Patellar chondrolamacia on my knee - need suggestions

[omer]

Hi there,

I love cycling. I was riding for long hours on my bike and enjoying it. Occasionally i was having some pain on my knee, not directly related with cycling, but more after sports like squash or soccer. I went to a doctor and diagnosed for patellar chondromalacia, degeneration of knee cap cartilage, on my right knee. The doctor urged me to stop cycling and recommended to strentghen my quadriceps muscles with some exercises like swimming.
I did so; no cycling but swimming. Nevertheless i have not been happy with this. I started to think to turn back to cycling, because there has not been much improvement on my knee for these two months and the pain was never been strong. On the other hand i have some worries about the effect of starting cycling again on my knee (will it get worser if i cycle, am i risking the future of my knee?) At this moment i need suggestions. I will be happy if you share your experiences/comments with me.

Shall i start riding again? Is cycling a way to get rid of this injury or will it make it worser? I am not a professional cyclist, rather an enthusiast. What do professional do when they are diagnosed with this injury? Do they quit? if yes for how long? And what kind of training is good for me? I assume high cadence.

I have read couple of suggestions regarding knee pains in this forum. These suggestions enhanced my knowledge. I am looking forward to hearing more.

Cheers,
Omer.

 

[ed073]

Have your doctor refer you to a sports medicine specialist, preferably one with experience treating cyclists. Your GPs job is to treat your injury to the best of his ability, however the sports med will treat you and advise on how to train/compete around your injury.

I've got chrondo in my right knee too....i managed a 10 year racing career before switching sports, so don't worry too much!

 

[Brunswick_kate]

Bike fit is so important with this condition. I ended up getting new cranks because my standard issue ones were too long and the stress on my knees was literally destroying them. Doctor prescribed exercises to strengthen the quads and I was advised it would take a while for the injury to heal up. In the mean while, keep the cadence high and the load on the knee joint low.

Do NOT keep working through the pain. I know we all like to be tough but is one case when pain is your body is telling you that you're hurting yourself.

 

[omer]

Will you recommend a knee brace also? If yes, do you have a suggestion for type or brandname or both?

Bike fit is so important with this condition. I ended up getting new cranks because my standard issue ones were too long and the stress on my knees was literally destroying them. Doctor prescribed exercises to strengthen the quads and I was advised it would take a while for the injury to heal up. In the mean while, keep the cadence high and the load on the knee joint low.

Do NOT keep working through the pain. I know we all like to be tough but is one case when pain is your body is telling you that you're hurting yourself.

 

[Brunswick_kate]

Will you recommend a knee brace also? If yes, do you have a suggestion for type or brandname or both?

There's been no recommendation from my doctor to be fitted with a knee brace and don't know enough about the issue to consider doing it without medical consultation.

Personally, I've found the strategy of taking plenty of time to rest following the initial injury -- from me diagnosis came as snow flew, it was easy. And from there the management strategy has been, if it hurts, fix it NOW. So, as soon as I start feeling stress, before it's pain just stress, on the knee joint, I gear down one notch. Cadence high; load low.

And when I got a new bike this year, and went through 800 configurations of fitting it (I exaggerate immensely), I was still having problems with my knee "twinging" on long rides or when I'd put in a heavy mileage week. This was fixed by swapping out the crank arms for a shorter set and another 800 configurations of "fit". I know most people aren't as finicky when it comes to bike fit, with me ANY little thing drives me kazoo-y. I'm such a pain in the ass I bake my wrench cookies just to keep on his good side.

 

[Kenman]

I had the same thing back in '94,Left knee would swell and ache for days,saw a Sports Doc. he did an MRI then recomended O-surgery and I have been absolutely pain free since!Was riding my bike to phys. therapy a week later.Doc said the inside of my kneecap was pitted like a golf ball and my tendon was rubbing on it.This may not be the case for you but worth talking to a sports Doc.

Best Luck
Kenman

Hi there,

I love cycling. I was riding for long hours on my bike and enjoying it. Occasionally i was having some pain on my knee, not directly related with cycling, but more after sports like squash or soccer. I went to a doctor and diagnosed for patellar chondromalacia, degeneration of knee cap cartilage, on my right knee. The doctor urged me to stop cycling and recommended to strentghen my quadriceps muscles with some exercises like swimming.
I did so; no cycling but swimming. Nevertheless i have not been happy with this. I started to think to turn back to cycling, because there has not been much improvement on my knee for these two months and the pain was never been strong. On the other hand i have some worries about the effect of starting cycling again on my knee (will it get worser if i cycle, am i risking the future of my knee?) At this moment i need suggestions. I will be happy if you share your experiences/comments with me.

Shall i start riding again? Is cycling a way to get rid of this injury or will it make it worser? I am not a professional cyclist, rather an enthusiast. What do professional do when they are diagnosed with this injury? Do they quit? if yes for how long? And what kind of training is good for me? I assume high cadence.

I have read couple of suggestions regarding knee pains in this forum. These suggestions enhanced my knowledge. I am looking forward to hearing more.

Cheers,
Omer.

 

[2zanzibar]

I've been diagnosed with Patella Femoral Pain Syndrome (chondromalacia is a much abused term by Doctors) officially for about 6months, although I can remember the knee ache starting 2 years ago though few and far between. Every concerted effort to increase mileage on the bike has been thwarted by this condition and its only now after lots of trial and error that things are looking clearer.
Firstly get a good Physiotherapist. I've had 2, the first one gave me text book rehab exercises on my VMO's........Useless!!! my current physio looks at the whole chain, strenghthening Hamstrings, glutes, VMO and balancing muscles around ankles, and FLEXIBILITY! over time a lot of the symptoms have gone away though not completely...it takes TIME!
Secondly; BIKEFIT, have someone look at you on the bike, avoid bikeshops that just type measurements into a computer which then spits out frame size, saddle height etc. according to some generic ideal, no, you need someone that looks at your peddling technique (especially when you start to get tired) for any biomechanichal anomalies. Check out Steve Hogg's posts on www.cyclingnews.com in the Fitness Q&A section to see how empirical these matters are.
Now when I ride it feels comfortable and smooth, there is still pain (post ride/work related) but there are ways of coping with this problem that doesn't necessarily mean abandoning the bike completely.
James

 

[Bikerbill98]

Hi there,

I love cycling. I was riding for long hours on my bike and enjoying it. Occasionally i was having some pain on my knee, not directly related with cycling, but more after sports like squash or soccer. I went to a doctor and diagnosed for patellar chondromalacia, degeneration of knee cap cartilage, on my right knee. The doctor urged me to stop cycling and recommended to]

Sounds like you've talked to everybody that has a medical opinion. If you have an "itis" you can ice it, rest it and medicate and do physical therapy for strength and flexibilty. If an MRI finds repairable damage, get it done. Life is short. If you've had an "itis" before, you know it could last one day or months/years. I've found time is the best medicine. If you continue to have pain and ignore it, you'll shorten your biking career. I'm sure I'm not telling you what you already know.

BTW, beer is a great anti-inflammatory! When I had some knee pain during a 500 mile ride, I'd stop at bars and buy two beers. Put one on the knee and drank the other. I suggest you follow this rule and increase the dosage with respect the degree of inflammation.

 

[2zanzibar]

Whats an "itis"??

Sounds like you've talked to everybody that has a medical opinion. If you have an "itis" you can ice it, rest it and medicate and do physical therapy for strength and flexibilty. If an MRI finds repairable damage, get it done. Life is short. If you've had an "itis" before, you know it could last one day or months/years. I've found time is the best medicine. If you continue to have pain and ignore it, you'll shorten your biking career. I'm sure I'm not telling you what you already know.

BTW, beer is a great anti-inflammatory! When I had some knee pain during a 500 mile ride, I'd stop at bars and buy two beers. Put one on the knee and drank the other. I suggest you follow this rule and increase the dosage with respect the degree of inflammation. [/QUOTE]

 

[Bikerbill98]

Whats an "itis"??

It is a suffix meaning inflammation.

 

[MLMercer]

Will you recommend a knee brace also? If yes, do you have a suggestion for type or brandname or both?

Hey omer

I've been dealing with chonfromalacia in my left knee for about 7 years now (I'm 26 yo) and I've started cycling this year to get some exercise (anything that jolts or impacts the joint such as jogging is out of the question for me! )

I'm far from a professional (cyclist or doctor) but I can reflect on my own experience on a few points ...

In my experience (over the past 6 months of riding), I believe that cycling has actually helped me by, like you say, strengthening the quads and supporting the joint. I agree with the other posts that you shouldn't ignor or ride through the pain and always use lower gears to take the strain off the joint.

I wear a knee brace whenever I ride - mine is a DonJoy ... I bought it from here ... http://www.jointhealing.com/pages/productpages/jbrace.html (they ship to Australia)

I thought it was worth a try and it turns out it works for me.

It sounds like the right diagnosis from what you describe but have you seen an orthopaedic specialist and had all the scans i.e. MRI to confirm his diagnosis and see if surgery is an option?

Unfortunately cartilage doesnt heal very quickly if left alone and if you have crunching in your joint too (?) it may need to be cleaned out (I think they call that debriding). If bits of cartilage have come loose, this will only cause more and more to come loose and aggrevate the problem.

Also if this has happened over a period of time you may have a badly alligned joint - if this is the case then further riding may aggrevate it more. A lateral realease is a sugrical option that loosens the hold of the muscles that come to hold your joint int he wrong position over time and helps encourage propper tracking of the knee cap. I'ts done arthroscopically these days - mine was done at the same time that they cleaned out the 'bits' and did chondroplasty to encourage re-growth.

Hope this helps but I would suggest that you speak to a specialist and/or a physio if your still concerned.

Regards,
Shell

 

[omer]

MlMercer,

Thanks for sharing your experience with me.

Definitely i am not ignoring my injury, just little bit confused because what different doctors say have some contradictory points. One says you can ride, but not too much, and the other says quit cycling until it heals.

Actually my knee is in good condition nowadays, probably thanks to swimming and resting. No "itis" (a terminology i learned new!) and no pain.

Going forward, synthesizing what the doctors say and the experience of people like you, i have decided on the below points:

1. I will start cycling, using less torque, high cadence
2. I will change the cranks of my bike with smaller ones.
3. I will use a knee brace, i bought one from http://www.braceshops.com
4. I will gradually increase the training intensity.
5. I will keep an eye on my knee, if it is irritated, i will rest&ice.
6. I will perform extra strengthening exercises for my quads.
7. I will cross my fingers for not encountering any more problems.

Any comments/reflections?

Cheers,
omer.

Hey omer

I've been dealing with chonfromalacia in my left knee for about 7 years now (I'm 26 yo) and I've started cycling this year to get some exercise (anything that jolts or impacts the joint such as jogging is out of the question for me! )

I'm far from a professional (cyclist or doctor) but I can reflect on my own experience on a few points ...

 

[pp12345]

Do NOT use GII Orthotics knee braces. They are expensive and start tearing within weeks. Worst is that their support is not nearly as good as other brands and tend to retain moisture causing great discomfort. Some are so bulky that they do not even fit in jeans.

 

[Mike_Rides_Red]

1. I will start cycling, using less torque, high cadence
2. I will change the cranks of my bike with smaller ones.
3. I will use a knee brace, i bought one from http://www.braceshops.com
4. I will gradually increase the training intensity.
5. I will keep an eye on my knee, if it is irritated, i will rest&ice.
6. I will perform extra strengthening exercises for my quads.
7. I will cross my fingers for not encountering any more problems.

Any comments/reflections?

I have had patella femoral syndrome for the past 6 months and learned a lot about my knees. My problem is that I had a quad muscle stength/tightness imbalance. My IT band was too tight and my VMO was too small. I have found that stretching the IT band and strengthening the VMO with a muscle stimulator have been very beneficial. Make sure after every ride that you stretch out your calves, hamstrings, quads, and the IT band to keep your legs limber. A foam roller works really well to loosen up my IT band.

I have gone through 5 differnt pairs of knees braces trying to find the most helpful knee support. I have found that the Cho-Pat Dual Action Knee Strap is the best for running and cycling. It supports your knee yet it doesn't impede knee movement. https://secure.cho-pat.com/products/product.php?product_type=10

Good luck with your knee problem.