High impact activities with chondral damage to the patella.

[Larrythelamb]

I have recently had an MRI scan which clearly shows the presence of chondral damage to the patella. This may have been caused whilst I was doing long distance runs as training for a marathon. I have been told to keep away from high impact activities such as running and was wondering whether rowing would come in to the category of a high impact activity? Should I keep away from rowing whilst I receive physiotherapy to help with the knee pain?

[Larrythelamb]

Thank you for your reply Doctor Vinod. In terms of the rowing action, in his book High Performance Rowing, John McArthur divides the rowing stroke in to four distinct phases: the entry of the blade, the propulsive phase, the extraction of the blade and the recovery phase. The objective is a smooth, continuous movement from one part of the stroke to the next and from one stroke to another. When the blade enters the water the body should be in a strong, tall position with relatively little forward pivot of the upper body. The head should be held up and you should be looking beyond the stern of the boat, the shins should be vertical, with the knees at a natural width apart. The entry of the blade should be initiated using a rapid lifting of your hands and arms whilst keeping your shoulders parallel to the boat. The propulsive stage is initiated by a strong, forceful acceleration of the leg muscles. At this stage the back and abdominal muscles should be braced to provide a strong link between the blade and the legs. As the legs are pushed down the shoulders should start to accelerate towards the bow of the boat. Although this stage involves  the strong, forceful acceleration of the leg muscles as the legs are pushed down I do not really think it is high impact. I was wondering whether you thought the action of pushing the legs down in a strong but smooth way could help the recovery of my knee or would I be better off avoiding it for the time being?

[Dr Vinod]

Rowing using your upper body is fine, but you should be very careful while going aboard the boat and getting down. If you can synchronize on some machines in a gym the rowing  things then it would be fine.