Chondromalacia Patella

I was diagnosed with the same injury a few months ago but somehow I turned it around and now I can run or pedal totally pain free

A few ideas without any particular order

  • NO ICE
  • No run or ride for a month
  • Address other same knee issues like a tendinopathy and a quad shortening using dry needling (5 sessions)
  • Very progressive load
  • No anti inflammatory drugs
  • Deadlifting with a lot of technique awareness
  • Collagen and gelatin supplementation
  • Tumeric pills with high bio availability
  • Respect protein intake target of 2 grams per kg of body weight
  • Ride if pain is below 3 in a scale up to 10
  • A big one: I use Look system pedals. I was using old grey cleats which allowed some freedom. I noticed that my injured knee was moving with a awkward line when I was tired and that caused me pain. I changed to black zero float cleats and now my knee feels much better and I can even sprint without pain (which is a new thing)
    This is my n=1 experience. It might not apply to everyone.
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I changed from Shimano SPD-SL to Speedplay with loads of float and it really helped me… N now = 2.

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Funny, as I just put SPD-SLs on my newish road bike went with the red cleats which have less float than yellows I started with. After a Retül bike fit, it was noted that my stroke/range was solid and smooth and was recommended to go with the less floating cleats. YMMV, but there’s been no downside yet and things feel a bit more secure as well.

I read some old blog post from Gordon Byrne (a very good and passionate former Ironman Pro) in which he was mentioning that some of the athletes he was coaching were developing Achilles Tendinopathy due to excessive float in the pedals.
If I find it I will link it here

Just curious to how you have progressed?

Hi Mike - thanks for checking in!

Things at my end are … interesting. I had an MRI which showed very mild patella Alta, but also an enormous ganglion cyst. I knew about the cyst but it had never bothered me.

On talking with my physio and with a sports doctor, the consensus was that the cyst (located laterally near my knee), in combination with mild de-conditioning from being on holidays for 3 weeks was causing patella tracking issues and hence pain.

Moving forward, they tried to aspirate the cyst—but couldn’t—so now we’re on a few rounds of cortisone injections to help shrink it. That, in combination with 45mins-1hr of physio a day, and occasional strapping, has got me to regularly completing 1hr30 SST workouts and recently my first group ride.

It’s still not great, but I’m in a much better place than I was before.

Cal

This condition sounds similar to mine! I was diagnosed with patellofemoral pain syndrome a year ago, but I guess both of them are different. Even I was on the road for about 30-40 hours a week. Later I had this intense pain at the front, back, and sides of my knee without any swelling, also, bending and straightening of the knee was becoming difficult.
There started my countless medications, including ibuprofen and naproxen, and frequent extended visits to the nearby physiotherapy clinic! They would say it would be healed soon enough, say in 3-6 months, but of course, it wouldn’t! My physiotherapist had devised a customized rehabilitation program for me. In the initial phase of rehabilitation, treatment focused on reducing the pain on my knee. I remember them saying using electrotherapy modalities; they even used acupuncture and made me do muscle setting exercises. Later, when the pain lessened, they created a treatment plan which focused on modifying the factors that were known as a cause.
Of course, it took about more than eight months to recover from the pain completely, and I have to adhere to leg extensions, quadriceps stretches, and other exercises to avoid any future pain. I am using custom foot orthotics to improve my foot and knee control as my physiotherapist suggested.
You should also schedule a physiotherapy session and follow their instructions; in time, it would subdue.
Here is a list of exercises that I found on research, I think it would help: https://www.braceability.com/blogs/articles/chondromalacia-patella-exercises

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