Patella Tendonitis or chondromalacia?
In the middle of March I sustained a injury to my right knee (the area
right below the kneecap) after increasing my weekly and daily mileage.
The pain became more pronounced after a long run with a friend It
should also be mentioned that I am also a weightlifter and lifting
weights i.e. squats do not cause any knee pain so I have continued to do
this activity. From that time to the middle of June I have tried to self
treat using RICE and very little running. In mid June I finally broke
down to see a doctor after wrapping my knee around my body to check the
stability he diagnosed chondromalacia(sp) and sent me to a physical
therapist. I have seen the PT twice a week for the last three weeks.
Today I have my last appointment and I will be sent back to the doctor.
So far I have not seen much improvement. Also I have always had some
sort of problem on the right side of my body be it ankle, hip or knee
and I have very flat feet. Finally my question to you is where should I
ask the doctor to send me next. The way things are going right know I
will be happy to be running by Christmas. I suspect that I have always
had some mechanical problem. If I can get my knee to heal I would not
like the problem to reoccur.
Chondromalacia Patella is usually felt as lateral patella pain. It sounds like you are describing patella tendonitis (does it hurt when you press on the patella tendon?) Nevertheless, if you have insidious onset knee pain over the patella tendon, I would first consider the biomechanics of your lower extremity complex. You describe flat feet, so get a therapist familiar with biomechanics to evaluate you for orthotics. While this won't cure your knee pain, it will allow you to repair without the recurrent re-injury. Second, continue to use ice, but do ice massage directly over the tendon for at least ten minutes daily. Third, take a theraputic dose of a non-steroidal anti-inflam. drug like Ibuprofin (2400 mg per day) or Naprosin (1000 mg per day). Check with your doctor. Fourth, make sure you stretch daily. To get a good stretch on your quads, lie on your stomach, knees together, abs contracted (pelvic tilt), and then bring your heel to your butt. To increase the stretch, raise your knee off the floor while being especially careful to keep your back from arching. Finally, gradually introduce loaded knee flexion activities (weight bearing, heel on the floor, single leg squats (we call them "balance and reach" exercises). You can do these off a step as well as on the floor. If you are so inclined, a pre-patella strap is also useful in transfering the load slightly, and might be a useful splint for a short time.