Re: Exercises for chondromalacia patellae

Dot,

Thank you for your thoughtful reply.

Going down the stairs backwards is a good idea and I'll give it a try.

The only person who has examined my knee is my chiropractor. I've been
going to him for years for my back and I really like him. He believes
the problem is most likely a small tear in the meniscus but of course
he cannot be sure. Based upon his exam (straigntening the leg, moving
the knee cap, etc) he does not think I have chondromalacia patellae.

My PCP is quite far away but he is wonderful and normally more than
worth the trip. However he knows how hard it is for me to see him
because of my back and he suggested chondromalacia patellae based upon
symptoms I described to him via email. I know that email is not the
way to diagnose a problem. He wants me to have PT but I thought it was
important to know what the problem was first so that I'm not given the
wrong exercises which could make things worse.

Can a PT diagnose the problem? I thought an MRI was really the only
way. Since I can see a specialist without my PCP's referral and if
that specialist ordered an MRI my insurance would pay for it, I thought
that was my best bet. There are many specialist close by. Problem is
I don't know what specialist to see.

Dot wrote:
googlemail2003@xxxxxxxxx wrote:
First of all, I'm not a runner. I'm posting here because I thought
this was where I'd find people with the most experience with this
problem.

I am a 60 year old female with pain in my knee cap. My doctor thinks
it's chondromalacia patellae. He suggested PT but I'd like to try some
exercises on my own first.

Welcome. I'm 59 yo female, so can relate to some issues.

First, is there a reason why you'd like to try on your own first before
going to someone trained who can diagnose and possibly fix the problem
with less trial and error - esp. if your doctor "thinks" it's
chondromalacia patellae? Especially if you have back problems also? Is
this your GP who's doing the diagnosis? or someone trained in joints?
Are the knee and back problems related?


FWIW, my first PT wasn't trained in lower limbs and relieved symptoms,
but not cause. Second one works with runners, got a better diagnosis,
and prescribed a bunch of exercises. While there were a few office
visits, they were mostly to assess progress and get me started on next
set of exercises. I had a re-occurrence of a related problem quite a bit
later and thought I knew how to fix it based on what he had told me
before. After many months of pain, I went back. He said, here's the
problem - and fixed it in 2 visits - actually 1 visit and a followup. I
was stretching backwards. Pain doesn't always manifest itself where the
problem is. duh.


I also suffer from chronic back pain so I cannot do anything that will
put any strain on my lower back.

You might look at straight leg lifts paying attention to cautions about
back:
http://www.drpribut.com/sports/spknees.html

If my knees start complaining, leg lifts are what I normally do. You
may have similar effects just by tightening the quads, without actually
lifting leg, so wouldn't involve back, I don't think.

Here's some others, but I think the straight leg raise may be the best.
http://www.med.umich.edu/1libr/sma/sma_patellod_rex.htm


I wondered if anyone could help me. I understand that strengthening
the quads and hamstring are important.

Unfortunately I live in a two story house and must go up and down the
stairs at least four times daily. Is there a "best" way of doing
stairs to minimize the pain? Going down seems to be the worst.

Try going downstairs backwards? When I had knee pain years ago while
backpacking, I found that hiking backwards down the trail relieved the
pain somewhat - enough to get back to trailhead. (then go out again the
next weekend and repeat)


I swim every day. Are there exercises I can be doing in the pool?

Just a thought, but tightening your quads while flutter kicking may
mimic the straight leg lifts to some extent.

Good luck.

Dot

--
"Success is different things to different people"
-Bernd Heinrich in Racing the Antelope

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