Heeelp! Chondromalacia (aka knee pain)

[salsabike]

Have you had a bike fit? Your saddle may be too low.

Here's one of the better summaries on the web about cycling and knee pain, including chondromalicia (I've had mild chrondro. for many years):

http://www.cptips.com/knee.htm

I keep my saddle fairly high, and also switched down to 165 mm. crank length.

[KnottedYet]

How about insoles/orthotics posted with a 2-6 degree wedge at the medial forefoot?

Patellar pain on the bike is pretty classic for a forefoot that needs some medial posting, especially for women. (I assume your PT addressed any other potential issues. VMO and taping is all peachy for walking/running/general knee health, but continuous weightbearing thru the forefoot has a very different effect on the kinetic chain and knee mechanics.)

Knot-beat-chondromalacia-thru-better-footwear.

[Velobambina]

Or better yet "Superfeet Knot!!" Thank you for recommending them, by the way. Both my podiatrist and my PT were impressed that I was using the green ones.

[short cut sally]

I had right knee pain that developed last year, only while riding bike, Went to a bike shop (not where I purchased my bike) who did the whole walk this line, walk that way, hop here and there, squat. Just so happened to have my bike and shoes with me. He kinda did a fit, off the bike, on the bike again, keep peddling, and he ended up moving ever so slightly my spd clip on my right shoe. That made the world of difference to me. I had pain to the outer aspect of my knee, and he said it would take a little bit of time for it to resolve, and so happened I was off the bike d/t weather and Ive not been bothered since. Just a suggestion.

[gingergin]

I have had right knee chondromalacia - no cartilage behind my kneecap, for 2 1/2 years, as seen on an MRI. The worst part for me was pain with bending the knee and lack of range of motion. After 7 months of PT and 6 weeks of accupuncture it wasn't much better. About a year a half ago I decided to try clinical massage therapy and was lucky enough to find someone great. After only a couple treatments my range of motion improved. Though it is still not 100% it is way better than it was. He also works on my back and hip as they get cranky too. It is not an inexpensive treatment, but you can use Flexible Spending Account if you get that. I would recommend to anyone!
When I bough my bike last year I didn't know how my knee would handle it, but I am sure cycling is helping as well as the massage therapy.
If anyone in the Boston area wants to know who my therapist is just email me!

[Tri Girl]

Everyone has given great advice. I, too, suffer from a serverly underdeveloped VMO. It's practially non-existent in my left quad- despite all the specific lifting and exercises I do to strengthen it.
My problem with my knees is my feet. Figured out that the severe overpronation leads the knee to track wrong, causing the chrondomalacia. I just got orthoitics (after two years of taping my foot), and hope that helps.

From my two running friends that have had knee surgery- avoid it at all costs until it's absolutely the last remaining option. Get a second (or third) opinion. Just because he's the most revered doesn't mean his opinion of treatment is the gospel truth and the only way. See someone else in your area. Austin is a cycling mecca, and you KNOW there's got to be lots of other docs out there.

Probably didn't help much, but good luck and let us know how it all goes!

[freshwater_pr0n]

Thanks for all the good advice. Salsabike, that's a great article.

Before I go under the knife, I'll definitely ask for a second or third opinion. I also just started working with a massage therapist who has about 30 years of experience under her belt and does myofascial release work.

Shelling out the money for a professional bike fit also seems like a great idea. And yes, my doctor recommended Superfeet insoles, and I'm pretty happy with them. Working with a massage therapist who has 30 years of experience under her belt has also helped.

Getting back on my bike, pain-free, is my new goal, and I'm as excited about my recovery as I would be about winning a big race. Gooo, knees!