Chondromalicia Solution Questions

Question
Hi John,

Thank you for addressing this issue.  I've read both of the recent questions about 'clicking' of the knee and it's something I have questions about.

My background:  I am an advanced marathoner with 9 races under my belt (in 9 years).  I've done 2 Boston's and am considered a good runner for my age group, often taking second or third place in local races.  I'm 49 years old with a PR of 3:23:51!  I took a year off from my last race to address a family situation and then began training for a December race this past July.  While working at a desk I had to crawl under it to change out a mouse and keyboard only to 'tork' my knee as I stood up.  It hurt in the medial menical area.  Years ago I was told that I had a slight tear there but no pain, and since then I have run all of those marathons.  I stretch (yoga) ... usually a lot, but recently took on more work and couldn't take the time to do a good stretch daily, thus the muscle imbalances that let my knee go 'sideways'!  I have trained with weights too, but I can't claim it was consistent.

I saw my PT about it and, because she's injured, she sent me to her office chiropractor who specializes in soft tissue work.  After seeing him twice the clicking disappeared but then came back when I worked (bar tending and office job). After a week went by with the knee still constantly clicking I saw a myofacial release therapist and she took the 'twist' out of my hip.  Now there is no pain in my left knee, just the constant 'clicking'.  Some days, after excessive standing or sitting, it does hurt.  I found your questions and answer and that night I went right to the gym to ride the bike.  After just 30 minutes my knee felt great walking (without clicking!!!).  Of  course, it clicks when I sit or stand (but that was two hours ago that I did this biking!).  

My questions: (after that long explanation)

1.How long should I expect this to continue if I follow your plan of stationary biking and strength training?  

2. When should I attempt running again?  

3.  What kind of stationary bike should I use, the recumbent (which is what I used) or the upright one?  

Please help!  

Thank you so much,

Gina

Answer
Hi Gina
Thanks for the great explanation.It makes my job so much easier.Also your performances are fantastic,GREAT JOB.Question number 1...nobody can answer that..You just have to keep testing the water from time to time.My self years ago with chondromalacia 8 months.The doctors were useless and none of them could help me,so i had to hit the books and figure it out for my self.Now i'm an expert..ha ha.Number 2...I would give it a couple of weeks and then test the waters and then get back to me with some imput.Do go easy though.Number 3...The upright only.I have copied some case history,prescription,cause,testimonials for your considerations.If you have any further questions just get in touch Gina.The real key is a whole lot of patience in the come back with a consistent work ethic.

All the very best

John



Hi Pettina
Just what i thought.I have copied a recent case history on the problem and a prescription on how to take care of it with some follow up testimonials from scott lowell and another youn lady.Pettina,the most important thing is patience,consistincy.Everybody heels at different rates depending on the severity of the situation.My self it took 8 months.If you have any questions just get in touch,and keep me posted on your progress like scott did.Also start taking 500mg of vit c with your three meals a day.This is like gold for active people and athletes and yoga instructors.

To a successfull rehap

John



Subject: Knee recovery

Question:
Hi John,
Its Scott Lovell here again.  Thought I would give you an update on the
knee.  I am into the full swing of refereeing and now doing up to 4x90
min games per week.  Great newsw is I have absolutely no problems at
all.  Am back to normal - jogging, running and sprinting.  Thanks again
for all your advice.  I feel well and truly back on track and actually
feel fitter than ever.  Absolutely no soreness at all now, so you can
imagine I am really happy about it.  I obviously keep up the bike riding
during the week, to ensure no reoccurance

Cheers,
Scott

Subject: runner's knee

Question:
Dear John,

Your program is working like a charm, I felt such a huge noticeable  
difference when walking up stairs. Thanx. My question is how much running
is a little running? I ran 1.5 m 2x on my on and with the running class
I ran 3m. This is in a one week span. I also did 5 spin cycle classes
this week. I tried the kickboxing but it messed me up. So I won't be
doing that any time soon. I'm trying hard not to gain weight while I
rehabilitate. I have quite a bit of a metabolism problem. What do you think?
-------------------------

Followup To

Question -
Dear John,
 I suspect that I have runner's knee. I've been stepping 2 to 3 times
a week for the past three years. I would sometimes have pain around the
knee especially if the next day after class I would wear heels. I
didn't think much of it until recently. Two months ago, I started running. I
loved it so much I was running 6 miles 2x a wk and then 1/2hr with my
running class.  The day after one of my runs I had excruciating pain
about 2 inches under the knee between the knee and the ankle.  It stop me
in my tracks for a few minutes and I had to walk very slowly. The next
day the pain was gone. I done some digging, it looks like I could do
some spinning and I need to do some quad strengthening. My question is
how do I do it? Take a spin class first then do my quad work or in the
reverse? When is it ok for me to go back to running? Do you think my case
is severe? I also found out that my pronation is off and my feet do not
rotate enough. Are there special running sneakers to help me? I run in
reebox speed runners for men because they are so comfortable. Do you
think these are good enough for me?

Answer -
Hi Revel
Pain 2 inches below the knee would be pantella tendonitis.Your case is
no severe and you will be fine and you can continue to run a little as
you work on my prescription for rehap.as explained in the attached
letter from a privious client.Your running shoes are just fine.Don't
change.Start adding 500mg vit.c to your 3 meals a day to assist recovery and
don't ever stop the C.Follow my program and keep me posted how it is
going.You will be is good as new in no time.The key is patience and focus
and consistency Revel.I would lay off the steping for a few weeks till
you get well into my program.Let me know if you have any questions.

To a successfull rehap.

John


Scott Lovell Asks in Category Jogging & Running ...

Subject:  Knee soreness
Private:  no

Question:  Hi,
I am 30 years old and have never really had any knee problems.  I am
very annoyed because I feel I have brought this on myself.  I run about 3
times a week, usually on a treadmill.  2 weeks ago I was doing some
lunges with hand weights at the gym.  Admittingly I strained a little and
had probaly used weights too heavy.  3 days later I had a run at the
gym and after 20 mins my knee was really painful.  I iced it up that
night and the following day and then it felt fine.  I have no soreness
walking and none on a very hard workout on the stepper.  2 weeks later I
had a light 5 min run and suffered no pain, then did a 30 min step with
no pain and no sorenes the next day.  2 days later I did a fitness test,
running 3.2km in 12 mins, then 2x100 meter sprints after it.  During
this I felt no pain, but an hourr later I could feel the pain and its
pretty sore again.  2 days since that, my k nee is feeling fine again.  
Does it sound serious?  Have I just pushed it too quickly?  I'm seeing a
physio in 3 days to be cautious.  The pain feels around my knee cap
really - never suffered this before?

Answer:  Hi scott
Great discription of your situation.Thanks for that.Sure makes my job
easier.You  have a slight case of chondro malacia.It isa disintegration
of the patella and femoral cartilage surfaces,resulting in uneven rough
gliding motion between these structures.Any disruption of the normal
smooth gliding motion of this structure will result in cartilage
damage.This is why your feeling where you do.Bottom line not serious but could
be if you don't adress it now.Your knee tracks like a train on the
railrod tracks,and it got out of the groves,jumped track do to some of
those exercises you just did.
To fix this there are 2 things you need to do.First start riding an
exercise bike for 30 to 40 min.3 to 4 times a week.Not a regular bike
except for rec purposes.You want a med to high spin with med to hard
tension.This will retrack the knee and also sand down the back of the knee
cap and smooth it out and also strengthen quads.Second start doing leg
extensions,curls,adductor,abdductor work.Thats it scott,cancel your
physio save $$$.Your situation does sound miner since it goes away quickly
so you should respond rapidly.I would continue with this routine as a
way to stay ahead of the curve as they say.To stay active you have to
incorporate prevention consistently or things will catch up with you,and
that is a promise.Hope this gives you a plan to work with.Let me know
how it is progressing and if you have any other questions.

To your success

John







Only those who risk going to far can
possibly find out how far one can go