Chondromalacia Patella

What is Chondromalacia Patella?

Chondromalacia patella refers to knee pain that occurs when the articular cartilage at the underside of the kneecap or patella undergoes degeneration, also called softening. It is one of the most commonly occurring medical conditions or anterior knee pain. The softening of the cartilage may eventually lead to fissuring, fibrillation, and erosion. The pain usually occurs when the knee and the femur bone rub against each other.

The condition often results from sports injuries, so taking a break between practices can help. Teenagers, women, and young adults engaging in sports or activities that cause overexertion of the knee can develop pain. Besides, overweight people and older adults with arthritis are more prone to this condition.

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Chondromalacia patella refers to knee pain that occurs when the articular cartilage at the underside of the kneecap or patella undergoes degeneration, also called softening.

Symptoms of Chondromalacia Patella:

The primary symptom is a pain in the knee region. People with this condition may feel the sensation of grinding or cracking when extending or bending the knee. The pain usually worsens when sitting for long durations or engaging in activities that put a lot of stress on the knee.  The other symptoms are:

  • A dull and nagging pain below and behind the kneecap and on the sides of the kneecap.
  • A grinding feeling when the knee is flexed to bend while moving down the stairs or a hill and standing up after sitting for prolonged periods.
  • A feeling of fullness or tightness around the knee region may also be felt.

The condition demonstrates initial changes in the cartilage on the underside of the patella. If the early signs are ignored, the condition may lead to osteoarthritis of the knee joint where the femur and the knee joint meet.

Causes of Chondromalacia Patella:

Chondromalacia patella may occur due to unexplained reasons. Usually, inappropriate tracking of the patella when it slides over the femur bone can cause it. This misalignment causes the cartilage under the knee cap to degenerate, resulting in localized knee pain. The abnormal movement of the kneecap may result from:

  • Weakness in the quadriceps and hamstrings or the muscles in the back and front of the thighs
  • Misalignment due to congenital defects
  • Repeated stress on the joints of the kneecap due to activities such as skiing, running and jumping
  • Imbalance of muscles between the abductors and adductors
  • Trauma or direct blow to the kneecap
  • Overuse of the knee in sports activities and small injuries or slack ligaments can also cause pain.

Weakness or tightness of the knee muscles or overexertion of the knee may damage the patella and cause knee pain.

When to see a Physiotherapist for Chondromalacia Patella:

Physical therapy is one of the best treatment procedures for people living with chondromalacia. Scheduling a visit to the physiotherapist’s clinic is essential when dull and nagging pain is experienced during running, jumping, climbing the stairs, or moving down the hill. The therapy aims to rectify the misalignment and strengthen the weaker muscles supporting the knee. It also reduces pain and stretches the tight muscles to restore normal activities. The exercises for this condition are:

  • Straight and roller leg lifts
  • Wall slides
  • Clamshell exercises
  • Hip abductions
  • Bridges
  • Patella taping

The primary purpose of physiotherapy is strengthening the quadriceps muscle, allowing the knee cap to track into the channel of the knee joint. Besides, strengthening of the hip abductor muscles, such as Gluteus Medius, is beneficial. The correction of biomedical abnormalities is essential to prevent any injury from returning. Exercises that stretch the outer part of the knee also helps. A professional and licensed physical therapist must offer advice to people with this condition.

Risks of Chondromalacia Patella:

The risks may occur in the following people:

  • Those with excessive weight
  • Soccer players, bicyclists, runners, and those who exercise often
  • Healthy young adults and teenagers, mistily females

The softening of the articular cartilage at the underside of the knee may eventually cause fissuring, erosion, and fibrillation. Those with a previous injury on the knee cap and engaging in high activity levels put pressure on the knee and cause pain.

How to Prevent Chondromalacia Patella:

The symptoms of pain can be prevented by avoiding stressful exercises, such as running and jumping. Long-term prevention includes strengthening the inner part of the quadriceps muscle to aid the tracking of the patella. The recommendations of prevention are.

  • Creation of muscle balance through hamstrings, quadriceps, adductors, and abductors.
  • Putting on shoe inserts for correction of flat feet through an increase of the arch. It can reduce pressure on the knees and rectify the misalignment in the knee cap.
  • Avoid repeated stress on the kneecaps and wearing knee pads when on the knees.

Treatments of Chondromalacia Patella:

The treatment for this condition usually includes the following:

  • Placing ice packs on the affected area for fifteen to twenty minutes and repeating it about four times daily.
  • Taking non-steroidal anti-inflammatory drugs or NSAID’s for relieving pain
  • Applying topical pain medication such as patches or creams

Physical Therapy:

Physical therapy focuses on strengthening the quadriceps, adductors, hamstrings, and abductors to improve muscle strength and balance. Muscle balance also prevents misalignment of the knees. Isometric exercises and swimming or riding a stationary bike release the muscles and maintain muscle mass.

Surgery:

In many patients, arthroscopic surgery examines the joints to figure out the misalignment of the knee. The other surgical options are implanting the cartilage graft, repositioning in the insertion of the thigh muscle, and smoothing the backside of the kneecap.


Related Conditions:

Chondromalacia causes the knee joint to move past a specific point. Besides, the knee may give out suddenly and these symptoms occur due to repeated bending of the knees.


Frequently Asked Questions

1. Is chondromalacia patella curable?
There is no permanent cure for this condition. Exercises aim at correcting the misalignment of the knee, and surgery helps in determining the exact condition.
2. Is chondromalacia serious?
The condition refers to the damage of the underside of the kneecap or the patella. Overuse of the knees must be avoided and regular physiotherapy is essential to relieving the symptoms.

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