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Author Topic: Chondromalacia.. what to do?  (Read 1403 times)

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Offline xtinastyles

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Chondromalacia.. what to do?
« on: April 18, 2007, 03:00:41 AM »
Hi everyone.  I am new to this board and started doing some research because I am a bit frustrated.

I am 24, female, have had pain in both knees for years.  I finally went to the orthopedist, had an xray and MRI.  The results came back and I was diagnosed with stage 4 (type 4, class 4, I don't remember) chondromalacia and patellar tendinitis.  He referred me to another doctor who referred me to their physical therapy department.  I was doing PT every week for a month or two then ran out of visits approved by the insurance and decided to just stop going....  I wasn't crazy with what they were doing, didn't see the benefits and it was costing me alot.

I am taking chondroitin/glucosamine/msm regularly and it is helping but I am still in pain, it hurts to take stairs, the muscles around my knees are VERY sore.  Should I go back to the same orthopedist? Maybe I should find a better one?  Do I really need physical therapy?  How can I repair years worth of damage with 6 months of therapy?  I feel like I am being bounced around the healthcare system....... 

Any input you guys may have will be greatly appreciated!!

Offline maile433

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Re: Chondromalacia.. what to do?
« Reply #1 on: April 18, 2007, 03:52:30 AM »
Hi, and welcome!

It sounds like your orthopedist is trying to help you out with some more conservative measures before going down the surgery route, which is great to avoid as long as you can.  Is the chondromalacia on your kneecap?  Grade 4 basically means the cartilage is worn completely to the bone, which hurts a lot.  Most likely there was some reason you got all this wear, perhaps maltracking of the patella.  In this case, physical therapy could help you out a lot.  One main cause of maltracking is a weak VMO (vastus medialis obliquus), the quad muscle in the front and inside of your thigh, close to your knee.  Most of the PT exercises you were doing were likely geared towards strengthening the VMO which will help pull the kneecap into the correct tracking position.  On the other hand, if your VMO is too big compared with other muscles, this could have the opposite effect.  Proper balance of all the muscles in your leg is very important for overall knee health, so this is where the PT can really help.  It may not be able to take away years worth of damage, but it can help avoid more damage and postpone more serious trauma to the knee.

The main thing is to get all your questions answered, so if you feel that wasn't done with your first doctor, by all means, seek out a second opinion.  In the meantime, I'd continue to do the exercises you were given in PT to help strengthen all the muscles, take the stairs one at a time if necessary, and ice lots! 

Hope this helps.  There's lots of great information on this site, so happy reading!

Good luck,
Sarah
7/03 RK medial meniscus repair & partial lateral meniscectomy
2/04 RK partial medial meniscectomy & microfracture
1/05 RK medial & lateral partial meniscectomy & microfracture
8/06 RK OATS autograft LFC + LR

Offline lozzie

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Re: Chondromalacia.. what to do?
« Reply #2 on: April 18, 2007, 02:14:56 PM »
Hi there,

I had a similar onset of problems as you, and first went to physio for it about 5 years ago. I did VMO exercises, and did lots of things like having an electrode thingy strapped to my quad muscles so that I could make my VMOs learn how to flex first. My major source of pain was from walking, which I have been known to do for 6 hours a day for days on end when I'm travelling (which I do a lot). Finally both my knees just refused to let me walk one day when I was on holiday in San Francisco. I nearly had to crawl to the station to get back to my friend's house!

Long story short, but I have recently had two lateral releases and chondroplasties to get rid of the maltracking and all the loose cartilage that was behind my kneecaps. After all the exercises and everything, the thing I found has helped the most is swimming. I got some of those little training flippers and even if I only do a few laps, my legs feel incredible afterwards, like everything is perfectly aligned. This relief lasts for a few days, which is usually how long it takes me to find the time to get back to the pool.

Can you swim? If you can, I'd suggest you try that, and also go see a sports OS if your insurance allows. Mine has worked on soccer players' knees for decades and I have total confidence in him.

Take care,
Lozzie.
Aug '06 Right knee LR and chondroplasty
Feb '07 Left knee LR and chondroplasty















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