Chrondromalacia Patella
- Thread starter Stryker
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I
imported_haskan
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Chondromalacia patella is somewhat of a crap diagnosis. It´s often used when no other cause can be found and the jury is still out on whether it´s a real diagnosis. But lets assume the diagnosis is correct. Your knees will hurt from time to time (many simply grow out of it) when doing something they don´t like; too much compressive forces, repetitive stress etcetera. The knees do not get damaged physically but it´s very uncomfortable. Many times a simple specific Mulligan mobilization can give dramatic pain relief. The doctors advice not to train your legs ever again seems to be completely unfounded. No research I´m aware of have shown exercise to be detrimental in these cases, on the contrary.
thanks haskan,
the doc told me that since I have been doing squats exclusively for thighs for the last couple years that I have a muscle imbalance in my quads. The imbalance has caused my patella to shift toward the outside, causing it to rub against my femur.
Do you think if I correct the imbalance, I will be able to train legs again??
the doc told me that since I have been doing squats exclusively for thighs for the last couple years that I have a muscle imbalance in my quads. The imbalance has caused my patella to shift toward the outside, causing it to rub against my femur.
Do you think if I correct the imbalance, I will be able to train legs again??
NWlifter
Active Member
Well.... chondro is a real disorder, IF you really have it. I have it but it's not that bad. I've even seen the surgery on the Discovery channel to fix chondromalacia. What happens, is due to poor tracking of the patella, the back of it (the bottom of the patella that rides in the condyle of the femur) is not tracking right. This causes the back of the knee cap to actually wear and kind of 'shred'. The orthoscopic view of it looks like when cheese is hanging out of the cheese grater.
The surgery involves shaving the back of the patella smooth again.
One way to tell if you might have it, is called 'The positive Theater Sign'. People with Chondromalacia always have this symptom which is discomfort and an aching feeling when the knees are kept bent for too long, like when sitting in a movie theater.
Hope your knees feel better or you can get that fixed if it's bad, cheers!
Ron
The surgery involves shaving the back of the patella smooth again.
One way to tell if you might have it, is called 'The positive Theater Sign'. People with Chondromalacia always have this symptom which is discomfort and an aching feeling when the knees are kept bent for too long, like when sitting in a movie theater.
Hope your knees feel better or you can get that fixed if it's bad, cheers!
Ron
I
imported_haskan
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Chondromalacia patella is a softening of the patellae cartilage. A maltracking of the patella can in and of itself cause knee pain and is due to the vastus medialis being stronger and fires quicker than vastus lateralis. The Mulligan mobilization I wrote about earlier can give temporary relief, but to really fix the problem you need to use a muscle stimulator (NMES=NeuroMuscular Electric Stimulation).
NWlifter
Active Member
That's odd you have heard this idea. It doesn't involve the cartlige actually but the back side of the patella and the cause is usaually the opposite, the vastus m. becomes weak from disuse atrophy. Usually from poor use from other injuries or the like. When the Vastus M. is weak it does not pull the patella toward the centerline of the body, the much more powerful vastus L pulls the patella toward the outside and causes the patella to ride on the outside of the condyle. This is exactly what I experienced. My knee would even pop as the patella snapped back in the groove. How I found releif was from first, isometric quad exercises to strength the vastus medialis, then later, top range leg extenstions for further strengthening of the vastus m.[b said:
There is good info. about this in many sports med books. I have 2 at home that talk about this. One is specifically called "Save your Knees" and the other is a general sports med. book written by Dr. Garrett who is a orthopedic sports med specialist.
Cheers,
Ron
edit: here is some info. on that
Great page on this (good pics and such)..
http://www.arthroscopy.com/sp05032.htm
http://www.sportsinjuryclinic.net/cyberth....ing.php[b said:
[b said:
NWlifter
Active Member
Your welcome[b said:
Yes, mine isn't nearly that bad. I ended up (years ago) taking a long break from weightraining and mostly did rehab. Once I got my Vastus Medialis muscles stronger and kept them stronger, my knee quit popping then things slowly started feeling better
What started all my problems was a tear in the insertion tendon of the vastus m. on my left knee, then the muscle atrophied and there I was A year and a half ago I could finally start doing squats 
I was diagnosed with this in college many years ago, and others in the family have knee issues. I was also told more or less not to exercise, because I supposedly had "no cartilage left." The previous semester I had been doing several sports activities-- basketball, volleyball, and running, all in a single day, twice/week. I was clearly overdoing it.
I did not follow the doc's advice completely. Resting didn't really eliminate the "scraping" pain, so I started from almost no activity and worked up. A second opinion advised strengthening it. I never did anything with legs two days in row (running, hiking, weights, shooting baskets all counted), because that would cause it to flare up again. I just very gradually strengthened the quads, and every time quit before inflammation set in. Patience, consistency, and not over-relying on pain-killers (i.e., false sense of security) were critical. Eventually it was stronger than ever, and I ran a marathon two years after that diagnosis, with no knee pain (but just about every other kind of pain ). I am only now starting to work legs on consecutive days (trying 4-5 times/week this hst cycle).
I want to stress that this is my particular story, but it may have been that I was misdiagnosed, or I have mutant healing powers, or even that my situation was worse than yours. So don't fail to take your situation seriously based on my story, and don't get discouraged, either.
I did not follow the doc's advice completely. Resting didn't really eliminate the "scraping" pain, so I started from almost no activity and worked up. A second opinion advised strengthening it. I never did anything with legs two days in row (running, hiking, weights, shooting baskets all counted), because that would cause it to flare up again. I just very gradually strengthened the quads, and every time quit before inflammation set in. Patience, consistency, and not over-relying on pain-killers (i.e., false sense of security) were critical. Eventually it was stronger than ever, and I ran a marathon two years after that diagnosis, with no knee pain (but just about every other kind of pain
). I am only now starting to work legs on consecutive days (trying 4-5 times/week this hst cycle).I want to stress that this is my particular story, but it may have been that I was misdiagnosed, or I have mutant healing powers, or even that my situation was worse than yours. So don't fail to take your situation seriously based on my story, and don't get discouraged, either.
I
imported_haskan
Guest
[b said:
The posterior part of the patella is lined with cartilage. That´s the cartilage I was refering to.
[b said:
Sorry, a typo from my side. Sometimes I just write too fast I guess.
The cause is not always disuse atrophy. Many times it´s idiopathic.
I
imported_haskan
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Nah, I´m a physiotherapist. I know my anatomy
NWlifter
Active Member
Hey cool, that's my dream job. Too late now, I'm too old LOL[b said:Quote[/b] (haskan @ June 09 2005,12:53)]Nah, I´m a physiotherapist. I know my anatomy
You can take over on all the other questions then
This one I only got involved in since I've suffered with my stupid knee problems for 20 years and have read so darned much on it. 
Cheers!
Ron
I
imported_haskan
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It´s my dream job too, and I´m living it ! I just love my job. I specialize in Orthopaedic Medicine.
it´s good when patients learn as much as possible about their problems and treatment options. I have way too many patients that are not even interested in the why and how, but just want me to fix it (preferably without putting any money or effort into it themselves).
I just love my job. I specialize in Orthopaedic Medicine.it´s good when patients learn as much as possible about their problems and treatment options. I have way too many patients that are not even interested in the why and how, but just want me to fix it (preferably without putting any money or effort into it themselves).
NWlifter
Active Member
Sounds cool and fun! It's great when someone actually enjoys their job, there are too many docs out there that really don't seem to care about their jobs or patients, just 'get in, get out and give me $$'.[b said:Quote[/b] (haskan @ June 10 2005,5:42)]It´s my dream job too, and I´m living it !
it´s good when patients learn as much as possible about there problems and treatment options. I have way too many patients that are not even interested in the why and how, but just want me to fix it (preferably without putting any money or effort into it themselves).
I happen to be one of those people that HAS TO know how things work and why they broke.
So when my knee started having problems after the accute injury, I read, read and read some more. By the time I saw an Ortho doc, I told him what I thought was wrong, he checked and said "Wow, that's what I think too, how did you know that!?" LOL