Physical Therapy Fatigue?

So back in early July I was diagnosed with advanced tendinosis distal quadriceps tendon via MRI. It was determined the that physical therapy was the best treatment and I was given the green light to continue road cycling as much / as hard as i wanted (head of sports medicine is also an avid cyclist) . I’ve been going to physical therapy 3x per week and while the routine listed below isn’t exactly a hardcore weight lifting program, I am wondering how much thrse 3 hours a week are contributing to my overall fatigue (which is definitely elevated).

Anyone else have similar experiences with PT? Or an I misattributing my source of recent fatigue?

15 min warm up on bike
Massage / scraping.
Multi hip machine (15 each out to each side, front and back)
20 leg presses
20 calf raises on leg press machine
20 wall squats with ball between knees
4x1 min wall sits.
20 hamstring curls with weightson ankle
2x20 eccentric step downs
30 leg extensions with ankle weights, 5 second holds.
15 min Ice and stim.

My approach to PT has always been “Do all the stuff for me here that I can’t do myself. Massage, scraping, dry needling, Zero-G treadmill work, whatever…but I don’t need to sit here for an hour while you watch me do ‘Stupid Human Tricks.’ I can (and will) do those on my own at home.”

I don’t have any experience with your injury, but it seems like if you have been given the green light to ride as much / hard as you want, you don’t need to go to PT 3x / week. You need to do the exercises at home, ride as you wish and see them 1x week for a check-in and therapies you can’t do yourself.


The PT is see, don’t take insurance. She has a flat fee. Her mantra is exactly that. She see you once. Will give you all you need to go home and do what you need to.

If you need her to babysit you and watch while you do stuff, she will gladly take your money.
Works great for me!

Sorry for off topic!

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Generally from my experience this would be plenty for me to notice fatigue in other workouts.

Another aspect to consider is if you are in the process of correcting a MS dysfunction, it may change how your muscles work together in ways they are not used to. For example if your program is addressing glute weakness, which it reads like that’s the case in part, you may be utilizing your glutes more on the bike causing earlier fatigue. If you keep powering through that fatigue, you may be pushing your body back into poor movement patterns.

I spent a number of years coaching track and dealing with injuries myself. My advice would be to back off if you feel a change in loading during your bike workouts. Try to be aware of how active your muscle groups are. If you realize your glutes feel weak and your quads suddenly start to load up, then rest.


It’s a very interesting place to observe people, 95% of people in there are putting in about zero effort, complaining and blaming everyone else for their troubles when its quite obvious their lack of motivation / self care is what got them there in the first place. Just Bsing with them they said there are studies that show something like 90+% do not do the at home activities.

A few years ago I started a functional fitness routine to help me on and off the bike. I was just using a couple of dumbbells and doing body weight exercises. I had major DOMS for a few weeks and it took pretty much 6 weeks before I didn’t feel like my short routine didn’t add an extraordinary amount of fatigue.

So, I would guess, yes, your routine is contributing to the fatigue.

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