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Author Topic: Chondromalacia: advice needed!  (Read 270 times)

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Offline Luce251

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Chondromalacia: advice needed!
« on: July 15, 2019, 02:18:45 PM »
Hi all!

My name is Luce, Iím 27, and I was diagnosed with Chondromalacia in my left knee a few months ago. The diagnosis came after months of pain following a very basic injury back in January. Was walking down some stairs at work and my knee kind of gave out on me a bit. Just a niggle of pain but I kept walking and thought nothing of it. By the end of my shift 8 hours later after walking another 8 kms I couldnít even put weight on it. It was a couple of months of limping around with constant pain made worse by doing anything other than lying with my knee up on the couch that the specialist got an mri and confirmed Chondromalacia. They believe there was partial subluxation of the patella which caused it.

Been seeing a physio who has been absolutely useless, giving me no exercises, braces, strapping, advice, nothing. But Iím in a small town so have no choice of seeing someone different. My work is as a tour guide doing bush walks, and my season starts in just over a month. We do 10 hour shifts, week on week off, walking 8-10kms per day. Right now Iím in pain after about 5 minutes walking. Iím only 27, if I canít hike my career is over and Iím not too keen on giving it up just yet!

Ive got codeine to take when the pain is really bad and currently need one most nights to manage to get to sleep through the pain. During the day the pain is on and off but it hits me every night. Some nights itís almost like jumpy legs (not sure of the technical term - hopefully you know what I mean!) but itís just that knee, I feel like I constantly have to change position and itís an absolute nightmare. I hate taking codeine every night though - feel itís a bit overkill but Panadol doesnít cut it.

Have just discovered a strapping technique on YouTube using kinesiology tape which I tried for the first time a few days ago, managed a 1.5 km hike pain free with it on which I could never dream of without it. I wish I had known about it earlier!! And looking at the list of exercises for Chondromalacia online which seem pretty universal for all the sites so going to start trying those next week.

Hoping for some more ideas/advice! I donít need to run/squat/play rugby I just need to be able to walk all day without crazy pain! And any advice for sleeping would help too. What has worked for you dealing with Chondromalacia?

Thanks in advance!  :)

Offline Geronimo

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Re: Chondromalacia: advice needed!
« Reply #1 on: July 16, 2019, 05:53:06 AM »
Sorry to hear that. I have same issue but upside down - can walk 10 miles but hurts to stand for 5 minutes.

First of all i would suggest to get an appointment with a good doctor in your area. even if there is nobody around - extend your search criteria.

Second: don't do this through pain. I used to do the same and my issue got much worse. I suspect that you need your knees more than your job. If you have to choose - knees or job - i would suggest to choose knees.

Then you can ice/rest/take NSAID and do some straight legs extensions.

I would also recommend an MRI to see if it's only a tracking issue or there is something going on with cartilage.

Offline SuspectDevice

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Re: Chondromalacia: advice needed!
« Reply #2 on: July 18, 2019, 09:28:06 PM »
I've had patella chondromalacia (PC) for decades, and your symptoms don't sound like mine, so although you probably have it (many people do - some get pain, some don't), I'm wondering if there is also something else going on? e.g. torn meniscus?

My symptoms are a sharp catching pain under the kneecap with certain movements (e.g. going down stairs, pushing in the clutch in a car), but when my legs are straight or at rest, there is no pain.  The night pain you have suggests something else might be wrong, as I never got that.

Then again, the improvement with taping suggests it may be PC, as that is one of the key physio treatments for the problem (look up Jenny McConnell taping).  They tape the kneecap to the inside of the knee to stop the kneecap moving too far laterally and rubbing on the femur....but I tried this many times and it never worked for me, though I've heard of others who have had success.  And then again, there is a theory that McConnell taping is far too weak to stop the kneecap from mal-tracking, but the V of tape they put under the kneecap can improve fat pad impingement which is actually the real cause of pain in some people diagnosed with PC.

I tend to agree with Geronimo that something else might be going on (they often miss things with MRIs) and that initially some proper rest/ice/anti-inflammatories might be worth a try.

If it is PC, the good news is that with careful management it can improve dramatically and be entirely resolved.  But healing that cartilage under your kneecap is a slow process due to poor circulation (if any?) there.  It gets most of it's nourishment through movement via synovial fluid, but as you know, too much movement = more damage, so it has to be gentle movement.

I also take a teaspoon of gelatin every day (the building blocks of tendons & cartilage).  I'm not sure if it helps, but my PC has definitely improved a lot (I can run a little, and mountain bike hard for up to 2hrs, and do some pretty solid leg weights in the gym...and I'm 55 so don't heal like a 27 year old!).
L Medial menisectomy 2012
PFPS both knees 2012-2017
Pre-CRPS diagnosed 2014 (I think this was crap)
2017 - 90+% cured via Dr Dye's research
2018 - MTB crash, busted collarbone & ribs - easy compared to knees!
2019 - ride 3x/week, swim 2x/week, gym 2x/week, aiming to get back to short triathlons

Offline Brandon123

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Re: Chondromalacia: advice needed!
« Reply #3 on: July 19, 2019, 10:00:28 AM »
I tend to agree with Geronimo that something else might be going on (they often miss things with MRIs) and that initially some proper rest/ice/anti-inflammatories might be worth a try.

+1

Health/knees first!
RK sharp pain while running, diagnosis chondromalacia patellae 6/09
RK arthroscopic chondroplasty 9/09
RK rehab, recovery, 90% normal, started running again -> back to square one 5/15
RK diagnosis patellofemoral arthritis + LK diagnosis chondromalacia patellae 8/15 -> conservative treatment

Offline kaylachrist

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Re: Chondromalacia: advice needed!
« Reply #4 on: July 23, 2019, 01:29:49 AM »
Hey Luce. I was diagnosed with chondromalacia a year ago following an injury as well. I'm 32 now, so I understand the frustration of dealing with such an awful condition so young and the massive impact it can have on your life. I finally got diagnosed during an arthroscopy and debridement after 6 months of awful limping and being nearly couch-bound, so I've had my injury for around a year and a half in total.

The only thing that helped me feel better was an arthroscopy and debridement when my surgeon smoothed out some of the jagged and damaged cartilage behind my kneecap that had formed a spiky flap. Prior to that I tried PT but with no improvement. Now, a year after the surgery, I still need to modify my lifestyle and deal with some daily pain, but I'm much more functional than before and can carry out activities of daily living (walking, standing, using stairs), whereas before the operation I was barely mobile. I encourage you to look into an arthroscopy that might help you in the same way, even just an exploratory one to get a close visual of what's going on behind your patella and assess the terrain.

I've never had much luck with painkillers since the pain I experience is due to a mechanical issue, but I do find that taking an Advil from time to time helps lessen any swelling and irritation that's building up.

Since your chondromalacia is due to an injury, I'm betting it's fairly focal and contained in comparison to the more common chondromalacia that usually happens due to maltracking. If so, that's good news on one hand because there are other surgical options you can try if a debridement doesn't help (ACI, autograft/allograft, Cartiform). However, success rates of any of these surgeries on the patella aren't as good as other areas of the knee and a successful outcome is more of a gamble, so you'll need to make sure it's really worth trying before taking the plunge. Do your research and find a surgeon who's experienced with cartilage restoration. Personally I'm hoping for an ACI or allograft when my time finally comes; for now I'm just thankful to be taking walks around the block again.

Good luck and keep us posted!
« Last Edit: July 23, 2019, 02:08:17 AM by kaylachrist »
Jan '18- Injured RK, age 30
June '18- RK arthroscopy, smoothed out patella cartilage damage
Diagnosed with post-traumatic cartilage lesion and osteonecrosis of lateral femoral condyle