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Chondromalacia Patella

Chondromalacia Patella

Originally published on Jun 24, 2010

What Is It?
The patella, or kneecap, can be a source of knee pain when it fails to function properly. Alignment issues and overload of the patellar joint can lead to wear and tear of the cartilage on the back side of the bone.  Chondromalacia patella is a common knee problem that results from poor alignment and movement (tracking) of the patella relative to its groove on the femur.  Runners with kneecap problems often have cartilage that has been worn, while runners with the more common patello-femoral pain syndrome (PFPS) are in the earlier stages of the condition.  Both conditions have numerous possible causes and are very treatable.

What Causes It?
Excessive wear and tear can occur because of the high compression forces on the joint. The cartilage, or slippery surface on the underside of the kneecap, can wear unevenly, roughen, and eventually degenerate in athletes whose kneecaps track poorly.  Runners, Soccer players, snowboarders, cyclists, tennis players, and ballet dancers are affected most often.

Following is a list of predisposing factors:

  • Weak quadriceps (usually the inner one), or tight quadriceps (usually the outer one)
  • Poor strength in the gluteal muscles resulting in poor knee alignment
  • Poor biomechanics with running
  • Running too many days in a row without proper recovery
  • Sports that involve a lot of cutting
  • Excessive Supination or Pronation,
  • Worn shoes that result in poor cushioning or instability
  • Tightness especially in the IT Bands, hamstrings, quadriceps and gluteals
  • Trigger points in the IT Bands, hamstrings, quadriceps and gluteals

How Can I Fix It?
Chondromalcia Patella responds best when treated early! Restoring the proper muscular balance, strength and flexibility to the knee are the keys to long-term recovery.  However activity modification is an important first step.

  • Decrease running mileage, hills, and intensity to below your pain threshold
  • Substitute cycling, swimming, elliptical, etc. if you can do them pain free
  • Improve patellar tracking. Use of McConnell or Kinesiotape can be helpful
  • A PT can help you with taping and kneecap alignment
  • Correct the imbalance of the quadriceps musculature
  • Stretch  and use a foam roll on the IT Bands, hamstrings, quadriceps and gluteals
  • Strengthen your gluteals and core musculature
  • Replace your worn shoes with an appropriate pair for your foot structure
  • Trigger point dry needling to your quadriceps and the tendon
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