chondromalacia treatment: exercises!

Please read the entire chondromalacia Exercises page before attempting the exercises further down the page. If you are experiencing knee pain, ask your doctor or physical therapist what exercises are appropriate.

Method A：
Straight leg lifts can help strengthen the quadriceps muscles and improve chondromalacia of the knee. This can be performed with or without 2-5 lb. ankle weights.
Another useful exercise can be performed by placing a towel between the knees and squeezing the knees together for several seconds. This will build up the medial (inner) aspect of the quadriceps muscle and restore a more normal relationship between the patella (kneecap) and the knee joint.
These exercises, when repeated daily, can dramatically lessen the symptoms of chondromalacia patella. Avoiding stair and hill climbing will also decrease the progression of knee damage.

Method B：
Consider these exercises:
1. Sit on a bed, keep your leg flat and straight out. Bend your toes towards your head as much as possible and hold this position for ten seconds. Release. Repeat ten times.
2. Sit on a bed, keep your leg flat and straight out. Bend your toes towards your head. Raise your leg off the bed six inches and hold it. Keep this position for ten seconds and release. Repeat ten times.
3. Hang your legs over the side of the bed, raise the lower part of your leg so your leg is straight out and hold for ten seconds. Release. Repeat ten times.
4. Sit and swing your leg over the side of the bed or chair to maintain knee mobility. Do this for about 1-2 minutes.
5. Sit in a chair, place your foot under the bottom edge of a desk or bed with the leg almost straight. Slowly, lift the leg from the top up as though trying to lift the desk or bed off the ground. Your thigh muscles will tighten and become fatigued. Hold for 10 seconds then relax. Repeat 20 times and then do the same with the other leg. Repeat this exercise three times a day for three or more weeks.
6. Hamstring Lengthening Exercises: While sitting in a chair, put your leg straight out in front of you with your heel resting on the ground. Rest both hands on your knee and while keeping your leg straight, slowly slide your hands down the front of the knee towards the foot until you feel a tightening and slight pain in your hamstrings (tendons behind the knee). Hold for 10 seconds, then relax. Repeat 20 times with both legs and perform the exercise three times a day for three weeks. Your hamstrings will loosen and you will be able to move your hands further down your shin towards your foot.
You will need to restrict your athletic exercise and do the above exercises for a month to get an improvement. You may then gradually return to your normal exercise. The pain may recur. You should then follow the above exercises again.
Other exercises for chondromalacia focus on the hip (gluteal exercises) and flexibility exercises. An exercise that directly put force through the knee, especially the knee extension exercise may be painful.
If you find the above exercises too painful, then try the one below.
Lateral “monster walk.” This requires a 20-inch piece of thick theraband or tubing tied in a circle and wrapped around both ankles. The patient will stand with the feet shoulder-width apart (never let the feet get any closer than that) and walk sideways across the floor against the resistance of the band. The knees should be slightly bent; the buttocks should be down and back. Stress should be felt in the quadriceps and in the gluteal (butt) muscles. Repeat 10 steps in each direction, 2-3 times.

Question about Chondromalacia and exercise:
I am a computer contractor in my 30s and recently had health insurance for a brief period of time- about a year and a half ago. I was experiencing pains in my knees when walking. I had an MRI. I was quite dismayed when the doctor told me then I appeared to have chondromalacia and some thinning cartelege, as well as an unexplained miniscus tear. I have since lost coverage and cannot afford to go back. How and why I got chondromalacia I have no idea, but I do not do strenuous sports.
After taking glucosamine and changing to better shoes, the knee pain went away and really hasn’t returned since. The tear, if it hasn’t healed, appears to cause me no trouble. However I have been concerened about cartelege and wear on my joints. I do hear some slight clicking/squelching when doing squats or straightening knees, and have read on websites that this could mean degrading carteledge, softening, wear, etc. Some warn about ignoring such signs, and give horror stories of ‘bone on bone’ after ignoring them for years.
My question is, I would like to exercise with weights, but I am concerned that exercises such as the leg lift, leg curl, etc will further ‘wear down’ the carteledge in my knees. Does the cartelege in your joints really behave like road tires, meaning such increased activity will wear them down prematurely? Am I dooming myself to ruined knees by such exercises?Thanks much!

Answer:
Although I don’t have expertise in the area of knees, I’ll try to address a few points you make on other general issues.
My one concern is the fact that you don’t have health insurance and you went to a doctor and got a diagnosis. My fear is that since there is a written record of a health issue, any insurance you pick up might consider this a pre-existing condition and will make it harder for you to get coverage. A pre-existing condition clause normally does not cover diagnosed conditions that are less than five years old. So you need to be very careful when looking into health coverage and be sure you are covered.
It might be that the pain you were experiencing was from the meniscus tear and that may have healed and that’s why you are pain free. thing that concerns me is that you are still experiencing clicking and and squelching noises and that you had been diagnosed with thinning of the cartiledge. If I were you I would not exercise with weights, that can exacerbate any condition you might have and if your meniscus tear has not completely healed you may tear it again.
You really need to get in touch with a competent physical therapist in order to see if there is any exercise you can do that will strengthen the muscles and not do damage to your cartlidge or the meniscus.
I can’t say for sure what you can and can’t do, only your doctor can tell you that. My main concern is your health coverage. My gut reaction is that if you are not in any pain, you should do very little weight lifting and try to stay healthy until the pre-existing clause of any health insurance has expired. Then get health insurance, and address any issues you may have at that time.
If you don’t do that, and for some reason, do damage to your knees you won’t be covered because of the diagnosis.
Hope this helped.