Question
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Followup To
Question -
Hello Brendon.  I am living in the UK and have had trouble with
my knees for about 6 months.  I didn't worry because I thought
it would go away.  But I realised it was getting worse so I went to
the docs.  

I am 51 and about 6 months ago I hurt my back gardening and
had terrible trouble getting off of chairs or the bed.  It would
take me ages of pain and during that time I spent a lot of time
half upright trying to get upright...

I relised I had pain in my knees after this.  I found I noticed it
when I bent my knees but not when I then straightened them.  
So I found I couldn't sit down gradually, I had to drop the last few
inches.  Also I am having to use the table surface to push myself
up.  My job involves standing for most of 8 hours and pushing
wheeled containers around.

Gradually it got more painful and then I realised it was also
happening when I straightened my knees.  I touched my knee
whilst straightening and bending my knee and I could feel
grinding.  I went to the doctor.

He examined me and told me that I needed to lose weight (I am
5ft 8 and weigh about 215 uk pounds).  He told me my cartilage
was good but the back of my kneecap was roughened.  He called
it "-roma (something) - Patella".  Sorry I didn't get it written
down.  It may be Chondromalacia Patella  I asked if it was
arthritis, he said no.  He suggested I used a knee support.  He
said to avoid slopes but stairs were ok (!).  He suggested
swimming.

Anyway I am seriously worried that I am looking at being on
sticks or a wheelchair in the future.  I am on a diet but I am
worried that the damage to my knee cap is irreversible( he didnt
say wether or not this was so).

Please have you got any idea what this condition is?  And, more
to the point, could you tell me what to do about it (apart from
losing weight, which I am trying to do anyway).  I would really
apprecate any help you can give.

I have a knee support on one leg at present.  It is a Neoprene
one with a hole in it.  I confess that I have no idea exactly where
I am supposed to position the hole.  I have to move it around a
bit because sometimes it feels a bit low and sometimes it
wanders off position anyway.  I would have thought it would be
simple to find the right spot but now I am wearing this support I
see it isnt as simple as I first thought, LOL.
Answer -
Hello Lynne,


       Yes, most likely it is Chondromalacia Patella.  The cartilage on the
back of the knee cap
becomes frayed/fuzzy looking.  Loosing weight will definately help
your condition.  In the mean
time you will want to use a exercise bike with very little resistance to
help heal the knees.  Biking
should be done for 20-30 minutes each day and ice for 15-20 minutes
afterward.  There is also
a stretch you can perform on the knee cap, it is painful but does help
your condition.  When
sitting on the ground with the leg straight out in front of you, cup your
knee cap between your
thumb and index finger, gently traction your knee cap pushing towards
your foot, after the knee
cap has moved down/ inch or two, contract your quads/upper leg
muscle forcing the knee cap
back up underneath your hand.  Pressure is to be light and this stretch
can be down 2-3x per
day.  Perform for at least two weeks.  The hole in the knee brace goes
directly over the knee.

Hope the information helps,
Dr. Brendon O'Brien D.C.

Hello Brendon,

Thanks so much for your reply.  I have printed it off.  I must confess I
haven't managed to push
my knee cap that far (so far) and I HATE the crunching when I move it.  
But I will persevere.  Your
info has made me feel more positive.

I wonder why exactly the cartilege is roughened?

And also if it will become smoother if I do everything right or if it is
always going to be
roughened from now on?

Yours, Lynne

Answer
Hello Lynne,


   The cartilage can become frayed from normal wear and tear.  Often young atheletes will have this condition.  It may last for several months but with the exercise I gave you it will shorten the time of recovery!

Thank you for responding I love hearing how my advise is helping.  I have been out of town, so it took me a little while to get back to you.

Sincerely,

Dr. Brendon O'Brien D.C.