Date: Tue, 7 Sep 1999 16:59:41 EDT From: Mcsiff@aol.com Subject: Strength_List: KNEE QUESTION On 9/7/99, SDSHAFLEY@dow.com writes: <> ***Doctors call this sort condition by names such as chondromalacia patellae or peripatellar pain syndrome and it usually involves deterioration of the cartilage lining the back of the knee cap. The roughness of the back of the patella grinding against the lower end of the femur (thigh bone) causes that 'crepitus' sound, but it generally is more alarming than debilitating in the active person. Often, they state that this may be a precursor to arthritis, but I have been living with a fairly advanced form of this problem for many years. Since the intense pain associated with it did not seem to hinder my progress most of the time, I played it by ear and kept on competing in Olympic weightlifting, actually achieving my best totals while my knees were the most gruesomely talkative in my life. I found that cycling and sprinting were two activities that often made my knees very uncomfortable, though heavy squats and full, deep Olympic snatches did not. Many years later a research colleague of mine reported on work which showed that long periods of cyclical endurance type activity tends to be associated with more arthritis and joint deterioration than regular use of more impulsive loading, so I have always tried to ensure that I do not use cyclical activity as a major part of my training. This seems to contradict the advice often given to older folk to walk instead of jog or run. An interesting theme to ponder! Now that we have some new supplements, I would take MSM, chondroitin and glucosamine three times day to improve the situation - these supplements certainly do seem to be helping my current partial rupture off the mensici in my one knee repair quite well. Let your awareness of pain-free range of movement guide you and you will no doubt still be doing what you are doing physically many years from now, as I am, though maybe at a less spectacular level! Let intelligence and good sense be your guide, but don't discard the occasional advice of a good doctor if you really become very concernde about any further deterioration. Some medics carry out patella scraping, but that is not a permanent solution - - I have had several colleagues just decline again after some years and even have their entire patellae removed. I regard my knees as very private parts! Dr Mel C Siff Denver, USA mcsiff@aol.com Date: Tue, 07 Sep 1999 19:26:04 -0700 From: Jeff L Fahrenbruch Subject: Re: Strength_List: KNEE QUESTION I agree with Dr Siff's informative post.To add to it, I see quite a few of these cases at my clinic. They appear to respond well to low intensity deep squatting in the early stages of rehab. The deep squat distributes the load on the underside of the patella much more evenly than parallel or above or (ugh!) leg extensions. The patellar scraping Dr. Siff refers to usually offers minimal, if any relief. In many cases the knee dysfunction is worse after the surgery. Jeff L Fahrenbruch MPT CSCS