RE: Knee cracking/chondromalacia???
Hi All, just wanted to say that I also have Chondromalacia (and the "crunchy" or rice krispie sound, aka: crepitus) in one knee - and want to preface this by saying that all I've done in this post is to condense a lot of my own online research for you...I'm not a doctor, and I hope that someone may share what they have found about this problem, and that this might be a helpful start to your own research.
I would be VERY interested to hear what kind of braces/knee wraps or stabilizers you have actually tried to improve patellar tracking and found most helpful, as I feel completely overwhelmed when I go to the store and see the amazing number of options that are available.
1) The CAUSE: poor patellar tracking (some debate over whether this is really caused by or can be fixed by correcting a muscular imbalance - more on that below) due to overuse, injury, etc...resulting in degeneration of cartilage behind the knee cap - causing the grinding noise (crepitus) as it slides over the end of the thighbone.
Here's one of the better comprehensive articles that I found on the subject, complete with symptoms, management, what tests will show, etc - the only thing it doesn't have is a diagram:
http://www.patient.co.uk/showdoc/40024870
2) The general consensus seems to be that its not a major concern until there's pain and/or swelling...
3) The Big Fix: while you can have surgery to essentially shave the burrs/uneven spots & resurface the back of the patella, resulting in smoother, hopefully pain-free & soundless tracking...this is a "last resort" and some patients seem to report they have as much or more pain after surgery - so, the non-surgical advice I found, summed up:
4) Non-Surgical Help:
Rest and stopping the activity/overuse (not practical for me, as even after a month off, it still does it)...plus, I go nuts if I don't exercise for too long.
Supplements for joint health, usually Glucosamine and Chondroitin, as mentioned above...here's a helpful article with some additional suggestions about those and other supplements that may help, along with dosage guidlines:
http://sportscenteraustin.blogs.com/the_view/2005/02/how_to_use_supp.html
Physical Therapy - common thinking is that one cause of the mis-tracking is a muscular imbalance in the thigh - the stronger side pulling the kneecap out of alignment. So, working to isolate & strengthen the weak side should pull the patella back on track, by strengthening the VMO (vastus medialis oblique - the muscle closer to the inside, not the outside, of the thigh). Here's a wikipedia article with highlighted diagram so you know which muscle we're talking about:
http://en.wikipedia.org/wiki/Vastus_medialis
I have no idea if this is true or not, but here is an article I found very interesting that called this idea of muscular imbalance being corrected by isolating the VMO "The Number One Myth of Knee Rehab":
http://sportscenteraustin.blogs.com/the_view/2005/01/the_number_one_.html
Finally, again, if anyone has found a great brace for improving patella tracking and has really found that it reduced the noise/discomfort...I have trouble deciding what's hype and what works as most sites have so many types its ridiculous...
Here's just one site I found that actually showed braces categorized by condition just so you can get an idea of what's out there (tracking, chondromalacia, ACL/PCL):
http://www.kneesupport.co.uk
Hope this helps others and that someone can recommend a good brace to try....luck to all!