Jason,

I feel for you because I had ITBS in my left knee and patellofemoral
pain syndrome in my right. For your teardrop, which is the vastus
medialus oblique (vmo), I recommend you avoid conventional wisdom and
common literature. Conventional wisdom believes the vmo is activated
significantly during the last 20-30 degrees of leg extension. This
is
true, but the vlo(vastus lateralit-outer quad) is activated an equal
amount. Therefore, all the literature that preaches about how short
arc/leg extensions isolate the inner quad is completely wrong.

However, I'm not saying general quad strengthening for some is not
the
answer. For those that have general quad weakness, leg/short arc
extensions are fine. For those that have determined that they have a
muscle imbalance between their vmo and vlo (weaker inner quad), then
leg extensions are only aggravating the issue. Why? Because, if
you're strengthening both equally, then the vmo is still going to be
weaker than the vlo.

So, an effective corrective exercise that got me over the top was an
exercise recommended by Chris Maund in Peakrun magazine. It's called
the split-toe, heel squat. Put both heels on a 2 inch lift (thick
dictionary will do). Make sure your heels touch. The front of your
feet should be on the ground 30 degrees apart. Keep your back
straight and look straight ahead. Cross your arms in front of you
and
do a slow, deep squat. Take 6 seconds to go all the way down till
your butt is touching your heels. Keep an upright posture! Rest for
one second, then take 6 seconds to come back up. Try to keep more of
your balance towards your forefeet. Concentrate on those inner
quads.
I was only able to do 4 reps when I started, so don't be
discouraged.
Do one set initially, and work your way up to 2 sets of 12 reps
each. Make sure you throw in rest day or 2 in between sessions.

After about 2 weeks, my patellofemoral pain syndrome (PPS) was almost
gone. Some people use chondromalacia and PPS synonomously. This is
incorrect. Both describe similar symptons, though one, PPS, is
simply
the irritation, while chondromalacia is the irritation with the
wearing away and roughening of cartilage. Either way, the split-toe,
heel squat will help both conditions--since they're usually caused by
the same muscular imbalance.

Don't forget to stretch and strengthen the hamstrings. Many people,
especially runners, think their hamstrings get plenty of work while
they run. Therefore, they feel hamstring strengthening is
unnecessary. Well, I'm hear to tell you that they're wrong on that
assumption as well. The quads, not the hamstrings, are worked
significantly during running.

Riding should be fine during re-hab. Bike riding is very effective
in
strengthening the vmo, but only if you stay in the saddle.

As for braces and knee wraps, leave them in the pile. They don't
work. However, if you have a cho-pat strap, you may find that it
gives you symptomatic relief. If you're looking for a device that
helps, orthotics may help. A combination of the corrective exercise
mentioned above with orthotics may make your chondromalacia a distant
memory.

Good luck and take care.

Gino
--- In itbs@y..., Jason Warner <jasoncwarner@y...> wrote:
> Hello,
>
> My name is Jason and I am a new member to this mailing
> list. I guess I will just state my questions and hope
> somebody is kind enough to give me some answers.
>
> First off, a little about me:
> 23
> 6'1"
> 200lbs
> I don't run except to play team sports (Basketball and
> football). I also use a stationary bike for cardio and
> I am an avid weight lifter
>
> Flat Footed
> Knock Kneed
> Pigion Toed
>
> Both knees are have this condition, although the knee
> cap in the left is pulled more noticebly while the
> right still has a slight case of chrondelmacia
>
> I have very very week quads and am (have) been working
> on stregthening them, but they don't seem to get any
> stronger....I am starting to lose hope that they ever
> will.
>
> My questions are:
>
> Besides leg extensions, what excercises can I do that
> will help me build stronger quad muscles
> (particularlly those that form the "tear drop" on the
> inside of the knee...that seems to be what I am
> lacking most as there is a visible void where muslce
> should be and is only bone)?
>
> Can I continue to ride the stationary bike / mountain
> bike as I rehab? If not, how can I stay in shape/lose
> some weight?
>
> Any recommendations on braces for the knees? I have
> more than I know what to do with, and I know they
> won't solve the problem, but if anything helps me to
> feel better as I walk/run/excercise I would love to
> have it.
>
> Thanks,
> Jason
>
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