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Author Topic: Chronic PFPS/Chrondomalacia - Seeking Ideas and Similar Stories  (Read 15281 times)

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Offline pfpain

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Hello Fellow Knee Sufferers,

I've been reading the forums for about 2 weeks, but have struggled with knee pain for 15+ months. Please consider reading my story for your benefit and mine. I'd be more than happy to answer questions about my rehab and would greatly appreciate any tips or tricks you feel apply to my situation.

I'm a 24 year old male with chronic Patellofemoral Pain Syndrome and/or Chrondomalacia Patella. PFPS is my diagnosis, but after reading a lot of information including "Saving My Knees" by Richard Bedard from these forums it seems that Chrondomalacia would add additional color to my diagnosis. I've had two MRI's that report no tears and "grossly intact" articular cartilage, but my symptoms, dull aching of the knee joint highlighted by frequent sharp pain around and just behind the top of kneecap and accompanied with grinding/clicking/popping, seem to be very much in line with weakend/softened cartilage. I should mention that x-rays were also taken to rule out poor tracking. I also endured PT for about 3 months (June-Aug 2010) without any noticeable improvements. I have continually been at a loss for how to improve my condition. Every new idea I find usually fails. These boards have given me renewed hope however. I have already read of 3 people who overcame very similar pain. I sincerely hope to be another.

My pain started in about Feb/Mar 2010. I was partaking in a 6 month family weight loss challenge. Before my sister finally inspired me to join I remember telling her on the phone that "weight has never really been a meaningful indicator for me of health." I wish I had been wise enough, or lazy enough, to take my brilliant advice. I ended up joining the program to support the family cause, but also because I weighed 208 lbs (a good 28 lbs heavier than I was used to weighing during college...only 2 years prior). At 6 foot 4 inch this put me on the border of overweight on a BMI chart I saw. Maybe I did need to lose some weight after all I thought. As it turns out, my extra belly fat was a much less meaningful indicator of the decline in fitness I had undergone in the 2 years since graduating college. Trading an active lifestyle for a desk job had left my muscles (and joints) weaker than they had ever been. I grew up athletic and active, was a varsity swimmer for 4 years in high school. I had an athlete psychology, but a shabby, white collar analyst body when I started the weight loss program. This, along with some sever naivete when it came to knee stress (I spent almost 90% of all my physical activity between ages 8 and 17 in a pool), had me doing some pretty disastrous things in Feb/Mar/and April 2010.

-----The causes-----

Vigorous Elliptical Use (extremely high RPMs. It sounds silly, but I once saw a rather fit looking basketball player do this at the YMCA when I was in high school. I thought it seemed like a good idea. I had struggled with shin splints from regular running so intense elliptical use seemed like a smart way to burn fat). At the time of injury I believed this was the sole cause. I see it now as the primary cause, but am aware that several diverse activities probably contributed in concert to overloading my knee joints. Talk about feeling stuck. A lot of Docs recommend the elliptical for people with "runner's knee".

Road Bike - I see this as a common cause. I had never biked before the spring of 2009. I think training for a sprint triathlon in August of 2009 probably set the stage for my PFPS later that spring. It was actually while riding my bike in Mar 2010 that I first noticed a twinge in my knee cap! It would go away as long as the joint was warm. Tendonitis I thought! Afterall, I had gotten tendonitis in my left shoulder and beat it as a 13,14, and 15 year old competitive swimmer.

Swimming: Pushing off walls vigorously (the equivalent of a rapid squat) up to 80 times per workout. Also, kicking breast-stroke, also known as "frog-kick". I didn't think this would be so bad at the time, but trying it recently highlighted the fact the kicking motion induces significant contact and pressure behind the patella...not to mention the motion itself stresses the patella laterally.

Sitting at a Desk - I went from athlete in my youth, to mobile college student biking about 4 miles per day, to completely sedentary office worker. Although I exercised in spurts as an office worker, the frequency was gradually declining before my weight loss challenge in early 2010. I had more fat and less muscle mass than ever before going into that 3 month period of intense exercise. Looking back I should have known better. I often plead with the powers that be that my knee heals, bc at age 24 with the appreciation for my body that I now have, i might live a very healthy and prosperous life.

Calorie Deficiency - This may be the first new/unique thing I've mentioned thus far, but I am convinced that a deficiency in calories (probably 200 calories below a maintenance intake level) contributed to my body's lack of ability to repair itself. I'm not sure I would have been spared were I to have the additional food, but I think it certainly accelerated the decline of my knees.

-----The Effect-----

Pain - I have chronic pain just behind the edge of the knee cap. It is usually focused on the top half, especially where the patellar tendon meets the patella, but migrates on a regular basis to all around the patella. It is a mild to intense burning sensation that is almost always with me. On good days I am spared the pain until about 10 minutes of walking around the house, but recently I'll feel it while sleeping and the moment I wake. If I put too much weight on the joint, especially getting up from a chair, I can feel a different type of pain, as if I'm straining the joint, but the burning and feeling that my knee cap rubs and grinds is my big concern. Doctors say grinding and popping is normal, which I partially agree since my left knee pops maybe once a day and it's fine, but my right knee grinds or clicks more than half the times I extend it. Often it is inaudible unless I rest my hand over the patella to "feel" the grinding/clicking. It is definitely there though. One thing unique to me is I think a lot of this grinding is caused by my right knee cap lying a mm or two lower than my left. That is to say that my right patellar tendon is perhaps 1 mm longer than my left, meaning that the top edge of my patella catches a bit on my femur as it tries to glide up during extension.

Lifestyle -
Walking (around the house, grocery store, to train) is when I notice the most grinding/clicking and pain.
Sitting is painful. I have to straighten the leg to dull the burning, which I hear is common. Recently straightening the leg has not worked as well as it used to. I think I am in a bit of a trough recently for some reason. Still trying to figure out which exercise at the gym is doing that.

Sadness
As is often mentioned, the psychological strain of PFPS can be as severe as the physical. My life would be stellar without the knee pain. I often lament this fact. I have worked hard for much in my life and have arrived to some meaningful levels of success and prosperity, but to not have a healthy knee at the age of 24 is a huge downer. Until I read this board I was starting to get sort of lost. I always just imagined I would keep finding a new thing to try, but I think I needed the sort of moral support this board offers. Thanks guys!

-----The Solution-----

This is yet to be determined mostly. I'm enjoying beginning the grand experiment right now. Don't get me wrong! I have done much over the last 12 months to try to improve my condition. It seems I just haven't gotten the right advice yet. My first round of PT probably worsened my pain if anything...with the single leg squats and the like putting extra pressure on my patella. My own brand of PT that my OS gave me (just single leg raises!) which I did religiously every day from Feb 9 thru May 9, 2011, produced stronger quads (yes!), but the jury is still out as to whether this improved my symptoms. After a few weeks of building confidence in April and some relatively mild knee pain days, I started to get more aggressive with progressively more strenuous exercises, including practicing shooting a basketball (with associated small jumps while shooting) and horizontal crabs walks with an elastic band around my ankles. The result I believe is a regression in my symptoms to about as bad as they ever were :( . I would be VERY depressed about this except for the fact that I am reading "Saving My Knees" by Richard Bedard today. He shares his ups and downs and makes me feel like a set back or two is part of the "learning to listen to your knees" process. I found the book on this site. I'm not affiliated with him, but it's a pretty awesome book. It's not a silver bullet to fix your knees, but he is very articulate and intelligent so reading his knee journey is sooo much more satisfying than trying to get compassion from your doctor!

It would be good to hear your responses. I know that was long...hopefully it means something to one of you. I know it means a lot to me to be able to share. Thank you.

pfpain
Illinois, USA

Offline TwoBadKneesUSA

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Re: Chronic PFPS/Chrondomalacia - Seeking Ideas and Similar Stories
« Reply #1 on: June 03, 2011, 02:49:40 PM »
Well I can at least say that you have learned the dangers of too much too soon!  Youch!  Many PTs will focus on the quads, but you need to make sure the quads, hammies, glutes, hip flexors, calves are all strong and working together.  Strong core muscles are a good idea too.  Pain can cause you to favor your knees and alter your gait causing a chain reaction kind of effect.  You may want to try and find a PT that works with local sports teams and discuss a whole leg strengthening program.  I've no doubt most of your muscles are strong, but they may not be working together properly.  I hope you can find a way to make this better.

'83 lt knee scope
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'05 rt knee scope (clean up)
7/5/07 - scope, LR left, right clean
3/19/08 - LR failed, Supartz failed
http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=47974.0
8/21/08 - new OS apt
8/5/09 - TTT, LR, PFJR sched.

Offline aaa

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Re: Chronic PFPS/Chrondomalacia - Seeking Ideas and Similar Stories
« Reply #2 on: June 03, 2011, 03:06:54 PM »
I can relate to your struggles with this.  My experience has been it was hard to find a therapist who knew how to address this problem.

After many years of trying PT, and trying to research the issue myself, I've concluded that quads strengthening being the primary focus will lead to failure.

I had to unlearn everything I'd been told over the years and change my approach.  You may want to look at:

http://www.patellofemoral.org/Education/docs/Core_to_the_Floor.pdf

Also, I'm not trying to sell, but I have had pretty good results with this - http://www.sports-injury-info.com/patella-femoral-solutions.html 

A few other things I've experienced:
- My left leg was my injured leg, and years of incorrect PT as well as protected the left actually messed up my RIGHT leg.  All the excessive quads strengthening made my right quads overactive.  I've been doing trigger point therapy, myself, on the right and its finally started to settle down / behave normally again.  Also balanced strength / mobility as above resources describe has helped

- QUALITY vs QUANTITY.  Rushing through exercises, overtraining, pushing through pain / strains around the kneecap didn't get me anywhere.  With all the therapy I make sure I am undistracted as much as possible and completely focused.

- Stretching / mobility.  Probalby 40% of the time spent on therapy for me is stretching and mobility work.  it is an essential part of overcoming this.






« Last Edit: June 03, 2011, 03:14:04 PM by yb »

Offline runnergal

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Re: Chronic PFPS/Chrondomalacia - Seeking Ideas and Similar Stories
« Reply #3 on: June 07, 2011, 08:22:11 PM »
Boy, did your post strike a nerve!  I too am struggling with PFPS/Grade IV chondromalacia.  I'm an ultramarathon runner, and I feel as if my life is on hold.  My pain started with a weird fall on the soccer field, in which I landed on a bent, twisted knee, with my foot in the middle of my bum.  This happened in January.

Like you, I feel like I've tried everything, and have yet to find somebody knowledgeable enough to help.  Just Friday, I had a follow up with my OS.  He told me to learn to like swimming and biking, said I could have a cortisone shot to numb the pain, and if I wanted I could try another round of injections in a few months.  (I had Hyalgan already, and it didn't do anything.)  Apparently, there's too much damage in my knee to warrant corrective surgery????  He suggested I might try a Bauerfiend Genutrain knee brace.  Said I could continue with PT "if I wanted to".  Then he pretty much dismissed me.  No follow up.  Nothing. 

So, I'm on my own.  I too have read Richard Bedard's book, and I've also purchased and am working on Doug Kelsey's "The Runner's Knee Bible" (available online), and he seems to have a lot of good suggestions, esp. on getting the core and other muscles strong, and keeping the knee moving enough to get the fluids circulating thru the joint.  Per his book, I've added supplements SAMe, fish oil, ACE & selenium, to my glucosamine and chondroitin.  Unlike you, I am able to go for long flat walks, and can ride my road bike (but not a mountain bike) keeping the tension on the pedals light with minimal pain aftermath.

One item you posted really caught my eye:  calorie deficit being a contibutor to PFPS.   Just prior to my injury, I had been getting really lean.  I wasn't overweight to begin with, but I was working out hard, eating light, and slimming down considerably.  My muscular legs were getting thin -- unique for me!   I'm wondering if that contributed to my problem as well.  Obviously, now that I haven't been able to run, I've lost my primary calorie burning activity, so I've put on a few lbs., and I now have a VMO muscle bud building up. 

Currently, my knee is holding steady.  It doesn't seem to be getting any better, but I no longer feel like I'm on that slippery slope of doom, with excruciating pain building up by the day.   Emotionally, tho, I'm so incredibly frustrated, I can't even begin to express my dismay at the lack of intelligence on how to treat this.  Maybe I'm seeing the wrong OS, but it seems EVERYONE with PFPS is in the same boat.  Since PFPS strikes SO MANY people over the age of 40, why isn't there a readily available protocol on how to treat?   Why are we doing so much of our own research, buying books online, and seeking a forum of strangers with whom to share our frustration?   It just seems crazy to me.   (I'm ready to book a trip to Texas to see either Dr. Mark Sanders or Doug Kelsey.)

That said, I truly appreciate being able to vent and share with fellow PFPS sufferers.   I found both Richard's and Doug's books via these forums.  Who knows where I'd be otherwise????

Offline Silkncardcrafts

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Re: Chronic PFPS/Chrondomalacia - Seeking Ideas and Similar Stories
« Reply #4 on: June 11, 2011, 04:35:26 PM »
Hi pfpain,

Sorry to hear about your knee troubles. I have suffered from patella problems for over 15 years.

In that time I have learnt a lot. I am now also an Allied Health Assistant and Sports Trainer.

Firstly, you need to find a doctor that specialises in patella problems. Luckily I was first referred to a knee surgeon that specialises in patella problems. We tried the conservative approach but didn't help so I initially had a lateral release on my right knee, followed by my left knee about six months later. Things started to go wrong and my physiotherapist gave up on me. So, I went back to my surgeon for more investigations and referred me to one of the best physios I've had. He recognized I needed surgery but also needed to spend time on building up my quads, hamstrings, hip muscles and calves too. The first physio that recognized that it wasn't just about building up my quads.

Eventually my surgeon decided on a MPFL reco for my left knee and continued with the same physio.

Whilst I was going through rehab for my knee I asked my physio whether he could recommend either a sports physician or GP that knows what they are doing. So he recommended the sports physician that assists my knee surgeon regularly. I have been seeing him ever since and has made a huge difference. He suggested I do clinical pilates (think it's called rehab pilates in the US) as it's an all body work out focusing on strengthening all muscles, not just the quads.

Now I don't do formal physio now, but just functional exercises like clinical pilates and a gentle gym program. It's really important to slowly build up. That's maybe why you got injured in the first place.

It's also important to get the right type of scans. CT scans and plain x-rays are the best for showing patella problems. My OS says MRIs area waste of time for patella instability alone.

Good luck !!
11/1996 - RK LR
07/1997 - LK LR
11/1998 - LK MPFL Reco
12/2005 - RK LR Repair
07/2006 - LK MPFL Repair
11/2006 - LK LR Repair
22/05/08 - LK Trochleoplasty
11/02/10 - RK Trochleoplasty
07/03/11 - RK Chrondroplasty

Offline smartdriver

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Re: Chronic PFPS/Chrondomalacia - Seeking Ideas and Similar Stories
« Reply #5 on: June 14, 2011, 06:44:25 PM »
Hi pfpain

Finding a PT (and an OS) who really understands knee problems is half the battle.  It sounds like you are on the right track though in trying to really focus on what is causing you more pain than not.  You will need to keep us updated on your findings.

I started out with PT, which didn't really seem to help any.  Then went for the scope - which seemed to make things worse.  I refused any injections as I felt that they were just going to be a band-aid and not fix the problem.  I've had two HTO's and unfortuantely now, my knees ache and feel worse than they ever have  :(  I went to PT after surgery, but the exercises just weren't doing anything for me, so I started doing things on my own.  I've always been active and this has just put me into major frustration mode.  It is tough when your mind and your heart says "Yes, let's do it", but your knees say "I don't think so...."

Like you, I can't sit for very long without either walking around or stretching my legs.  My knees are pretty much in a constant state of ache anymore.  I'm working with a trainer now (who I think is absolutely the best --- OK, I'm biased!) who knows what I've had done and been through, to try and strengthen my core and doing a total body workout.  I know I'm getting stronger, but I haven't noticed any difference in how my knees feel, so I guess time will tell. 

I do take vitamins and supplements, but haven't noticed any real difference there either.

Heinselrunner - have you tried taking hyaluronic acid?  I have read numerous articles that this is supposed to be better than glucosamine and chondroitin....  I haven't tried it as I want to finish the supplements I have before buying any more.


Offline Fathead D

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Re: Chronic PFPS/Chrondomalacia - Seeking Ideas and Similar Stories
« Reply #6 on: June 14, 2011, 07:38:32 PM »
I am in the same boat as well.  I have had a lateral release on both knees after several years of pain.  Both failed.  I then had the 5 injection series of Supartz.  Failed agian.  PT hasn't worked at all.  I have an appt at a patella specialist in July.  Right now I am focusing on strengthening my inner quads.  Hopefully that will help.  If not I hope the new OS can help.
11/29/2010 Lateral Release left knee
1/2011 Cortizone injection left knee
4/1/2011 Lateral Release right knee
5-6/2011 Supartz injection series (5)
12/12/2011 TTT and Lateral Release repair left knee

Offline runnergal

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Re: Chronic PFPS/Chrondomalacia - Seeking Ideas and Similar Stories
« Reply #7 on: June 14, 2011, 08:11:34 PM »
Smartdriver, I haven't tried hyaluronic acid yet.  I'll certainly add it to my list of things to try.  (But, like you, I need to use up what I have first.)

Fathead D, I have a stupid question:  how did you find a patella specialist?  When I search, I can find knee specialists, but I want somebody who knows the patellofemoral joint, not a top-notch ACL fixer!

I'm happy to say, today I'm having a good knee day!  (knock wood!)

Offline Fathead D

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Re: Chronic PFPS/Chrondomalacia - Seeking Ideas and Similar Stories
« Reply #8 on: June 14, 2011, 10:01:53 PM »
Smartdriver, I haven't tried hyaluronic acid yet.  I'll certainly add it to my list of things to try.  (But, like you, I need to use up what I have first.)

Fathead D, I have a stupid question:  how did you find a patella specialist?  When I search, I can find knee specialists, but I want somebody who knows the patellofemoral joint, not a top-notch ACL fixer!

I'm happy to say, today I'm having a good knee day!  (knock wood!)

I had one suggested to me from a person on here.  He specializes in PF joint issues.  I have to wait a month and a half to get in to see him and that is usually a good sign.
11/29/2010 Lateral Release left knee
1/2011 Cortizone injection left knee
4/1/2011 Lateral Release right knee
5-6/2011 Supartz injection series (5)
12/12/2011 TTT and Lateral Release repair left knee

Offline smartdriver

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Re: Chronic PFPS/Chrondomalacia - Seeking Ideas and Similar Stories
« Reply #9 on: June 16, 2011, 01:05:46 AM »
FatheadD - good luck with your July appointment!  Keep us posted!

Heinselrunner - I hope your good knee days continue!

The group I work with went to lunch today - all I did was step out of the truck and bam!  My knee felt like someone had hit it with a baseball bat.  But, anymore it seems like that is par for the course.  Some of my friends have had knee and hip replacements and are out golfing, playing tennis, racquetball, etc. and I can't even get out of a truck!  Some days you just want to scream!!

Offline runnergal

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Re: Chronic PFPS/Chrondomalacia - Seeking Ideas and Similar Stories
« Reply #10 on: June 16, 2011, 08:45:47 PM »
The group I work with went to lunch today - all I did was step out of the truck and bam!  My knee felt like someone had hit it with a baseball bat.  But, anymore it seems like that is par for the course.  Some of my friends have had knee and hip replacements and are out golfing, playing tennis, racquetball, etc. and I can't even get out of a truck!  Some days you just want to scream!!

OMG, so true!   At times, I've even thought about amputating my leg. (Not seriously!) I see runners racing on prosthetic legs -- and doing quite well.  And I can't even jog around the block.  It's so incredibly frustrating!

Offline smartdriver

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Re: Chronic PFPS/Chrondomalacia - Seeking Ideas and Similar Stories
« Reply #11 on: June 19, 2011, 03:11:39 PM »
And I can't even jog around the block.  It's so incredibly frustrating!

It sounds like we're in a similar situation....  I was also told "I hope you like swimming....".  It's not that I don't, it's just I would prefer to not stare at a blue line forever.

I used to play alot of racquetball with a group at the gym.  They keep asking when I'm going to be back on the court, but anything that involves turning, pivoting, etc. sends my knee into orbit. 

As for a brace, I do wear a Bioskin QLok brace.  It doesn't help 100%, but every little bit helps!

Here's hoping your knee is still "holding steady" (or even better, improving!!!!)


Offline pfpain

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Re: Chronic PFPS/Chrondomalacia - Seeking Ideas and Similar Stories
« Reply #12 on: July 16, 2011, 06:59:49 AM »
Thank you everyone for your responses. It took so long to reply because I wanted to have something meaningful to say.

My current rehab routine:
Heat - I start all my therapy sessions at the gym with the jacuzzi. This really helps to warm up my knee and the surrounding muscles. Standard warm ups like riding a bike or jogging caause clicking in my patella and subsequent pain, so I am very glad to have discovered the benefit of the jacuzzi.
Flamingo Leg Raises - I got this from one of your posts! Stand on one leg (knee slightly bent) and raise other leg so thigh is parallel to floor. This is similar to the middle of normal walking action. Walking is where I get most of my pain now, so I decided to try to reconstruct walking from its components.
Pool Walking - Since walking is where my pain usually surfaces, I decided to start in the pool to strengthen all the component muscles of the walking action. It is certainly making my legs stronger, most notably my feet, ankles, and knee joint i believe. It helps me build the stabilizer muscles in my leg with out straining the joint I think.
Quad Straightening - SLR w ever increasing ankle weights. Just added isometric leg press against an exercise ball on the wall while im lying flat on my back. I do this with a single leg. My quads didnt seem to be getting much stronger from the SLRs so I have been in search of an alternative exercise that didn't cause knee pain, I think I have invented one! Any sort of squat is too painful.
Pool Squat - I have done a few sets of this in the shallow end of the pool but I am pretty sure my knee clicks when doing so. Im not sure if these will turn out to be overall beneficial yet.
Hip Strengthening - clams, side straight leg raises.
Hamstring Curls - no weight, lying on stomach. While my OS thought only quad strengthening was necessary, I am skeptical and have started strengthening all muscles in my leg as of about 1 month ago.
Calf Strengthening - i used to do double leg calf raises standing on my tip toes, but my injured knee leg has a much smaller calf...all my muscles in that leg are smaller because I've been babying it 24 hours a day. As a result I wanted to do single leg calf raises to make sure my right leg was getting its fair share of weight. So I now do these in the pool! I grew up swimming competitively, so working out in the pool is natural, but I am thankful of it's supporting properties. If I heal, perhaps I can write a book about using water to overcome PFPS!

Outlook

I have had the same chronic pain since April 2010 with no significant improvement. I have become more successful with managing my condition and avoiding the more extreme flare ups, but I have been going to the gym Since Feb 1 2011 at least 6 days a week to do therapy and my recovery is stagnant. Getting stronger does help to a degree, but I am growing to believe that I have a tear in my cartilage which my OS believes he saw after my 3rd follow up and 2nd MRI (on a much higher resolution machine).

I moved to a different state this month, and am going to get a 2nd opinion on what my last OS thinks is a flap tear on the back of my right patella. Anyone know a good patella specialist/OS in Southern California? I am willing to drive to Irvine and even San Diego. I have family in San Francisco, so that is an option as well. As is Texas, but my gut is that some of the best are in Southern California anyways! I want to have my potential surgeon read my MRI since I am starting to think a scope and possible debridement is going to be the right path if I have not continued to improve from PT by about October or November.

What doesn't work
ICE - I only use occasionally if I have a bad flare up and the pain is psychologically depressing. Even then, I will only use at end of day and be very careful not to use my knee afterward. Ice does give some relief the following morning, I believe due to the anti inflammatory effect, but in the long run I prefer heat bc it allows me to do PT. ICE slows down the processes in the joint. So I just see it as sort of contrary to building strength and healing the joint matter.
LegPress or Squats - I have tried finding alternatives. I am doing pool squats and single leg press against a big exercise ball while lying on the floor on my back.
Walking on land too much - the constant varied forces on the knee from walking seems to be terrible for my PFPS. Although I completely avoid stairs due to conventional wisdom, I think very shallow stairs would hurt less that normal speed walking. If I could walk pain free I think I could elect to not have surgery...
INSAIDs - i thinks these were worse or as good as ice in actually reducing inflammation overnight. i would use ice if that is your goal. It does dull the pain in the present, but what good is that?

Questions
Immobilizing leg while sleeping - anybody do this? I am thinking i might aggravate my patella pain while tossing and turning and have been searching the net for some neoprene type sleeves that are made to immobilize the joint. I usually sleep with a pillow under my leg to raise it while i sleep on my back, but it's usually gone when i wake up.

If anyone else likes a good leg exercise please mention it. Hopefully something above is helpful. I'm going to reread all your posts again and make an extra post if I missed anything.

pfpain

Offline Fathead D

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Re: Chronic PFPS/Chrondomalacia - Seeking Ideas and Similar Stories
« Reply #13 on: July 16, 2011, 02:19:49 PM »
My Dr has me doing one legged squats on the stairs.  Big thing is to keep your knee over your foot.  I am also working on core strengthening.
11/29/2010 Lateral Release left knee
1/2011 Cortizone injection left knee
4/1/2011 Lateral Release right knee
5-6/2011 Supartz injection series (5)
12/12/2011 TTT and Lateral Release repair left knee

Offline runnergal

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Re: Chronic PFPS/Chrondomalacia - Seeking Ideas and Similar Stories
« Reply #14 on: July 18, 2011, 08:12:52 PM »
I'm in Orange County/SoCal too, and have yet to find a good patella specialist.  To be honest, I'm currently doing so well, (knock wood) I'm not even looking.  I have a terrific PT (located in Costa Mesa), who has helped tremendously.  She has me on a pilates machine, strengthening my entire leg/hip/glute/core circuit, without stressing my knee.  I've been stretching and strengthening my calves, hamstrings, hips and glutes as well as my quads.  I've been fortunate in that road biking (with clipless pedals) does not cause flareups for me, so I've been able to get both my cadio and strength work by cycling and swimming.  For the past couple of weeks, I've even been able to run!!!  I have Grade IV chondromalacia with full thickness cartilage loss, as well as a crushed meniscus, and I'm able to run!   :D

I think understanding what causes flareups and avoiding those activities is key.  I can't do squats, weight machines, or bent knee quad stretches.  So, I've focused on doing the things I CAN do, practicing patience, and taking care of my joint.  I do ice after a long workout, and I'm still taking supplements (don't know if they help, but since whatever I'm doing now is helping, I'm not going to quit!)

Good luck to you, and WELCOME to California!    :)