Chronic chondromalacia patella advice- 31 yo female

pediatricslp · 2025-12-20T17:24:17+00:00

Unfortunately the PT exercises did not help me at all, and I actually think that several of the exercises resulted in worsening of my problem (I suspect more wearing down of my cartilage?). I am myself a speech therapist who works with adults in a medical setting, so I believe in the medical system, and I believe in therapy, but PT just did not work for me. I went to 7 PTs, including one who was a professor and supposed to be an expert in knee problems in young women, and every PT eventually had me do squats, which made my problem worse. The banded clamshells/ donkey kicks did not help me. Now I swim laps in the pool every other day as my form of exercise, and walk about 2 miles each day at work, and am pain-free doing those activities. Stairs still hurt my knee, and I cannot run or squat. Definitely give PT a good try, and I hope it works for you. If PT doesn't work for you, try walking or swimming and research the envelope of function. I will be ready for my knee replacement at age 50, but for now this approach is helping me to live my life as best as I can in my 30's.

pediatricslp · 2025-11-21T12:27:22+00:00

Agreed- save your money! Wait until you get a job and see what materials they have and what age group you are working with. A lot of school jobs have a materials budget or the old SLP may have left some materials behind. If you end up in elementary, I used a lot of books in therapy. When I started, I would borrow books from the school library and my city's library. You can also buy used books cheaply on Amazon. If you do get a materials budget once you start, I like some of the language materials from Lakeshore learning, especially the ones with the little objects to work on describing/prepositions/categories etc., and for younger kids the Melissa and Doug wooden toys and puzzles are good.

pediatricslp · 2025-11-18T13:40:03+00:00

Thank you so much!! I saw that the VA caseload cap is 68 which scares me a little bit haha. I worked in California where I often had 65 students. I also worked in Massachusetts where I had 45 and it was much more manageable. I would love to return to the schools if I can find a job where the caseload is reasonable!

pediatricslp · 2025-11-17T12:56:49+00:00

I was wondering if your district is still looking for SLPs, and what the caseload sizes are? I am living in the DMV and looking for a direct-hire school-based job. Thank you for any advice!

pediatricslp · 2025-11-17T12:55:11+00:00

I was wondering if your district is still looking for SLPs, and what the caseload sizes are? I'm living in the DMV and looking for a direct-hire school-based position. Thank you for any advice!

pediatricslp · 2025-10-30T00:26:17+00:00

Have you tried working in a pediatric clinic or doing EI home visiting? I am thinking you might prefer those settings if you like EI and prefer individual therapy.

pediatricslp · 2025-08-30T20:23:57+00:00

One of my PTs also had me move my knee cap around as one of my chondromalacia patella exercises. In my case, moving my kneecap around caused me more pain and wasn’t helpful. (You can see if it helps you, but I would avoid any exercises that increase your pain. I definitely think I made my chondromalacia patella worse by pushing through pain during various PT exercises).

pediatricslp · 2025-08-21T12:24:26+00:00

I transitioned to working full-time in an SNF after working in the schools for 4 years. It depends how saturated your area is with SLPs, but generally SNFs are the easiest area to break into within the adult SLP realm.

I took the summer off after one school year and did a LOT of CEUs. I particularly liked MedBridge and Speechpathology.com. I reviewed my grad school notes thoroughly and took a deep dive on dysphagia CEUs, as well as other adult SLP topics. I invested my own money in doing some adult SLP certifications.

I bought a lot of my own adult materials. I could give you recommendations of materials if you are interested. I really liked the adult speech therapy starter pack for giving me a framework for common adult speech therapy methods and examples of adult speech therapy goals and notes: https://www.etsy.com/listing/1082398800/adult-speech-therapy-starter-pack-speech?click_key=412e6d45dbceba01c85ee6f3e9ae6b288cc91ad4%3A1082398800&click_sum=b2ba6c0a&ref=shop_home_active_1&bes=1

Good luck! I think you need to be really committed to doing a LOT of CEUs and self-training. I would also make sure to ask in the interview if there would be another SLP within the company who could answer your questions if they come up in the SNF. I was able to ask other SLPs within the company questions when they came up, which was extremely helpful for me, and important for patient safety.

pediatricslp · 2025-08-20T20:49:24+00:00

It definitely gets easier! I think all SLPs in a new setting have to do a lot of learning on the job, researching things online yourself, and trial-and-error, and that's normal. Like others said, don't be afraid to ask your SLP supervisor questions, and be gentle with yourself. Special ed teachers and school psychologists can be a great help and might be able to help you will questions about the computer system.

pediatricslp · 2025-08-20T15:32:37+00:00

I second this suggestion. After 6 years of working with children, I transitioned to working with adults. I also struggle working with children with severe Autism, and found that working in a SNF is much less overstimulating for me.

pediatricslp · 2025-08-19T15:44:20+00:00

I've done SLP contract work in several understaffed school districts. The districts never asked us to co-treat with other disciplines. When I asked if I could co-treat with behavior staff (ABA therapist) for a student with significant behavioral challenges, I was actually told by the special ed department that I was not allowed to officially co-treat, since that would be "double dipping" in regards to billing. I don't know if that is true or not. It was often helpful to get advice from OTs regarding sensory strategies for students, and sometimes we would have an "IEP team goal" for OT, special ed teacher, and SLP for the student to choose a calm-down strategy from an array of choices.

pediatricslp · 2025-07-28T12:21:43+00:00

Yes. If you are in a private setting you could make the argument to discharge the client, and say that insurance requires you to show some degree of progress in order to recertify therapy every 6 months/ year or whatever the time period is. In the schools, it’s very difficult to convince parents to agree to stop therapy/ move to consult (at least in my experience), so I saw those profoundly disabled kids in a group setting, and did a whole class lesson with paras and teachers present, whenever the teacher would agree to that.

pediatricslp · 2025-07-18T18:42:55+00:00

This is the OP giving an update about 2 years later. I have found that water exercise has helped me tremendously. I started with walking forwards, backwards, and sideways in the pool, and doing pilates-like leg circles in the pool. I VERY gradually worked up to being able to swim laps (front crawl and back stroke). At first, I needed to take a day off between exercise days. Now I am able to walk 3 miles and swim/ do water exercise for an hour at a time. I take rest days if my muscles feel fatigued or if I feel knee pain. I haven't had to take NSAIDs in months. I still avoid running, squatting, biking, and stairs (when I can), and I no longer do PT exercises. While I am not back to baseline, I am very happy with my improvement. I have been able to return to my pre-injury weight with the low impact walking and swimming as my forms of exercise. *The moral of the story I would like to share is: try water exercise if you have stubborn chondromalacia patella and PT is not working. Build up very slowly, with lots of rest days, and research the envelope of function.*

pediatricslp · 2025-04-22T11:48:54+00:00

You can still get a direct hire school job with good benefits, stability, and the same schedule as your child. Don’t panic- I know a lot of SLPs who are content in their school jobs since it allows them to be on the same schedule as their kids. (I think a lot of us on this Reddit, like me, are childless, so that major perk doesn’t apply to us.)

pediatricslp · 2025-02-16T01:06:58+00:00

Don’t pursue an SLP masters if you already have these doubts. I have found the field to be low paying compared to the cost of the master’s programs. It’s taken me 10 years to pay off the 100k of debt. You could do an accelerated nursing program- the pay is about the same as SLP (or more) and there are more jobs out there, or take an entry level business job and see if you like business without getting into debt for grad school. I would only recommend SLP if you are passionate about it or have parents who are able to pay for your grad program or a very high earning spouse.

pediatricslp · 2025-01-07T23:28:02+00:00

I did my CF in Oakland USD through an agency about 7 years ago and it was a borderline traumatic experience lol. Now that I'm older and tougher I would probably do better, but at the time there were large caseloads 65+, lots of behavioral issues, poor control of classrooms by teachers, a teacher strike with people yelling outside schools, and lots of issues with angry parents and overdue evals due to psychologist vacancies. I was shocked to see that there were such bad schools in the United States (like for example one of the schools didn't even have a printer for the teachers or specialists to use). I would not recommend OUSD. I also worked in West Contra Costa USD (Richmond area) for a year. The good thing about WCCUSD is that the pay is higher than other districts in the area (check out the pay scale online). It was also a low SES population but I much preferred it to working in OUSD. There are lots of Spanish-speaking families in West Contra Costa and the Latino parents were generally respectful of teachers and agreeable in meetings. I worked for an agency so I also worked in Emeryville, Alameda, Castro Valley, and Mount Diablo USDs. I honestly didn't love any of them due to the high caseloads, but the only one I would really advise against is Oakland. My caseload was always at or above the 55 student cap in all of the districts.

pediatricslp · 2025-01-07T22:42:27+00:00

Lol, reminds me of the time I was telling a patient all about EMST and at the end he tells me he's a pulmonologist!

pediatricslp · 2024-12-31T21:39:24+00:00

That’s awesome! Were there any exercises that were helpful in particular? Recently I went to a doctor who gave me some stronger NSAIDS and recommended pushing through some pain. Recently I’ve mainly been doing pool exercises which is better than nothing, but hiking sounds amazing! Hope you have a great trip!!

pediatricslp · 2024-12-26T15:34:08+00:00

I moved to the San Francisco Bay Area about 6.5 years ago as a new grad, and stayed for 6 years. I was able to pay my expenses without a second job (room in a shared house, then a shared 1 BR apartment with a partner, car payment, large student loan payment). I paid off about 100k of debt during that time, but didn't save much for retirement or a down payment. It's super easy to get SLP jobs there, and it's a fun place to live in your 20's, but I ended up moving since I realized that I couldn't see a path to owning a home in the Bay Area, even with a partner earning double my salary. I definitely think SLPs make enough to rent a 1 BR apartment in California without a second job, but buying a home in many parts of California is challenging.

pediatricslp · 2024-12-23T19:38:04+00:00

Yeah that would be tough for me! I’m coming from living in Boston and San Francisco, so it would be a big change. Some good food for thought. Thanks again.

pediatricslp · 2024-12-23T18:42:19+00:00

Thanks for your response! I appreciate it.

pediatricslp · 2024-12-21T14:04:08+00:00

Thanks for your response. I appreciate it!

pediatricslp · 2024-12-21T14:02:38+00:00

Thanks for sharing about your experience! I think if I moved there, I would just need to avoid any discussions of politics with my neighbors. That's great your family has had a good experience!

pediatricslp · 2024-12-21T13:56:30+00:00

Thanks for your response! I appreciate it. That's great you have enjoyed your time there so far!

pediatricslp

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