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Cycling and chondromalacia(9 posts)

Cycling and chondromalaciaMJCBH
Dec 9, 2002 1:25 PM
Any of you cycling/medical guru's have any experience with cycling and chondromalacia (softening of the cartilage in the knee joint causing pain under the knee-cap). I am a fairly young rider(24 yr.old) with some serious degeneration in my knees after years of sports (two surgeries on each knee, not much cartilage left).
I have now taken up cycling as an alternative to the pounding of running. My bike/cleat set-up seems pretty good, I'm just a bit tentative to push my training too far for fear of wearing out my knee joints prematurely, since cycling is such a repetitive motion. Any info. or opinions would be greatly appreciated! Thanks in advance.
re: Cycling and chondromalaciajtolleson
Dec 9, 2002 2:28 PM
Two different folks I ride with have dealt with it... and two different ways. One had the surgery where they actually change the way your knee cap tracks. A more permanent fix, but longer recovery time. She's never been sorry.

Another has worked with a PT on the right stretches and leg strengthening exercises and believes she's got it kicked. I think that it is not an uncommon sequella of cycling, but it should not prevent you from achieving your goals.

Start with a good cycling oriented PT if you can get one.
re: Cycling and chondromalaciadarbo
Dec 9, 2002 2:38 PM
I have chondromalacia in my left knee, though not as severe as yours (no surgery), but have been able to road-bike pain free. No medical training though, so take this anecdotal evidence for what it is...

Some things i did that worked for me -- First and foremost, reset my pedals and cleats so that my legs were moving straight up and down. I got a shorter crankset (from 177.5 to 172.5 mm), and moved my saddle back a little bit so that at the top part of the pedal stroke, my knee wasn't bent at an extreme angle. I then reset my seat height per the standard rule (slight bend in the knee at bottom of pedal stroke with foot parallel to ground). I try to avoid mashing the big gears, and maintain consistent 80-90 RPM cadence. I found that standing on the pedals caused some pain, so I geared my bike with sufficiently wide gearing to allow me to stay seated on most hills (53-39 tooth chainrings with a 12-25 cassette).

I've been back on the bike for about a year now, and have been gradually increasing my mileage with no ill effects. Best of luck to you.
re: Cycling and chondromalaciaeddie m
Dec 9, 2002 3:32 PM
I had some chondromalacia limited to my kneecap. The advice at the time was use low gears and spin. I found that didn't help much. Strength training did help. I started doing intervals in big gears once or twice a week, but only when my knees were completely pain free. I also eventually trained with weights. I also use ice and ibuprofen, and I've stayed with the same basic approach for 25 years. There have been no restrictions on my activities, and my knees are generally pain-free. I've never regretted refusing the surgery. Your results may vary.
re: Cycling and chondromalacianellie
Dec 9, 2002 3:35 PM
I grew up skiing and biking and have had chronic knee problems over my lifetime. I had very similar symptoms to yours during the late summer this year. I was put on a routine of stretching, using a foam roll on my IT band and hamstrings (this was key!), yoga and strength exercises I no longer experience any pain. My main issue was very tight IT bands and hamstrings caused by too much riding (along with a 20 years working out as a kid) and not taking the time to stretch after. The tightness in my IT bands were pulling my kneecap off to the out side and not allowing it to track correctly - chewing up my cartilage. Getting on a stretching program for my legs has re-aligned my kneecap and I no longer have any pain.

Speaking as one that has had 3 major sports injury related surgeries, I would suggest using surgery only as a LAST resort.

good luck.
re: Cycling and chondromalaciaChen2
Dec 9, 2002 3:47 PM
I've had it all of my life. Five knee surgeries since 1964. With the last two I had tibial tubercle transfers, petella ligaments moved medially and screwed back down. I have two screws through each tibia. No problems riding the bike, in fact my surgeon recommends it. I was back on my bike 4 weeks after surgery but took a full year to regain all of my strength. Now I'm stronger than before surgery. With todays technology there would not have been a need for me to have more than two surgeries, one on each knee.
My knees prefer a high cadence, high saddle position, and Speedplay pedals, X1's. I ride about 2500 miles per year including 2 or 3 centuries and race a few time trials. The knees do not limit my riding, my job does. I can climb hills OK too. Surgery is not the answer for all folks with chondromalacia but it was for me.
~Al

~Al
re: Cycling and chondromalaciapeter1
Dec 10, 2002 8:08 AM
Yes, I had it really bad when I was training seriously for mtb racing about 8 years ago. (I was 26). I was probably riding too much too soon without being more careful about my cleat position and pedal stroke mechanics.

I went to my doctor who diagnosed it and sent me to a physical therapist. He gave me some stretches and exercises, and it has helped. I would consult a therapist who is familiar with chondro. For me, what helped the most was supplementing cycling with specific weight-training exercises. (I won't tell you what I do because I don't want to steer you wrong)

Now, I've got plantar fasciitis to deal with. Ouch! I guess aches and pains just come with the territory if you want to be an older athlete...

cheers, and good luck.
chrondromalacia misdiagnosis..dotkaye
Dec 10, 2002 10:18 AM
I think you got some bad advice there.. surgery is almost never the right answer for knee pain in runners, and chrondomalacia is extremely improbable for someone as young as you. I'm assuming the problem came from running ? It could probably have been fixed with orthotics and strengthening exercises.. see Dr Tim Noakes' book Lore of Running for details. His '10 laws of running injuries' are online at:
http://health.iafrica.com/fitness/running/injuries.htm
These really apply to any repetitive-motion exercise, not just running. But now the surgeon has wrecked your knees, I guess you'll have to live with it..

The good news is that cycling is unlikely to aggravate the condition and may even help it. Strengthening underdeveloped vastus medialis (inner thigh) cures "chrondomalacia" in the majority of cases. Outside magazine had a good article sometime which recommended:
Specific exercises
* Avoid full 90-degree leg extensions, but do final-20-degree (to fully extended) with light weight, to build thighs without harming knees.
* Avoid tall steps; do smaller steps with more repetitions.
* Best for inner thighs is extensive cycling with saddle height set properly -- knee only slightly bent at bottom of stroke. Spin fast in easy gear.
* Cross train away from pounding exercises.

Just make sure you're properly fitted, that the cleats on your shoe are angled properly so the knee moves in its natural plane of motion (may be helpful to get cleats with some float), and spin, don't mash.

I had severe problems with "chrondomalacia" as a teenage runner (lost the 1974 season entirely), and periodically since then: but good stable shoes and regular knee extensions have always cured it. I was lucky to have a good conservative MD who did not send me to a surgeon, or the story might have been different.
chrondromalacia misdiagnosis..peter1
Dec 10, 2002 1:45 PM
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This is exactly what helped me.

Peter