Chondromalacia patellae (Knee Pain)

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Hey

I just wondered if anybody else suffers from this condition. I have had it for the last 10 years, often suffering in pain which feels like somebody has hit me across the knee caps, but generally when I'm exercising, I find this a problem as, 1) my knees seem to have a permanent bend in them and, 2) I can't do exercises such as jump rope, star jumps etc, which uses a lot of the knee to move.

I am currently using Jillian Michaels 30 DS, so I have to modify these exercises to help me but I have heard that pains such as these can go away with exercise. When it was first diagnosed, my doctor said it was usually young althetic women who suffer, but as a young girl, I despised all kinds of sports so I don't know how this has occured!!

Here is the Wikipedia description of the condition for those who don't know what it is, and if you are also suffering the same symptoms as described, I hope this has helped in diagnosing it too

BTW, my doctor only gave me co-codemol, which made me feel sick all the time so I stopped using it. Sometimes, Ibroprofen helps but not always

Chondromalacia patellae (also known as CMP) is a term that goes back eighty years. It originally meant "soft cartilage under the knee cap," a presumed cause of pain at the front and especially inner side of the knee. This condition often affects young, otherwise healthy individuals.

Chondromalacia is due to an irritation of the undersurface of the kneecap. The undersurface of the kneecap, or patella, is covered with a layer of smooth cartilage. This cartilage normally glides effortlessly across the knee during bending of the joint. However, in some individuals, the kneecap tends to rub against one side of the knee joint, and the cartilage surface becomes irritated, and knee pain is the result.

The term "chondromalacia" sometimes is used to describe abnormal-appearing cartilage anywhere in the body. For example, a radiologist might note chondromalacia on an MRI of an ankle.

Pain at the front / inner side of the knee is common in young adults, especially soccer players, gymnasts, cyclists, rowers, tennis players, ballet dancers, basketball players, horseback riders, volleyball players, and runners. The pain of chondromalacia patellae is typically felt after prolonged sitting, like for a movie, and so is also called "movie sign" or "theater sign". Snowboarders and skateboarders are prone to this injury, particularly those specializing in jumps where the knees are under great stress. Skateboarders most commonly receive this injury in their non-dominant foot due to the constant kicking and twisting that is required of it during skateboarding.

The condition may result from acute injury to the patella or from chronic friction between the patella and the groove in the femur through which it passes during motion of the knee. Possible causes include a tight iliotibial band, neuromas, bursitis, overuse, malalignment, core instability, and patellar maltracking.

Pain at the front of the knee due to overuse can be managed with a basic program consisting of RICE (rest, ice, compression, elevation), anti-inflammatory medications, and physiotherapy, however; if there is cartilage damage this is not easily repairable.

Usually chondromalacia develops with no swelling or bruising. The treatment of chondromalacia remains controversial, but most individuals can undergo effective treatment by resting the knee and adhering to a proper physical therapy program. Allowing the inflammation of chondromalacia to settle is the first step of treatment. Avoiding painful activities that irritate the knee for several weeks, followed by a gradual return to activity is important. In this time, cross-training activities, such as swimming, can allow an athlete to maintain their fitness while resting the knee. The next step in treatment is a physical therapy program that should emphasize strengthening and flexibility of the muscles of the hips and thighs. Use of nonsteroidal anti-inflammatory medication is also helpful to minimize the pain associated with chondromalacia.

Replies

  • Debi_
    Debi_ Posts: 6 Member
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    I have problems with the cartilage in my knees too, and after a few operations to smooth it out I have got to a point where I'm able to do most things and accept a certain level of pain. I was told the best thing would be to do water based stuff, swimming and aqua aerobics. However they aren't really my thing and I soon got bored of that so now I go to the gym instead. I had a couple of personal training sessions with someone who specialises in dysfunction/injury rehab, and they were able to point me in the right direction. Part of my problem is to do with the way I walk too, so they were able to show me ways of correcting that over time too. Is it a possiblity to do something like that?

    I very much just have to go by what my body can handle each day, but I am able to do things like spinning, weight training (careful on the squats/lunges), the cross trainer (elliptical) is generally fine. Yoga and stretch classes have been good too, but you just have to work with what your body can do and take advice from the instructor if you're finding it too painful as they can often adapt things.
  • Hayter2013
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    Thanks,

    I tend not to have time to go to the gym as I work full time and have a son whos nearly two. I am quite shy/nervous when it comes to doing stuff like that in public too!

    I have tried swimming but like yourself, got bored, and the times I went were full of spotty teen boys hanging around, splashing, so it got quite annoying haha

    The doctor didn't explain much to me all those years ago, he just checked out my knees, listened to the crunching and me telling him about the stabbing pains I got.
    I was working as a chef at the time, so I thought it could be down to being on my feet all day. He didn't explain it could be the way I walked though... What could I do to change this?

    My dad and brother both have bad knees, think my dads dad did too, although I'm not sure.

    I have not been consulted to have operations and such. The doctor I have now does not seem to be very forthcoming in actually wanting to help his patients but I am not able to move!!! Feel a bit lost!!
  • Gail3260
    Gail3260 Posts: 354 Member
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    Knees can be very painful.....a physiotherapist once told me they are the most painful joints to have problems with after your fingers!

    I have different problem but with the same effect.....I only have half a knee cap in my right leg folliwing a car crash 21 years ago. The best all round exercise I can do is swimming and yes it's boring. I have just invested in a waterproof MP3 player and it's great. 60 minutes of swimming now feels like 30. Fortunately I go to a members only gym with a pool where there are no spotty teenage boys!
  • Hayter2013
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    Haha I'm jealous!

    I can't afford gym membership, I have bought most of my fitness dvds and games for a few ££ each!

    Our local pool is only a few ££ too, need to find an adults only night I think and the waterproof MP3 player sounds awesome, might be an idea for an early birthday present to me lol
  • Debi_
    Debi_ Posts: 6 Member
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    I guess first you'd need to find out if there was a problem in the way you walk, I'm not sure who else would do it, perhaps a physiotherapist or see if there are any personal trainers that could do a one off thing without a membership to a gym?

    My experiences with seeing drs and stuff was long a drawn out before I had surgery, I think often it's expected for it to go away or that it cannot really be treated all that sucessfully by intervention. Surgery doesn't necessarily help everyone so I've heard and there are always risks involved. My knees were a lot weaker and still don't take much to become painful and swollen, I think perhaps more so than before surgery. I wish I had investigated more of the physiotherapy/personal training side of things, but it wasn't available to me. But then again, day to day the pain and uncomfortable catching/clicking/crunching/giving way is much better than it was. I was also told that it's not a cure, but a temporary fix if anything and I will have further surgery in the future as it progresses. It seems you need to persist with your doctor, or find a physiotherapist and ask whether they might be able to help?

    In the mean time, perhaps try and find a time when the pool is quieter- when kids are at school? Even if you go once a week it's better than nothing. With classes and stuff, perhaps you could find someone to go with you? I was nervous at first, but everyone was so welcoming I soon felt comfortable.
  • deg0ey
    deg0ey Posts: 1
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    Sorry to hear about your knee pain. My little sister has been suffering with something similar for years - there was tightness on the outside of her knee cap pulling it to one side so that it wasn't seated properly resulting in a similar issue with worn cartilage that you seem to be describing. She has recently (about 3 weeks ago) had an operation to cut one of the offending tendons and put the knee cap back in the right place.

    Obviously this is all anecdotal evidence, but it seems like there are many things that can cause this kind of knee pain and physio can only help for some of them. The best advice I can offer is that you ask your GP to refer you to a specialist to get a proper look at whatever is going on in there - hopefully then there's something they can do to help you out.
  • klwells08
    klwells08 Posts: 158 Member
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    I was diagnosed with chrodromalacia following a MRI a few years ago. The underside of my right kneecap looks like it has hair and blisters, so I have named my right knee Harry Patella. For me, it was caused by wear and tear when I was younger (I was a figure skater) and then uneven muscle development. My kneecap pulled to the outside, causing it to rub against another bone as opposed to tracking straight in the existing groove. The BEST thing that ever happened was finding and buying a Cho-Pat dual action knee strap. It works far better than any other knee brace I have tried. I've had it about a year and have very little knee pain now. It allowed me to start running and working on developing my leg muscles evenly. I only wear it when I run now, but squats and other exercise are pain free. HIGHLY recommend picking up one if you are dealing with this!
  • Hayter2013
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    I was diagnosed with chrodromalacia following a MRI a few years ago. The underside of my right kneecap looks like it has hair and blisters, so I have named my right knee Harry Patella. For me, it was caused by wear and tear when I was younger (I was a figure skater) and then uneven muscle development. My kneecap pulled to the outside, causing it to rub against another bone as opposed to tracking straight in the existing groove. The BEST thing that ever happened was finding and buying a Cho-Pat dual action knee strap. It works far better than any other knee brace I have tried. I've had it about a year and have very little knee pain now. It allowed me to start running and working on developing my leg muscles evenly. I only wear it when I run now, but squats and other exercise are pain free. HIGHLY recommend picking up one if you are dealing with this!

    THANK YOU SO MUCH FOR THIS POST!! Am looking on the net now! Am in the UK and all the straps seem to be USA based... Hmm, gonna need to think about this before I invest. I don't have much free cash flow at the moment, but if I'm gonna continue 30DS I need to weigh up if its gonna cause me much more trouble...
  • hippiechel
    hippiechel Posts: 170 Member
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    i don't remember the exact condition i was diagnosed with but i'm pretty sure it's chondromalacia patallae. /edit - it might be http://en.wikipedia.org/wiki/Patellofemoral_pain_syndrome

    i think it's because i used to play netball which requires a lot of jumping. my knees, especially my right, is always cracky and makes a lot of weird noises. i can't extend my legs for too long but i can't really keep them bent for too long either. the knee pains have gotten better (maybe because i became lazy and stopped exercising as much) but there was a time where they would hurt even from walking. my doctor said i could "lose weight" to put less pressure on my knees or opt for some kind of injection which is apparently "very painful".

    i am also doing the 30DS and i also do feel that some of the moves are hard on my knees. i heard that strengthening quad muscles can help to relieve some of that stress. also like what other people mention - swimming and biking with low resistance maybe. don't run on hard ground! i don't swim because i usually look like i'm drwoning.

    i have used knee guards and tape in the past when i trained/played in competitions to hold my kneecap up. not sure how effective that is in the long run but it worked while we were playing sports.

    would love to see updates on this!
  • ssdivot
    ssdivot Posts: 193
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    It seems like chondromalacia is catchall term for pain under the kneecap and can be caused by a lot of different things. I have for years had pain in knees if I sit too long and then stabs under kneecap when the leg bears weight and knee is bent at a certain angle. I went to a doctor years ago and got xrays and he just said the underside of my kneecap was rough and it was just age related.

    I've been exercising a lot for the past month or so and was kind of bummed that I wasn't able to squat down very far due to this stabbing pain in the knees. I didn't know if this would go away or not if I got into better shape. I googled and found some exercises for this condition as sometimes it can be a muscle imbalance causing the kneecap to track wrong. I have been doing a lot of walking and then these inner thigh exercises I found on youtube. The other day I was delighted to notice that I can now squat down to almost parallel without the pain. Now I'm doing a lot of squats an am hopeful the condition will retreat further. My one knee still does hurt if I sit with it bent for too long though. good luck!!