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Author Topic: recently agravated Patellarfemoral Chondromalacia  (Read 1029 times)

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Offline LPNYjaime

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recently agravated Patellarfemoral Chondromalacia
« on: January 02, 2006, 04:43:48 AM »
Forty two year old knee injury baby here recently diagnosed with patellarfemoral chondromalacia from an early November injury. Recovery was progressing until I agravated the condition a couple days ago, and now I find myself in need of some help and advice.

History: long time marathoner and ironman with loads of miles in his legs with virtually no previous injuries of any sort. During an increased period of running between cycling and skiing seasons, the original damaged occured. No x-rays or mri seemed necessary in my insurance deprived state, and the very capable orthopod sent me to a very capable sports therapist who did a run gait analysis, gave me exercises to correct muscle imbalances, and stretches for my itb and quads. The pain was slowly but steadily decreasing, mobility was increasing, and the pressure and abuse my knee was able to take was increasing. I still was unable to run yet, but with xc ski season in full swing, all was well with the world until this weekend.

This past Friday I seem to have significantly agravated the problem during a hilly skate ski workout. I've done the same workout several times since the injury with no problem. There was also no fall or anything unusual with the exception of the out-turned foot on a skate ski climbing a steep hill. At the top of the hill, I released my knee from this climbing position and instantly had pain accompanied by an uncomfortable sensation that felt as though something was sliding through the area under the knee cap. I was able to complete the ski, but my knee's been stiff, swollen and sore ever since.

I've stretched and iced it since and taken aleve. It feels as though I've taken a big step back in my recovery (about three weeks worth), and I'm unsure what to do next. My follow up with the capable orthopod is three to four weeks out yet, and I want/need to keep xc skiing. I can't stand the idea of completely staying off my knee and am not convinced that it's necessary or important to do that. I am thinking, however, I may just need to bite the bullet and get the mri and subsequent surgery (my insurance situation as recently improved) to get this behind me. Not really sure what the surgery would do besides "clean up the cartilage". I'll be grateful to hear someone's previous experience with something like this or some informed advice on my problem.

Jaime

Offline rozzzie

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Re: recently agravated Patellarfemoral Chondromalacia
« Reply #1 on: January 02, 2006, 12:23:29 PM »
Jamie,

Sorry youíre having knee problems and had to find this board.

You said
however, I may just need to bite the bullet and get the mri and subsequent surgery ".
  If you have Patellar femoral Chondromalacia an MRI may not be indicated.  MRIís show soft tissue problems and are not 100% accurate,  X-rays and a thorough exam can often let the OS make a diagnosis.  Patella femoral problems are tricky to diagnose and treat, there are many on the board that had x-rays and MRIs say they had normal knees in error.  If your knee is stiff, sore and swollen; your knee is trying to tell you something is wrong and you need to RICE (rest, ice, compression and elevation) with an emphasis on rest ice and elevation.  Can you go back to the sports therapist?  IMHO, that would be my first step; he may be able to tell if you need to back of on your training or if you need to change/add to your rehab exercises or if maybe you need another visit to the OS.  Knees are tricky and a visit to a knee specialist may be in order.  A second or third opinion can never hurt; if you are not comfortable with the diagnosis or treatment plan keep looking, itís your knee.

Good luck!  Let us know how things are going.

Rozzzie
OA of knees since 85†
93 scrambled ankle - PE
98 PE
99 anlke fusion
04 hit by car broken leg, ribs AC joint seperation
RTKR† Dec 1 2005
LTKR. IM rod removal March 16, 2006

Offline KarenS

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Re: recently agravated Patellarfemoral Chondromalacia
« Reply #2 on: January 02, 2006, 02:31:57 PM »
I agree with the above, and I also wanted to add that I wouldn't be so quick to "just" have the surgery. Even a simple surgery like "cleaning up the joint" can cause additional problems (this is not necessarily likely, but it is possible, as many can attest to on this board), and it's essentially just a means of pain relief -- it doesn't necessarily allow you to go back to intense activity like skiing or running. You will eventually redamage the cartilage when you do these things. So, realistically, how many times can you have a "cleanup" in your lifetime? You only have so much cartilage, so...you do the math! I'm not trying to be a downer, just trying to be realistic.

I say look into what you need to change in regards to your rehab, and give your knee a good, long rest (RICE). There may be something fairly simple that you need to do with your therapy to correct what's causing the reaggravation. Keep us posted!
« Last Edit: January 02, 2006, 02:33:47 PM by KarenS »

Offline shade

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Re: recently agravated Patellarfemoral Chondromalacia
« Reply #3 on: January 02, 2006, 02:54:25 PM »
Jaime,

Hi I agree with Rozzzie and Karen.†
Cleaning up the joint helps some people for a short period of time & others (like me) it does not help much at all & may even make the pain levels worse.† Try all the conservative methods before having surgery.....
PT exercises, pool therapy and recumbent biking may really help with your condition.† Good shoes and shoe inserts and maybe even orthotics can be tried to relieve pressure on the knee.  Your OS or GP can give you prescriptions for this. 
Resting for this condition is very important - ace bandage/kneesleeve/bracing might also help.† Has your OS or GP put you on any meds for your condition - like anti inflammatory meds?†  Many people also take supplements like Glucosamine and find it really helps with this condition.
Let us know how everything goes.  Good luck.  ~Shade
July '05†(RK) - LR/debridement
Mar '06†(RK) - Open LR + Allograft w/OBI TruFit Plug + Fulkerson TTT
 Feb '07†(LK) - LR + Fulkerson TTT

Offline LPNYjaime

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Re: recently agravated Patellarfemoral Chondromalacia
« Reply #4 on: January 02, 2006, 04:06:22 PM »
Thank you all for your thoughts. Snow was falling gently last night through calm cold air. Perfect conditions for a light run around the lake. Part of me is deeply saddened although I do understand my body's nature. Nothing lasts forever. Everything deteriorates and eventually ends up as dust. But, stuff deteriorates at different rates, and I'm holding out hope for a recovery that'll have me competitive in triathlons this summer.

Your input on resting and surgery is greatly appreciated and taken to heart. Hard to do, but necessary. In answer to your questions, I can go back and see the trainer. As a triathlete and a knowledgeable professional, her opinion is valuable to me, and I respect her greatly. The orthopod has had me on aleve and also recommended glucosamine, which I just started yesterday. I didn't really think much of the glucosamine after hearing about it, but now I'm willing to try anything that'll help. I've always just recovered from things, so managing a chronic condition will be a new experience for me.

Thank you all for your generous sharing of ideas and experience here.

Jaime

Offline LPNYjaime

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Re: recently agravated Patellarfemoral Chondromalacia
« Reply #5 on: January 02, 2006, 04:42:23 PM »
Like most things, I've waded into the KNEEgeeks bulletin board in a rather naive state. I rant about MY little problems and don't realize the extent of the injuries and personal pain others are feeling around the world. I've just taken a little time to read through others' posts and am feeling dumb on the one hand and utterly grateful on the other for everything I DO have and CAN do. A little meditation on this is in order for me. I hope to give back to the group sometime.

feeling fortunate to have found KNEEgeeks,

Jaime

Offline shade

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Re: recently agravated Patellarfemoral Chondromalacia
« Reply #6 on: January 02, 2006, 04:59:57 PM »
Jaime,

We all have arrived at this destination for whatever reasons & all try to help one another.  Don't think in terms of your problems being small - pain is pain.   You are an active person & coming to grips with being less active is not easy.  Think that is good though as you will keep seeking help until you find solutions.
Meditation is wonderful and helpful.  The biggest thing you have to learn is trying to be patient and never giving up.  Keep your dreams - they will keep you moving forward.
Hang in there - hope your knees feel better soon.  ~Shade
July '05†(RK) - LR/debridement
Mar '06†(RK) - Open LR + Allograft w/OBI TruFit Plug + Fulkerson TTT
 Feb '07†(LK) - LR + Fulkerson TTT

Offline KarenS

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Re: recently agravated Patellarfemoral Chondromalacia
« Reply #7 on: January 02, 2006, 06:17:09 PM »
Jaime, I agree with Shade! Don't feel like your problems are small -- they are not. Anything that impacts your life and changes your ability to function normally is not small, no matter how it compares medically to someone else's problems.

Good luck, and keep us posted on how you're doing. :)















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