Patellofemoral Pain Syndrome (Chondromalacia), a done deal?

[frostfire]

It is the common most cause of chronic knee pain caused by softening of cartilage under knee cap, which eventually lead to the kneecap rubbing against one side of the knee joint. Overuse of the knee, trauma injury, and misalignment due to bad posture and pronation are among the factors that result in chondromalacia...I believe it's been mentioned only once here.

Gentlemen, I would like to know if any of you have any success/miraculous stories of complete recovery from chondromalacia. Medical reference said this syndrome is often "chronic and recurrent." I firmly believe in the power of will and mindset, but if you had successfully got rid of it, what did it for you? Arthroscopy? Plain rest and rehab?
I'd assume if your body weight alone is enough to hurt your knee, an additional 120 lbs won't make it better. Hence, one with this problem will be a liability to the team and is simply not cut out for SF?


Here are some references. If you are having the syndrome, hopefully they save you some time from googling and oogling

pictures:
http://adam.about.com/encyclopedia/9858.htm
http://adam.about.com/encyclopedia/19506.htm

general info and symptoms:
http://www.arc.org.uk/about_arth/booklets/6022/6022.htm
http://www.med.umich.edu/1libr/sma/sma_patellod_sma.htm
http://www.medicinenet.com/patellofemoral_syndrome/article.htm
http://www.medicinenet.com/script/main/art.asp?articlekey=43529
http://orthopedics.about.com/cs/patelladisorders/a/chondromalacia.htm
http://sportsmedicine.about.com/cs/knee_injuries/a/knee10.htm

diagnosis and treatments:
http://sunzi1.lib.hku.hk/hkjo/view/47/4700050.pdf
http://www.emedx.com/emedx/diagnosis_information/knee_disorders/patellofemoral_pain_syndrome_outline.htm
http://www.emedx.com/pt/dx_info/pfp.htm

Only advice I got is if you're an aspiring young 'un or have an aspiring young 'un, all I can say is pay great attention to posture and allignment of the feet for any signs of pronation. Also spend money on shoes with fitted insole, and don't run around for years in boots with soles worn-out on one side. There's hell to pay in the long run.

[Roguish Lawyer]

I had it as a teenager. When I would lift, I would not do squats and some similar exercises because of it. Did physical therapy, and I don't think it's much of a problem for me any more.

[jatx]

I suffered from it during my triathlon days. Custom orthotics to correct for a funny Q angle helped a lot, as did a Cho-Pat (sp.?) strap when mileage got high.

[Texian]

I recently got over it through limited activity (no knee bends, no stairs, no running) and glucosamine chondroitin supplements for six weeks. My doctor told me to keep taking the supplement through September. I went to the doc as soon as the pain started, so I guess I caught it before it could've gotten really bad.

[Jack Moroney (RIP)]

I never got over it. Sound like a coffee bean grinder when I walk up stairs and scare the pups everytime I rise to get out of a chair. I attribute it many miles running in boots and perhaps the more than occassional foot implantation in target butts of opportunity.:D

[frostfire]

Texian, at which stage did you catch the syndrome? Were your knees already making grinding sounds at that point? Did you do rehab exercises to strengthen (stabilize and balance) the muscles around the knee?


JM Sir, I assume the grinding started after you got out from the service? or had it always been there throughout the SF years?


Thank you for all the responses

[Texian]

I didn't have any detectable grinding sound: Just the pain. I did have to do exercises to stabilize the kneecap and then do a "walk/run" regimen to get my knee used to running again once I got well.

[Jack Moroney (RIP)]

JM Sir, I assume the grinding started after you got out from the service? or had it always been there throughout the SF years?


Now give me a break, I'm old and cannot remember when, if, or what I had for breakfast. IIRC it started about my 10th year in service.

[dave_az]

I'm not a QP, just a dad with crappy knees for a 49 yr old. I just had arthro in January on one knee, due to this condition. Had moderate to severe cartilage deterioration, with increasing secondary problems. There was some relief, but not enough. During March - May I received a series of 5 injections into the worst spot on the knee (inside) of a somewhat new chemical which has the planned primary benefit of a lubricant, and a possible secondary benefit of the stimulation of growth of cartilage. It is successful in about 1/'2. I'm not finding it helps the worst spot, where there is little if any remaining cartilage - some bone on bone contact. Ourch.

[BoyScout]

I got diagnosed for this in both knees at 14, right now my left knee pops al the time, a few months back, the right popped and i had to wear a brace for a week. It's liveble, genetic in my case and I can deal with the pain.... ususally.

[BoyScout]

forgot to tell you that my grandmother and a couple of cousins have it too. I always figured it to be genetic because of this.

[Bishop]

My knee does a clicking sound and only the left knee and there is no pain of any sort around the knee. Also it only happens if I go down the stairs or if I try doing a squat. Visiting my doc in couple of days to see what it might be.

[Dusty]

My knee does a clicking sound and only the left knee and there is no pain of any sort around the knee. Also it only happens if I go down the stairs or if I try doing a squat. Visiting my doc in couple of days to see what it might be.

If I went to the doc for every joint that clicks, I'd have to PCS to his office. I sound like a popcorn maker when I get out of bed.

[Eagle5US]

I HAD TO have surgery to correct mine just this past Feb. It was to the point where I was unable to go up or down stairs without significant difficulty and pain. It affected my daily activities (walking, standing from a seated position, and even sitting for any period of time).

My 20 minute drive home from work often involved me stopping to get out and straighten my leg, hobble around for a few minutes, then finish my drive home. I was unABLE to weightbear and squat past 10 degrees of flexion without significant pain.

I am 7 weeks post-op, tried to start running too soon after surgery so am back to resting it...but it does feel 100% better and I am encouraged by the early results.

[greenberetTFS]

Try Synvisc shots they do work for me................;):D

Big Teddy :munchin

[Geenie]

Dear members of the board, I would like to ask for your guidance on the following matter:

Historically I have always had relatively "weak knees". In the past, when I played high-impact sports for too long, or ignored the "three too's" of running, my knees would swell up a bit underneath the patella and I would be in pain.

Now that I have my eyes set on joining the service and giving SFAS a shot, I am dedicated to building up my legs and stabilizing my knees. I understand they will take a beating if I sign up and make it.
I have recently been diagnosed with Chondromalacia Patellae / Patellofrontal Pain Syndrome by an orthopedic doctor. I can confirm that, at the moment, there is some crepitus in my knees. I have no way of comparing it, so I can't say whether it's severe or not.

I checked AR 40-501, and Chondromalacia is listed as a disqualifying condition. After reviewing relevant information, however, my impression is that it is only disqualifying if it is a chronic issue, affecting one's ability to perform permanently.
Thus far I never felt like I had *chronic* knee troubles. My notion was simply that my legs were weak and every time I overdid the training I would have trouble.

I've searched this board and others for people who had similar issues and worked through it prior to trying out for SOF. Unfortunately I was not able to find much information. Most posts were made by people who were on the tail-end of their career, or not interested in military service.
I would therefore like to resurrect this thread to ask the members of this board what their experience is with this condition. Can it be rectified to a point where it is a non-issue? Have you known people who suffered from this condition but were able to overcome it through training or other measures?

I hope to be in a position where I can do a more significant amount of running, and begin rucking, in about 6 months. So far my action plan involves:

- Get an MRI to determine the degree of damage and overall condition of my knees and cartilage. Adjust my training plan and expectations to the results.

- Start taking 1500 mg of Glucosamine and 1200 mg of Chondroitin daily for the next 6 weeks. I will then check for results and perhaps continue taking Glucosamine (after consulting with an MD).

- Continue slowly(!) building up the muscles in my legs, especially the quads and hams.

- I will avoid running and doing squats in the near future, instead focusing on isometric exercises and things like cycling and swimming.

- If necessary, explore other options, such as prolotherapy.


I would be grateful for any advice or opinions. The doctors have not been very helpful and it is important for me to realistic idea of what I am dealing with.

Thank you.

[Patriot007]

Eagle lateral release ? If not what type of surgery?

Had major issues with patellofemoral for years when at higher mileage that is now slowly resolving. Like any other overuse or non-acute ortho injury the recovery is proportional to time you've had the problem.

I have had success with going to a more minimalist shoe (low heal to toe drop) for not only running but everyday use and focusing on proper running form, i.e not heel strike. Additionally, it seems like most of the research out there points to weak hip abductors (weak glutes), tight hip flexors, and possibly over-stretched hamstrings as the cause. Get evaluated by a good sports med doc concerned with more than cutting and/or a physical therapist who knows what they're talking about as they can help you find your deficits. Typically deficits are not in isolation as one starts a chain of events that you have to reverse, and it may take time. Stick with it.

[Eagle5US]

I had a lateral release, "Plica-ectomy" and chondrectomy (shaving/smoothing of both the underside of the patella and the distal condyles of the femur)

Still hurts - just not nearly as bad.

[Geenie]

I had a lateral release, "Plica-ectomy" and chondrectomy (shaving/smoothing of both the underside of the patella and the distal condyles of the femur)

Still hurts - just not nearly as bad.

Did you have the surgery before or after you joined the service?

[Eagle5US]

Feb of this year - 28 yrs of active duty...