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Chondromalacia Patellae

indysmithindysmith Posts: 276
edited February 2012 in Training, fitness and health
I wasn't really sure where to put this topic, but I suppose this will do.
Last September I was diagnosed with Chondromalacia Patellae; the doctor told me that the cartilage between my patella and femur had been eroded and roughened through over-use. He said that for some reason my patella does not track properly in the groove it's meant to move within as the knee bends.
I was told to rest and not to ride for a while.
I rested completely for 2-3 months and felt significantly better so started to ride again, but immediately my knees started clicking, grinding and aching again.
I am now having physiotherapy and I am doing daily exercises to strengthen the muscles around my knee.

My question is have any of you experienced this? Did it get better? Do you have any tips to kill the pain? How can I get back to riding? These exercises aren't helping so far and actually seem to be exacerbating the problem. I've also experimented with taping the knee and wearing compression bandages for support with no success.
All I want is to be able to ride my bike and it's making me miserable.
Thanks for any help

Posts

  • I also have pretty dodgy knees (although no idea what specific condition I have - just lots of clicking and aching etc) - I find that cycling actually helps my knees a lot (on the recommendation of a physio), however I've noted the following things which may or not be useful to you:
    1: Bike fit is very important - my fit was already pretty good, but after a proper bike fitting, it was immediately noticeably better. And when having a bike fitting, make sure you mention your knees so they can pay particular attention to cleat positioning etc.
    2: Spin, don't grind. As recommended by my physio (and many people on here), it's better to spin a lower gear in high cadence, rather than grind a high gear with low cadence - essentially put less pressure on your knees. Also, along with this, avoid standing on the peddles, at least until your knees are feeling better.
    3: Finally, I also take Glucosamine Hydrochloride supplements - I *think* these help, but plenty of people will say it has no effect.

    Hope the above helps, although I'm no expert so take the above with a big pinch of salt (like all internet-based advice)!
  • ilm_zero7ilm_zero7 Posts: 2,213
    CP is normally a younger persons problem - late teens to early 20's. I am not sure how old you are, but with care you can grow out of it. I was a road runner in my younger years, doing 80-120 miles a week, so it was a problem, but I found some x-training (swimming esp.) and some fancy lasers and foot beds improved the condition.

    Now I am 48 and my knees make an awful gristly grinding noise and can be a bit susceptible on long hard rides - but again a bike fit, a slightly higher saddle, and learning to spin rather than push gears has all helped me continue to enjoy cycling.

    Having got this far and then read what Gllewellyn has written, you can see the similarities and comments. Not so sure on glucosamine - I know that’s good for arthritics, by CP it more a tissue problem. It also really upsets my guts, but if it works for you, do it.
    http://veloviewer.com/SigImage.php?a=3370a&r=3&c=5&u=M&g=p&f=abcdefghij&z=a.png
    Wiliers: Cento Uno/Superleggera R and Zero 7. Bianchi Infinito CV and Oltre XR2
  • d87heavend87heaven Posts: 348
    Has the physio done any soft tissue work? (massage, trigger point, myofascial etc)
    Weaseling out of things is important to learn. It's what separates us from the animals! Except the weasel
  • Anterior knee pain, assuming it isn't due to patello-femoral osteoarthritis, is normally caused by poor tracking of the patella as your physio has said. The usual cause in sports people is an unequal build of the quads, especially the lateral part of the muscle. Obviously, saddle height is critical to ensure your vastus medialis is doing it's share of the work. At least worth checking your knee flex angle with a goniometer, but, as has been said, a pro bike fit would be better still.
  • stevewjstevewj Posts: 227
    I've had this for around 30 years and have had to stop two other sports through it. Had it when first cycling and tried SPD, Crank Bros and Look pedals but got no relief until I bought speedplay Zeros. I don't think I would be riding/racing if I had not tried them. Well worth a go - the completely free float (not centred by the springs that other systems use) means that my knees and ankles can freely rotate so alleviating the stresses that aggravate the knees.
  • d87heavend87heaven Posts: 348
    How was this diagnosis made. MRI or arthroscopy?
    Weaseling out of things is important to learn. It's what separates us from the animals! Except the weasel
  • I had a knee op in the summer of 2010 to deal with this problem. I used to be a hockey player, but suffered a horror tackle in 2000 that collapsed my knee in the wrong way; I struggled back to hockey again but was never the same again, with non specific pain floating around (appearing in different places on different days) around the knee. I gave up hockey completely in 2005 and started cycling. I had been seeing a physio privately but it didn't deal with the pain I experience on and off the bike. After an MRI, the consultant did the op, saying that there wasn't much wrong, but that he would go in and have a look. He did the op, basically a bit of tidying up - he said there wasn't much work to be done. I had some post op complications with DVT, but that didn't affect the success of the op.

    The point of this story is that by December 2010 I was beginning to think that I wouldn't be able to walk again properly because my knee continued to feel so weak, and liable to collapse. In despair I went to a different physio, whose advice turned out to be the thing that got me back on the bike. He diagnosed an essential weakness in my quads, showing me how the development in my left leg (the one with the dodgy knee) was so much less than the right. He got me to change the gym exercises I had been doing: I moved from lighter weights, lots of reps, to heavier weights, 10 reps. This was designed to build strength, not endurance. After about 4 to 6 weeks I felt able to get back on the bike again, and I haven't looked back since, although I need to keep working separately on the still weaker leg.

    So my advice is consistent with MartinB2444's in terms of quad muscles, and that you could do a lot worse than find a physio that knows what he/she is talking about.
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