I have a sharp pain in the backside of my patella. With my history of osteoarthritis I believe it is torn miniscus. In truth, my knees generally feel better now at age 46 than they did when I was a teenager, but this injury has caused me to have to stop training for off-road bicycle racing, which I love. I take glucosamine and chondroitoin and fish oil. My question is what can I do to speed the healing and to further improve the health of my joint? I think the reason it was injured was that I was trying to incorporate weightlifing into my off-season training and I was using a little too much weight. It was only 90 lbs on the leg press machine, but that is about all I could do without pain to my right knee. Any suggestions will be appreciated.

Gary, I feel your pain, literally. I'm a roadie, but I've hung up my bike for the season. I have found weight training in the winter keeps the muscle mass in my legs, and have personally come to like SuperSlow-like leg curls and presses. Muscles and bones stay strong with minimal stress on the joints. After the knee feels better you can add a few minutes on the stationary (or rollers if you got 'em) to keep from being wobbly.

Hi, being a yoga teacher, I would recommend a good yoga therapy or yoga restorative class to rehab your knee. Gaining strength, range of motion as well as stability in the joint will get you back on your feet without the nagging pain. Where are you located, I maybe able to direct you to a good location for help. :P

Hi there SupeUser . . . what about using prolotherapy to INDUCE inflammation for recovery of the joints? http://www.bonesdoctor.com/prolo.html

. . . this does NOT make sense to me personally - however, it is not my field - so perhaps you can shed some light on it for me, please? . . .thanks, Ayesha

I know this original post was posted a while ago, but I must add a comment about medical advice. Many people might have good intentions about offering advice that might have worked for them, but often people don't realize that it may not work for others, and more importantly, they do not know the medical history of the individual, and may do more harm than good. It is best to seek the advice of your health care professional.

Retropatellar pain is not caused by a meniscal tear; the meniscus is situated in the knee (tibiofemoral) joint, whereas you are actually having pain in your patellofemoral joint, which is often mistakenly associated with the knee itself.

Pain behind the patella is usually caused by a condition called 'chondromalacia patella', which is the destruction of the articular cartilage on the backside of the patella. It is basically osteoarthritis of the patellofemoral joint.

Unfortunately, once injured, this cartilage does not heal, so the damage is permanent and will get progressively worse over time.

Nevertheless, with good rehab, most people are able to overcome the condition and resume a considerable level of physical activity. As the condition is thought to be caused by maltracking of the kneecap due to tensile imbalances between the tendons and ligaments attached to the patella, the problem is often correctable through rehabilitative exercise.

Admittedly I am not an expert on cycling, but since patellofemoral stress increases with the degree of knee flexion, I would infer that you may benefit from raising the height of the seat since this will keep the knee closer to straight.

If you are weight training, you should probably avoid exercises which call for a great degree of knee flexion, i.e. squats. You can decrease the stress on the PF joint during the leg press by using a higher foot position.

Prolotherapy is generally considered to be a quack practice. I'm not saying that it is or isn't, but I do think that many of the claims made by prolotherapy practitioners tend to be on the outrageous side, and are usually largely unsubstantiable.

I do agree with the basic philosophy that local inflammation is a natural part of the healing process and that it is wrong to use anti-inflammatory modalities to suppress this response.

And, while prolotherapy may or may not be useful for certain soft-tissue injuries, it definitely won't regenerate an arthritic joint. Anyone who makes that claim is a quack.