Another knee pain post!

Background on the knee:
In January, after a fun night of laser tag with friends, my right knee hurt the next day and continued to be sore on stair-climbing and other knee-intensive movements for two months. I went to my ortho and he diagnosed chrondromalacia (which I gather is medical speak for "umm.. your knee hurts") and said that the patella doesn't track in a straight line so when I move my knee, it hits some soft tissue.

He told me to stretch daily by pulling my right foot behind me towards the left side and said to take glucosamine and an anti inflammatory. A month later, the pain has subsided a *little*, but there's still fluid around the knee.

Between the first appointment and my followup last week, I realized that the pain might be due to another injury I had several months prior. I fractured a sesamoid in my right foot late last year and slightly modified my gait so that less pressure was on the ball of my foot with each step. In my followup appointment, the doctor agreed that this may have contributed and told me to "walk normally".


I feel like there's more I should or could be doing to make this better but I'm having difficulty finding any good information. (I am actively working with my LBS to make sure my fit is fine-tuned to try and prevent further knee issues).

Does anyone have any suggestions to make my knee happier?

I have found that moving my cleats to the furthest point back and to the inside of the shoe relieves my minor knee aches. Good luck in your search for happy knees.

Brenda

Karen, I have similar issues to you in that my knees like to not track properly. I was prescribed with custom insoles (which I absolutely love) and some physical therapy sessions. During physical therapy it was determined that my m. vastus medialis was very weak and so I underwent some strength training exercises and electro-stimulation. I also started cycling which has led me to where I am today. I love how that muscle now twitches on its own from cycling.

Your prior injury probably had a great deal to do with your knee problems today as you had to compensate by changing the way you walk. I was born fairly knock-kneed so I know all about over-compensation. ;) Strengthen your m. vastus medialis. I can help you with some strength exercises if you need them. Also, try not to crank on the hills when you're on your bike.

I have patellr femoral syndrome with chondromalacia too. I am weak in the VM and in the hips. I was first diagnosed in Jan. I have been working hard for 5 months to get rid of it. Lots of PT and ice and stretching.

It is a tough one! I am sorry that you are going through it too.

Quote:

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Originally Posted by karen

In my followup appointment, the doctor agreed that this may have contributed and told me to "walk normally".

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I've been given that genius diagnosis as well.
Do they think we enjoy limping around?


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Quote:

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Originally Posted by zencentury

I've been given that genius diagnosis as well.
Do they think we enjoy limping around?

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Cognitive-behavioral therapy for the knees :rolleyes:

"Doctor, it hurts when I do this."
"Well, stop doing that. That'll be $200."

Wahine's still recovering from her TT no doubt, but Knot should be along shortly! Listen to our resident PTs! And get a referral for your own!


ETA: There's a lot that can be done for patellofemoral dysfunction, aka "chondromalacia," but none of it is surgical, so the orthos don't even want to know about it. When the only tool you have is a hammer, etc. etc. Proper bike fit is critical, and as I just discovered, there are fitters and fitters, and there's at least one who isn't really up to speed on patellofemoral dysfunction :rolleyes: But find a good physical therapist, for sure.

Welcome to the wide world of women diagnosed with chrondro-whatsit and patellar alignment issues.

For patellar alignment, one issue can be that if you don't fully extend your leg, the inside quad doesn't fire (at least, this is what a PT told me). In cycling you don't lock out your leg, so your outer quad gets stronger and contributes to the issue. So cross-training may help you. One exercise is to stand on one foot on a step, the other foot hanging off the lower side. Slowly lower yourself so that your knee is bending, then straighten up again, making a point of fully straightening the leg. Two or three sets of 10-15 ...

Also, stretching the IT band is key. If you can stand the pain, some massage work on the IT band may help; it's painful, but good. You can get some of the same effect by rolling the outside of your hip over a foam cylinder. If it hurts, you're doing it right.

There are other exercises; I don't remember them off hand, though. Most of my knee issues have gotten a lot better in the last few years, and I'm not really sure why, although I suspect it has to do with getting into a variety of different activities rather than just riding my mountain bike. Hiking can be a bear, still, though, and after playing two and a half hours of indoor soccer yesterday (normal game is one hour), my knee is definitely talking to me (mostly saying that I need to build up my lateral stabilizers before trying that again).

I'll keep working out my legs and see if I can get everything of equal strength.

I'm also quite curious to see if our resident PTs have any specific advice for me... Paging PTs! :D

I tore my cruciate ligament in the right knee about16 years ago...and four surgeries later. For the most part it holds up, but tends to swell (fluid on the knee) when over exerted...over time...and sometimes...it 'slips.' I have been told with knee injuries...as with back injuries...we will probably be dealing with them the rest of our lives! Stretching and chiropractic work on your legs can be extremely helpful as well as keeping up the electro-stimulation...I posted on this cute little hand-held electro-stimulator on another site that I religiously visit (www.traxee.com). The device is the same concept you use at physical therapy, but for people like us that will be dealing with old knee injuries for the rest of our lives, it is a great investment. And just be good to yourself...i find if I spend the whole weekend running, I'll pay for it the better part of the week. Stay in there, be strong, and don't give up!

-Pink

Have you tried this? I'm not sure if you went to PT but this is one of the things that helps me. I had surgery on my knee in 2006 and couldn't walk after a 'simple' scope surgery to remove bone frags and trim my meniscus. To tell you the truth if I don't ride, my knee bothers me.

So back to the self myofascial release, it's basically giving yourself a massage with a foam roller. Roll your IT band, quads and calves and it takes a while but it helped me. I had fluid on my knee for the longest time as well and I did water therapy which is what triggered me to go into part time personal training but that's another story.

You can get the foam rollers through www.performbetter.com and I think they are about 3 feet long. You can also roll your back with them, which for me is HEAVENLY. Especially the a.m. after a long mtn bike ride.

Chondromalacia is usually what they say when they detect crepitus (popping and cracking)- kind of a blanket diagnosis. I would find a good sports med person or orthopod. But the orthopod usually wants to start cutting you open. I'm having the same kind of problem right now with a foot injury from Oct where I shoved my foot between two rocks when I was riding. I think alot of it is just getting it stretched out but it hurts like heck. Good luck!