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chondromalacia patellae

woody66

This is my boy Yankee!
Year of past OR future Camino
2021
Hi everyone!
Hope this is right place to put this?
I said on a recent thread that my foot and knee problems had vastly improved and that i was walking with no pain.
However i have now got quite intense pain in my right knee ,but only when going up stairs to the point where i climb them with the right leg straight (coming down is far less uncomfortable)
I searched Dr Google and because of the fact that the pain is so specific, it came up with this on NHS website

Chondromalacia patellae.

Has anyone on the forum had this and how did they deal with it long term.
I know physio , ice and stretching is recommended which i will do; but it's more the personal effect on your long term ability to walk that concerns me!!
Any advice most welcome
Thanks Woody
 
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edandjoan

Active Member
Year of past OR future Camino
St. Gallen to Muxia
2012-2018
I am no doctor...but it sounds like an IT band issue...if the pain is on the outer side of the knee. Usually an over use injury that need rest and core strengthening.You can research that and maybe see a doctor and PT.
 
Year of past OR future Camino
Us:Camino Frances, 2015 Me:Catalan/Aragonese, 2019
Seeking medical help is best but in the short term I have an idea that you could try out. About a week into my last camino there was a day when my knee would give out on me and I would drop, three times right to the ground. I ended up making an instep support with tissue paper wadded up under my insole. The next day I had fewer problems and then none after that.

Good luck Woody.
 
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Marbe2

Active member
Year of past OR future Camino
2015-2019 walked all or more than half of CF 7 times... CP recently cancelled by Covid 19!
Seeking medical help is best but in the short term I have an idea that you could try out. About a week into my last camino there was a day when my knee would give out on me and I would drop, three times right to the ground. I ended up making an instep support with tissue paper wadded up under my insole. The next day I had fewer problems and then none after that.

Good luck Woody.
Hi Woody, I sympathize with the struggle you are currently having. However, I echo Rick+Peg’s response that it would be best to get medical advice regarding treatment. Even with a diagnosis, your treatment is best served by medical and theraputic intervention supervised specifically by your healthcare providers.
Wishing you well, Woody!
 
Year of past OR future Camino
2017
Seeking medical help is best but in the short term I have an idea that you could try out. About a week into my last camino there was a day when my knee would give out on me and I would drop, three times right to the ground. I ended up making an instep support with tissue paper wadded up under my insole. The next day I had fewer problems and then none after that.

Good luck Woody.
Just curious, @Rick, what brought you to the decision to use this instep support? I've found that simple is frequently helpful for me, but I need to know the "backstory" before trying it. Thanks! ;-)
 
Year of past OR future Camino
Us:Camino Frances, 2015 Me:Catalan/Aragonese, 2019
Just curious, @Rick, what brought you to the decision to use this instep support? I've found that simple is frequently helpful for me, but I need to know the "backstory" before trying it. Thanks! ;-)
On my first camino, again about a week in, I was having a knee problem. Not the collapsing, the knee was just sore. I finally paid close attention to how I was walking. I noticed that my foot was going flat and when it did my knee twisted just a little (this is called pronation). So I inserted tissue to keep the foot from flattening. Five years later it is still in the boot it did the trick so well.

Last year I walked in new shoes but this time with doctor prescribed insoles. Long practice walks didn't bring up any problems. On camino on the day I had the collapsing there was a lot of asphalt and uphill walking so I suspected a different cause and I didn't think of adding extra instep padding . That night though I figured I didn't have anything to lose except some toilet paper so I went for it, with great results.
 

trecile

Camino Addict
Year of past OR future Camino
Francés (2016 & 2017), Norte (2018), Francés-Salvador-Norte (2019), Portuguese (2019)
I am no doctor...but it sounds like an IT band issue...if the pain is on the outer side of the knee. Usually an over use injury that need rest and core strengthening.You can research that and maybe see a doctor and PT.

I had what I believe was an IT band knee issue last year. It began on the descent into Zubiri, and hurt when I was walking downhill. But @woody66 says that his problem is going up, not down. I don't know if that makes a difference.

However i have now got quite intense pain in my right knee ,but only when going up stairs

I was lucky that another pilgrim saw me icing my knee out on the patio at the albergue in Larrasoaña, and suggested that pain on the outside of the knee like mine could be an IT band issue. I immediately started searching for exercises, stretches and massage that could help. I found a combination of massage and stretches which pretty much eliminated it within a day. I found the self massage most effective.

I had one other instance of the same kind of knee pain after I returned from the Camino. I went on a 10 mile hike, with the first 4-5 miles uphill. My knee was perfectly fine until I started going downhill, then I had the knee pain again. I did some stretches and self massage and finished the hike with some knee pain, but it was totally gone the next day.
 

Doughnut NZ

From Aotearoa New Zealand
Year of past OR future Camino
2022
I finally paid close attention to how I was walking. I noticed that my foot was going flat and when it did my knee twisted just a little (this is called pronation). So I inserted tissue to keep the foot from flattening. Five years later it is still in the boot it did the trick ...
Not to hijack this thread too much but I pronate when I walk and buy walking shoes that allow for this by having more support in the instep. Many trail runners and walking shoe manufacturers have models for pronators like us. I also buy double wide shoes.

Prior to using them I was getting very fatigued legs. This cleared up and I significantly improved my pace with the same effort with shoes designed to alleviate pronation. I imagine that the inserts are even better if they are designed specifically for you.
 
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Us:Camino Frances, 2015 Me:Catalan/Aragonese, 2019
I also buy double wide shoes.
The extra room could cause the foot the slide and that could lead to blisters. Is that a problem for you? Thicker socks could help with the sliding. If you use them does that degrade the performance of having the extra wide shoes?

Just curious. Generally I only get blisters in the breaking in period.
 

Doughnut NZ

From Aotearoa New Zealand
Year of past OR future Camino
2022
The extra room could cause the foot the slide and that could lead to blisters. Is that a problem for you? Thicker socks could help with the sliding. If you use them does that degrade the performance of having the extra wide shoes?

Just curious. Generally I only get blisters in the breaking in period.
No blisters so far. The double wide is as much associated with being a Kiwi and Fijian kid of my era as much as pronation.

I never wore shoes until I was 6 and moved to NZ except for my Confirmation. Even in NZ I rarely wore shoes until I was 9 or 10 and I remember playing in the ice covered puddles on the side of the road during Winter. Jumping on the ice in my bare feet to break it.

If anything, the not wearing shoes may have caused the pronation.

It is common to get double wide shoes in NZ because many contemporaries also did not wear shoes as children.
 
Last edited:

Penbaysail

Member
Year of past OR future Camino
2017
Chondromalacia is softening of the cartilage on the deep side of the kneecap (patella). It's aggravated by repetitive motion (like a long day of walking or hiking) and when the patella doesn't track properly in the groove on the front of the thigh bone. It would help to get a diagnosis and x-rays, but you can't do any harm by trying the following:

* Strengthen the quadriceps muscles on the front of the thigh. This helps the patella to track straighter. 

* Cycling is a good quadriceps strengthener, but be mindful to use gears properly so that you don't push in hard gears and aggravate the situation.

* An elastic knee sleeve provides comfort, support, and keeps the knee relatively warm.

* Trekking or Nordic poles can be used to take some load off the knee while walking, especially uphill. 

* Excessive pronation causes internal rotation of the tibia (lower leg bone) during gait, aggravating the poor patellar tracking. Almost any kind of insole (Superfeet, etc.) will lessen pronation while walking.
 

woody66

This is my boy Yankee!
Year of past OR future Camino
2021
Hi all!
Thanks for all your help and information i am going to see the physio i normal see for a proper diagnosis!
I have custom made orthotics.
I have wondered perhaps if they have contributed to my knee problem?
My reasoning is this and if you think i am on the wrong track please say so as i won't be offended!
My gait is a bit odd i walk with my feet landing like this I / left leg plants straight and neutral,right foot plants at an angle and supinates. (result of six motorcycle crashes over the years and several broken bones; still here so someone up there must like me ha!ha!).
The orthotics i imagine have aided my plantar fasciitis because pain has gone.
However this is my thinking;i have walked an average of 35- 40 miles a week for many many years and all that time my right foot has supinated with no effect on me.
I got the orthotics because of the plantar fasciitis.
Could the orthotic be the cause of the new knee problem,because it's forcing me to change the gait i have had for such a long time and altering the way i imagine my kneecap would sit?
All the best
Woody
 

henrythedog

Loved and fed by David
Year of past OR future Camino
Frances 2017, 2018, 2019, Ingles 2018, (Madrid 2019 partial - retired hurt!) (more planned)
Hi all!
Thanks for all your help and information i am going to see the physio i normal see for a proper diagnosis!
I have custom made orthotics.
I have wondered perhaps if they have contributed to my knee problem?
My reasoning is this and if you think i am on the wrong track please say so as i won't be offended!
My gait is a bit odd i walk with my feet landing like this I / left leg plants straight and neutral,right foot plants at an angle and supinates. (result of six motorcycle crashes over the years and several broken bones; still here so someone up there must like me ha!ha!).
The orthotics i imagine have aided my plantar fasciitis because pain has gone.
However this is my thinking;i have walked an average of 35- 40 miles a week for many many years and all that time my right foot has supinated with no effect on me.
I got the orthotics because of the plantar fasciitis.
Could the orthotic be the cause of the new knee problem,because it's forcing me to change the gait i have had for such a long time and altering the way i imagine my kneecap would sit?
All the best
Woody

Yes to all of the above. My orthotics were made in response to PF, but it’s a condition which can be alleviated by over aggressive correction. I’ve weaned myself off my orthotics over the last year after an attack of PF which cut short my 2019 CdMadrid.
I have also lost 13kg, but I was a fat lad to start with.

The only way forwards is via your physio or a good podiatrist.
 
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Year of past OR future Camino
Portugues '15, '16, & '19
Via Francigena '17
Frances '18
Muxia & Finisterre '18
Tahoe Rim Trail '19
I have had chondromalacia. It was fixed through several months of physical therapy.

My PT stretched my iliotibial band (IT Band) to realign my patella against my femur. Chondromalacia is common among runners, cyclists, and skiers and is often called "runner's knee". These sports often result in a strength imbalance between the quads and hamstrings which will shorten the IT band and pull the patella to the lateral (outside). When this happens the patella and femur rub resulting in the loss of cartilage and eventual bone to bone contact.

The PT along with stretches at home can fix the problem. Some have to have their IT band surgically stretched but I'm not sure how they do that.

Also, a PT can diagnose chondromalacia is about five minutes.
 

Eric G

Member
Year of past OR future Camino
1st timer
Hi everyone!
Hope this is right place to put this?
I said on a recent thread that my foot and knee problems had vastly improved and that i was walking with no pain.
However i have now got quite intense pain in my right knee ,but only when going up stairs to the point where i climb them with the right leg straight (coming down is far less uncomfortable)
I searched Dr Google and because of the fact that the pain is so specific, it came up with this on NHS website

Chondromalacia patellae.

Has anyone on the forum had this and how did they deal with it long term.
I know physio , ice and stretching is recommended which i will do; but it's more the personal effect on your long term ability to walk that concerns me!!
Any advice most welcome
Thanks Woody
I get steroid injections. Works amazingly well.
 

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