soon.

  11. #11
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    there are tendons from you posterior (calf) muscles that connect to the tibia and femoral condyles but none really near fibular head except maybe the lateral muscles that turn your foot in and out.

  12. #12
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    Thanks mmdirt for the anatomy lesson and I'm sorry to hijack your thread. To wrap it up, compared to when this first happened, there is so much more info available. As I googled around, it looks like my problem probably is a Baker's cyst. It's usually associated with some other knee problem, but in itself there isn't much that can be done to prevent or treat it beyond RICE. I think that's why my surgeon looked around so much in my knee orthroscopically way back to see if he could find an underlying cause and said the basic structure was fine. But the result was a long rehab from “exploratory” surgery that literally made me grateful to just be able to walk!
    Also, from HS and college basketball and high jumping I do have chronic "jumper's knee" that long predates this injury and may have resulted in some overall imbalances in that leg. So I can use 1 ice pack for both the front and back of my knee and just be grateful that if I don't over stress it I can still ride 90% of how long and how steep I want.

  13. #13
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    I had this two years ago.

    I had an arthroscope done to fix a torn meniscus, and discovered the "snapping" in the weight room about 3 months after the scope. It only did it at a certain point in flexion. My doc and several of his partners were stumped by the "worm" under my skin. He opened me up and shaved the head until it stopped snapping when he flexed my leg. I'm told it was a very gruesome procedure involving saws, rasps, and flying blood/bone.

    The problem with having an operation right there: The skin flexes a lot. The scar tissue become THICK.


  14. #14
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    Cypress, the more I think about it and the more research I do, it seems the only way I'm going to get a real cure is to have the same procedure done. The strange thing is that the head of my fibular seems to have grown over the 3 years I have been riding. I don't remember it always being that big.

    Does the thick scar tissue cause problems for you?

  15. #15
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    No problems with the scar tissue. My doc is a magician, so the knee is 100%. After two operations, it feels better at any given time than the knee that has had 0 surgeries.

    Post op hurt more than the arthroscopic procedure. I'm pretty sure it had something to do with how aggressive it had to be, what with saws and whatnot. If you live anywhere within 500 miles of Bozeman, MT, I suggest Mark Deibert.

  16. #16
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    Hmmm. Might wait until Summer is over before I do anything about it. Got too much wakeboarding and waterskiing to do before I potentially get cut open! I'm in Australia which is a bit more than 500 miles!

  17. #17
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    Yeah, that's a bit far.

    Wait it out for sure. If you are seeing an orthopedist, let them know about my condition (I was the first case known in Montana). If needs be, your doc can get in touch with mine. (his LONG list of commendations)

    http://www.alpineorthopedics.com/deibert.html

  18. #18
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    For K2D2, I agree that your symptoms sound like a Bakers cyst or popliteal cyst. Another possiblity that popped up to me is some kind of problem with your popliteus muscle. The popliteus is a deep muscle in your knee that helps with stabilizing and knee flexion. Here's a link with a description: http://www.sportsinjurybulletin.com/...popliteus.html

    For sime1810, another thought that I have is not so much that the tendon is flicking over the fibular head, but that somehow the ligaments that hold the head of the fibula stable have blown out, meaning the head of the fibula would move over the tendon. I say that in part because of the success you've had with the strap. That would effectively hold the fibular head in place and stable. As above, the popliteus also has some attachments to the fibula. You might also want to check out the above link.

    Food for thought...

    Marcia (a Physical Therapist)

  19. #19
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    thanks Chillmolly,
    Good article and thanks for lending me a little of your expertise. I'll follow up and see if I can at least keep the injury from flairing up so much and getting worse.

  20. #20
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    Chillmolly, that article has some helpful info, thanks. (Per my doc, my knee pain is somehow related to my popliteus muscle and a fallen arch, and all of this goes with my new clipless pedals.)

    Sime1810, it sounds like my pain is different from yours, but I hope you find the right answer. Keep searching for a doc or therapist who will listen to your individual symptoms and not just give you a textbook answer. Best of luck.

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