Knee injury advice, chondromalacia patellae

[ctcyclistbob]

I've had good luck over the years with these (I've used Mueller and Cho-pat brands):

[Plum Hill]

Is there any reading material on too much pedal float?

[DRZRM]

What are these called? What should I search under?

Originally Posted by ctcyclistbob

I've had good luck over the years with these (I've used Mueller and Cho-pat brands):

[akelman]

Look for a "patella strap." Or a "jumper's knee strap."

[ctcyclistbob]

Originally Posted by DRZRM

What are these called? What should I search under?

Mueller:
https://www.muellersportsmed.com/jum...nee-strap.html

Cho-pat:
https://medi-dyne.com/products/cho-p...yABEgLQj_D_BwE

These and various brands are also available from Amazon and others. As Ari suggested search for "patella strap" or "jumper's knee strap."

Good luck!

[11.4]

I had major chondromalacia problems of my own which I completely eradicated, and then took the lessons I'd learned to about twenty years' worth of riders with similar problems. Everyone is different, but here are some of the ways to approach the problem.

First of all, recognize that most PTs are NOT serious cyclists and don't understand leg development in cyclist or how you've built latent leg strength (and also certain issues like latent muscle shortening). With that in mind, start very lightly on your own regimen, focusing on both rebuilding flexibility and also on selective strength enhancement. Imperative is to roll your glutes well, because they can pick up tension both from cycling generally and from coping with your injury. Your knee won't heal properly if you don't regain flexibility.

Second, do religious weight work. Start with a single kettlebell and do squats. Make them full squats (thighs parallel to the ground) and start lightly enough that you don't feel hurt afterwards. Remember you've already got a lot of latent strength and you just need to retrain the muscles around your knee joint. You don't need to go into heavy lifting, though I recovered enough to take a couple state age-categorized titles in powerlifting. You can do it.

Third, help out your knees. You may have had a good position, but after an injury it isn't going to be the same. Flexibility, muscle tension and elongation, and so on are all changes in how your body fits your bike. For starters I'd suggest raising your bars a centimeter or so to ease up on your hamstrings and consider shortening your cranks by 5-10 mm. Also slide your saddle back 5-10 mm and potentially down by the same amount. Again, remember you don't have the same flexibility after an injury and you want to help that along with these changes.

Fixed cleats can help you manage your recovery -- you will likely rotate your feet in a bit more and push your knees out more, but don't want to throw in excessive float. Align your feet with fixed cleats and your knees will find their own more-natural place. That will help restore healthy tracking to your knees.

Don't be afraid of taking some naprosyn every day -- it'll prevent pain or swelling from disturbing your knee position and your recovery efforts.

It may take a little while to get back on your bike in a normal fashion, but getting on your bike on a smart trainer with low load is a great way to transition.

Keep your legs warm -- leg warmers always and lots of warmup before you work out.

The PT will help structure your workout. I will mention I've commonly run into PTs who have knee extension stations rather than sleds or similar machines, so they tend to have you do knee extensions (calf hanging off a table and straightening the knee with load against the ankle). Those are bad for cyclists -- they can induce more extreme problems with your joint when it isn't aligned to begin with. Low-weight squats are much better. A big part of the business for many PTs requires quick responses to recovery but doesn't require recovery to real athletic prowess.

Be very reluctant to accept surgery for chondromalacia. It doesn't work all that well. Do consider stem cell therapy -- it can be very effective on this problem. And remember that the damage itself is very slow to repair or won't ever recover, so you are committing to a lifetime of training because otherwise your problem will exacerbate and leave you facing a knee replacement or an enduring handicap.

[velomateo]

I had arthroscopic surgery on both knees for chondromalicia almost thirty years ago. I’m sure that there have been changes in they way doctors approach this now, but it worked well for me. Video of the surgery showed that I had large flaps of cartilage, that the doctor groomed with laser.
One thing that I believe was very beneficial was PT before and after surgery. I had a really good PT guy, that got me on a stationary early and worked to get my muscles to “fire” in the correct order. Total time till when I felt well enough to start regular rides again, was about a year... and that was when I was young and healed a lot quicker.
Good luck

[DRZRM]

Thanks for all the advice ya'll, things are improving...though not as quickly as I hoped. For riding the dogs around the neighborhood, raising my seat and using lower gears seems to help, but most days, it seems like walking is the most aggravating thing I do. I'm not doing any long rides or climbing until I feel fully recovered. My PTist supports many of the exercises you all have suggested, and added a bunch of others. Hopefully I can ride in the spring.