Chondromalacia Patellae means "soft cartilage under the kneecap".
Chondromalacia is due to an irritation of the undersurface of the kneecap. The undersurface of the kneecap, or patella, is covered with a layer of smooth cartilage. This cartilage normally glides effortlessly across the knee during bending of the joint. However, in some individuals with malalignment issues, the kneecap tends to rub against one side of the knee joint, and the cartilage surface become irritated, and knee pain is the result.
This condition often affects young, otherwise healthy athletes. When anterior knee pain or kneecap pain exists in the absence of cartilage softening, it can be referred to as patellofemoral joint pain syndrome.
It is most common in sporting individuals; however, it can affect any member of the population. It is common in any sport that involves running, jumping, squatting and landing.
The non-sporting person can even experience kneecap pain when descending or ascending stairs.
The condition usually results from either acute injury to the patella joint surface or from chronic friction between the patella and the groove in the femur (thigh bone) through which it passes as the knee bends.
Potential causes include a tight lateral knee structures such as the ITB, weak medial quadriceps (vastus medialis oblique - VMO), overpronating feet and weak lateral hip rotator muscles. These muscle imbalances result in a rotational instability that causes the patella to be laterally aligned in the femoral groove, which causes pain.
The good news is that patellar mal-tracking is very quickly fixed with physiotherapy assessment and intervention.
The aims of Chondromalacia patella rehabilitation are to decrease pain, strengthen weak muscles of the knee and hip, stretch tight muscles and gradually return to full fitness. Patella taping is often a key part of treatment and rehabilitation.
Rest from activities that aggravate the injury. As a general rule, if it hurts or is made worse by an activity then don't do it! Running and jumping activities are usually restricted. Applying ice may be beneficial. Ice may be applied following injury or activities that cause pain.
The main aim is to strengthen the quadriceps muscle. This should allow the knee cap to track normally in the groove of the knee joint.
Strengthening exercises for the hip abductor muscles such as Gluteus medius, may also be beneficial.
Exercises to stretch the outside of the knee should be perfromed. Tight lateral structures will not allow the kneecap to track naturally. Stretching the ITB, Quads, Hamstrings and groin is usually advised. Sports Massage can play an important part in this. Deep massage techniques to the thigh, particularly outside of the thigh can assist in releasing the tight lateral structures.
Return to full fitness should be gradual and sports specific training should only begin when there is no pain. Full strengthening exercises should be completed, to restore the muscles to full and balanced strength. Any biomechanical abnormalities should be corrected to prevent the injury returning.
To make a booking to see your local Melbourne sports physiotherapist for treatment of your Chondromalacia Patellae Injury, please call your local clinic or book online.