Chondromalacia patellae (also known as CMP) is inflammation of the underside of the patella and softening of the cartilage. While the term chondromalacia sometimes refers to abnormal-appearing cartilage anywhere in the body, it most commonly denotes irritation of the underside of the kneecap (or "patella"). The patella's posterior surface is covered with a layer of smooth cartilage, which the base of the femur normally glides effortlessly against when the knee is bent. However, in some individuals the kneecap tends to rub against one side of the knee joint, irritating the cartilage and causing knee pain.
"Getting up from the couch or a chair, and especially climbing stairs, have become my worst enemies. Talk about tender knees!"
After the car accident I was in at the end of 2010, I found myself before my Osteo doctor once again. Having already been diagnosed with osteoarthritis, the reason I was there to see him was because the accident has given my joints a rather good shake and jarring. Always careful to avoid medical terminology, my good Osteo doctor avoided presenting me with words I might not understand. The insurance company; however, did.
On the explanation of benefits mailed to me by my insurance company was the medical terminology describing my Osteo doctor's diagnosis. One of the diagnosis I have is, 'Chondromalacia Patella,' a condition that is also referred to as, 'Patellofemoral syndrome,' or, 'Knee pain - chondromalacia.' Chondromalacia patella involves the softening and breakdown of the tissue (cartilage) that lines the underside of the kneecap (patella). It is a common cause of anterior knee pain.
As many people here at Disabled World are aware - I am married to the Director of Nursing, my wife Wendy. Chondromalacia of the patella; it seems, is a condition that occurs in teenagers and young adults! (Wait just one dang minute here...wasn't that, 'osteo-osteosis,' another one of these young people things I was diagnosed with). Not only that, but the condition is also more common in women. It is apparently related to the abnormal position of a person's knee. A person's kneecap, or patella,' sits over the front of their knee joint. When you bend or straighten your knee, the underside of your kneecap is supposed to glide over the bones that make up your knee.
There are tendons that attach your kneecap to the bones and muscles around your knee called the, 'patellar tendon,' and the, 'quadriceps tendon.' My issues started when my kneecap began moving improperly and rubbing against the lower portion of my thigh bone (ouch). According to Nurse Wendy, this can happen because my kneecap is in poor alignment, or there is a weakness or tightening of the muscles in the back or front of my thigh. She also told me that the decades of nursing assistant work I did (too much activity) probably had a lot to do with it as well. Other people can develop chondromalacia patella from having flat feet.
The osteo doctor I see told me that I also have arthritis of the kneecap - at least that is consistent with my age (I am about to turn forty-seven). He told me that people who have experienced fractures, dislocations, or injuries to their knees (can anyone say, 'skiing') also have the potential to experience chondromalacia patella.
So - what are the symptoms I have
Well, I have a grinding and grating sensation when I bend or flex my knees. I also experience a level of pain on the front of my knees after I have been sitting down for a period of time. Getting up from the couch or a chair, and especially climbing stairs, have become my worst enemies. Talk about tender knees!
What about medications for some of this
My doctor prescribed some NSAID's that I don't like to take because they eat my stomach. I do; however, take Tramadol. I also like a product called, 'Biofreeze,' when things get really bad where pain is concerned.
Stretching has become a three times a week effort; one that is helping actually. Even though I don't like climbing stairs, I still do it. I also do a certain amount of walking, although I watch just how much I do because too much finds me reaching for that Biofreeze (believe me, there are knock-offs of this product). Where the stretching is involved, I stretch my hamstrings and my quadriceps.
Some of the suggestions my Osteo doctor gave me included swimming, riding a bike, and walking. He doesn't treat my feet so he has no awareness of the four bones in each of my feet that are ready to snap. I don't ride a bike. Swimming is something I am waiting for warmer weather for, even in the pool here in the complex I live in.
Understand that I have already been through the arthroscopic knee surgery involving the removal of cartilage from both knees. I now find myself using not only knee braces, but ankle braces as well. The scars from that surgery are minor; I had expected two-inch or better scars but my surgeon is highly-skilled. The AFO's (ankle braces) I use have support for my feet built into them. The knee braces I use are hinged ones, providing better support.
The kid who used to jump over cars and hit those twelve foot ski jumps at the ski resorts won't be doing those things anymore, this much is certain. Perhaps a little Tai Chi instead. The two things that give me the most trouble are stairs and getting up from the couch or chairs. Deep knee bends are out of the question. Lifting heavy objects off of the floor makes my knees sing, 'Ave Maria,' for the remainder of the day. Does any of this get me down? Sometimes, but I am very thankful for what I do have. I am also thankful that I have Wendy in my life, and that I work from a home office.
The majority of people who experience only chondromalacia patella, without all of the osteoarthritis and additional forms of disabilities that I do, usually improve with therapy and the use of NSAID's. Others might require surgical interventions which are successful the majority of the time.
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