Could you please outline the VMO exercises and stretches that you have been doing? Did he recomend taping your knee?
I can not see any harm in taking glucosamine, chondriotin or msm. Maybe the reason the physio was hesitant about telling you whether of not to get these supplements is because cartiliage is an avascular tissue. With no blood supply the chances of regeneration and repair once it is injured are minimal. Atleast that is what we have been told at university. This does not necaserily mean that glucosamine, chondriotin or msm will be useless, infact some studies seem to show that it may be effective.
There is no harm in seeing whether they work or not. Although I have similar injuries and am not taking these supplements I would be taking them if I had the money. There was an article here at t-mag a little while back that said that glucosamine may not be the best because it may decrease insulin sensitivity etc but I think that in your case I would not worry and would use it.
As far as other things you can do... Just stick to what he said AND KEEP UP THE STRETCHING. Also Poliquin I think actually recomended getting back to full squats, he mentioned using 1 and 1/4 squats as a method of rehabilitating some injured athletes VMO with great success. This would be something that you would definetly work up to and not rush into. I have had a similar injury for a while now and while I can deadlift 450+ can not full squat the bar without pain.
Here are some studies that I found that may be of interest. There were several others you will need to go to pub med and do a search though.
Correlation between radiographic severity of knee osteoarthritis and future disease progression. Results from a 3-year prospective, placebo-controlled study evaluating the effect of glucosamine sulfate.
Bruyere O, Honore A, Ethgen O, Rovati LC, Giacovelli G, Henrotin YE, Seidel L, Reginster JY.
WHO Collaborating Center for Public Health Aspect of Osteoarticular Disorders, Liege, Belgium
Objective To investigate the relationship between baseline radiographic severity of knee osteoarthritis (OA) and the importance of long-term joint space narrowing.DesignSub-analysis from a three-year randomized, placebo-controlled, prospective study, of 212 patients with knee OA, recruited in an osteoarthritic outpatient clinic and having been part of a study evaluating the effect of glucosamine sulfate on symptom and structure modification in knee OA.Material and Methods Measurements of mean joint space width (JSW), assessed by a computer-assisted method, were performed at baseline and after 3 years, on weightbearing anteroposterior knee radiographs.Results In the placebo group, baseline JSW was significantly and negatively correlated with the joint space narrowing observed after 3 years (r=-0.34, P=0.003). In the lowest quartile of baseline mean JSW (<4.5mm), the JSW increased after 3 years by (mean (S.D.)) 3.8% (23.8) in the placebo group and 6.2% (17.5) in the glucosamine sulfate group. The difference between the two groups in these patients with the most severe OA at baseline was not statistically significant (P=0.70). In the highest quartile of baseline mean JSW (>6.2mm), a joint space narrowing of 14.9% (17.9) occurred in the placebo group after 3 years while patients from the glucosamine sulfate group only experienced a narrowing of 6.0% (15.1). Patients with the most severe OA at baseline had a RR of 0.42 (0.17-1.01) to experience a 0.5mm joint space narrowing over 3 years, compared to those with the less affected joint. In patients with mild OA, i.e. in the highest quartile of baseline mean JSW, glucosamine sulfate use was associated with a trend (P=0.10) towards a significant reduction in joint space narrowing.Conclusion These results suggest that patients with the less severe radiographic knee OA will experience, over 3 years, the most dramatic disease progression in terms of joint space narrowing. Such patients may be particularly responsive to structure-modifying drugs. Copyright 2003 OsteoArthritis Research Society International. Published by Elsevier Science Ltd.
Glucosamine sulfate use and delay of progression of knee osteoarthritis: a 3-year, randomized, placebo-controlled, double-blind study.
Pavelka K, Gatterova J, Olejarova M, Machacek S, Giacovelli G, Rovati LC.
Department of Medicine and Rheumatology, Charles University, Prague, Czech Republic. email@example.com
BACKGROUND: Conventional symptomatic treatments for osteoarthritis do not favorably affect disease progression. The aim of this randomized, placebo-controlled trial was to determine whether long-term (3-year) treatment with glucosamine sulfate can modify the progression of joint structure and symptom changes in knee osteoarthritis, as previously suggested. METHODS: Two hundred two patients with knee osteoarthritis (using American College of Rheumatology criteria) were randomized to receive oral glucosamine sulfate, 1500 mg once a day, or placebo. Changes in radiographic minimum joint space width were measured in the medial compartment of the tibiofemoral joint, and symptoms were assessed using the algo-functional indexes of Lequesne and WOMAC (Western Ontario and McMaster Universities). RESULTS: Osteoarthritis was of mild to moderate severity at enrollment, with average joint space widths of slightly less than 4 mm and a Lequesne index score of less than 9 points. Progressive joint space narrowing with placebo use was -0.19 mm (95% confidence interval, -0.29 to -0.09 mm) after 3 years. Conversely, there was no average change with glucosamine sulfate use (0.04 mm; 95% confidence interval, -0.06 to 0.14 mm), with a significant difference between groups (P =.001). Fewer patients treated with glucosamine sulfate experienced predefined severe narrowings (>0.5 mm): 5% vs 14% (P =.05). Symptoms improved modestly with placebo use but as much as 20% to 25% with glucosamine sulfate use, with significant final differences on the Lequesne index and the WOMAC total index and pain, function, and stiffness subscales. Safety was good and without differences between groups. CONCLUSION: Long-term treatment with glucosamine sulfate retarded the progression of knee osteoarthritis, possibly determining disease modification
Oh yeah and if you could please outline the exercises and stretches I would greatly appreciate it.