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chondromalacia

 
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cat2112
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Joined: 10 Sep 2017
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PostPosted: Tue Sep 12, 2017 8:16 pm GMT +0000    Post subject: chondromalacia Reply with quote

Doc, I had an MRI done on my right knee and it was discovered that I had chondromalacia. Doctor sent me to PT, but the knee didnít improve. Do you have suggestions before I go back to the doctor?
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The Bike Doc
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Joined: 08 May 2003
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Location: Corpus Christi and Warda, Texas

PostPosted: Sun Sep 24, 2017 8:46 am GMT +0000    Post subject: Reply with quote

Chondromalacia is the wearing down of the cartilage layer on the back of the patella (knee) cap. Treatment is usually nonsurgical. It is caused by heavy repetitive stress loads to the knees such as leg presses with high weights, mashing hard on the pedals with high loads, stair climbing and other high loads that require bending and extending the knees.

Management includes backing off on the activity that is putting the high load on the knees. For cyclist, that means back off on the out of saddle pedal mashing low RMP riding style and switch to high RPM (90 - 120) RPM cadences in lower gears. The newer style single front chainring mountain bikes, cross bikes and road bikes with the 10 or 11 speed rear cogset, may not allow for low enough gearing for some riders to do the high RMP seated climbing. Single speed bikes are even tougher on the knees for this reason.

A course of nonsteroidal anti-inflammatory drugs (NSAIDS) is sometimes helpful in reducing the pain and inflammationof chondromalacia. However, using NSAIDS must go pedal by pedal stroke switch from high load, out of saddle pedal stomping riding style to seated low load, high cadence spinning riding style for climbing. Otherwise the transient reduction of the pain from the NSAIDs can mask worsening injury from the gear mashing, standing on the pedals riding style.

Thanks,
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The Bike Doc
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Joined: 08 May 2003
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Location: Corpus Christi and Warda, Texas

PostPosted: Wed Sep 27, 2017 1:24 pm GMT +0000    Post subject: Knee Pain Reply with quote

Cat2112:

Additionally, there are some other things to consider in knee pain. Pain in the front of the knee including Chondromalacia may benefit from some adjustments in your bike setup. Below is a list of locations of knee pain, potential causes and beneficial bike adjustments for the identified cause.

Knee Pain Location as Indication of Fit Problems:

Location- Front of Knee
Causes -- Correction:
Seat too low -- Raise Seat
Seat too Forward -- Move Seat Back
Excess climbing -- Reduce climbing or
Big gear mashing -- Spin at Higher RPM in lower gear
Cranks too long -- Shorter Cranks

Location- Inside of Knee
Causes -- Correction:
Cleat malposition toes point out --Adjust cleats to bring toes in or use floating pedals/cleats
Excess pedal float -- Limit float to 5 degrees
Excess exit tension to release -- Lower tension
Feet too far apart -- Move cleats out (moves shoe position in on pedal), narrower bottom bracket or cranks with narrower Q factor

Location- Outside of Knee
Cause -- Correction:
Cleat malposition toes point in -- Adjust cleats to bring toes out use floating pedals/cleats
Excess pedal float -- Limit float to 5 degrees
Feet too close -- Move cleats in (moves shoe position out on pedal), wider bottom bracket or cranks with wider Q factor

Location- Back of Knee
Cause -- Correction:
Saddle too high -- Lower saddle
Saddle too rearward -- Move saddle forward
Floating pedals with too much float -- Limit float to 5 degrees

Modified from: Arnie Baker, MD Bicycling Medicine 1995 Argo Publishing
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