I am writing you concerning a new problem that I may be suffering from. I was
diagnosed with patellar tendonitis and chondramalacia 2 yrs. ago in both knees
and I am still having problems with pain. I am 24 and I am now very limited in
the intensity and duration of my physical activity. The last nine months I have
seen progress, however, about every 6-8 wks. one of my knees will "flare up" and
I can't do anything for 1-2 wks. I have been to physical therapy and tried
everything. I have worn custom made orthotics since I was in my early teens b/c
I pronate badly. I just went back to the Dr. and he told me that the plica may
be what is causing the problem. Would inflammation of my plica cause or be
associated with patellar tendonitis and chondramalacia? I'm trying to avoid
surgery, but if removing the plica will help my tendonitis I'm all for it.
Please advise me as to the relationship of the plica problem and tendonitis.
It is not uncommon for there to be a plica problem that behaves a lot like
tendonitis. Whenever someone presents in my clinic with knee pain, especially
the history you describe, I always ask the question - "who is zooming who?" in
other words, is you knee inflammed because of the plica, or is the plica
inflammed because of the biomechanical issues? More often than not, your knee is
the victim rather than the culprit. My advice to you is:
1. Use ice for a half hour every day without fail.
2. Make sure your orthotics are posted aggressively.
3. Have your PT give you specific weight bearing butt exercises to improve your
muscular response to loading.
4. Put off surgery for six months while you try this approach.
If you are still having trouble then reconsider.