Today I'll discuss an injury called chondromalacia patellae. This is a famous running injury, don't let it happen to you! What is Chondromalacia patellae? Chondromalacia literally means “softening of cartilage” and patellae means "knee-cap". The particular cartilage, is the cartilage lining under the patella, that articulates with knee joint. Normally this cartilage is all smooth, so that it can glide easily along the articular groove of the femur as the knee bends. In pathologic cases, when it softens, it can break down, and cause irregularities below the surface of the knee-cap.
What are the symptoms? The typical patient is a female teenager complaining of pain in front of the knee, around the patella. The pain comes periodically, usually with squatting, kneeling and walking uphill. Although the majority of patients are girls, boys can have this injury aswell. Many doctors won’t use the term chondromalacia patellae at this stage, because there is no breakdown of articular cartilage yet. It is then preferably called “anterior knee pain syndrome”. In most of the patients, pain comes and goes for a few years, until growth is over. When this is the case, pain usually goes away forever. However, in other cases, pain gets increasingly worse and surgical treatment may be necessary.
Prevention? When a girl is lanky and knock-kneed, she will be more likely develop the condition. The same goes for girls with rigidity of her lateral leg muscles. There are a few hints to prevent chondromalacia patellae..
1) Always warm-up and stretch out before sports, especially hamstrings and quadriceps.
2) Vary sports: alternate cycling with swimming and running.
3) Avoid too many kneeling, hill running, squatting,..
There are also few exercises that can be done to prevent chondromalacia. It takes more than 6 weeks before you get the benefits of the exercise, so be consistent and don’t give up!
Short arc extensions: Twice a day, 10 times for each leg. Done sitting up or lying down. Use a rolled-up towel to support the thigh while you keep leg and foot in the air for 5 seconds. Afterwards, lower your foot as you bend the knee slowly.
Straight-leg raises: Twice a day, 10 times for each leg. Done lying down. Lift the whole lower limb at the hip, with an extended knee. Keep it in the air for 5 seconds, then slowly lower the leg.
Stationary bicycling: Start with 15 minutes a day and work up to 30 minutes a day. Done on low tension setting improves your exercise tolerance without stressing your knee. Adjust your seat high enough in a way that your leg is straight on the down stroke. Start with 15 minutes a day and work up to 30 minutes a day.
What can be expected after treatment? Most patients do well after correct treatment. Doing the exercises written down above will be a long and worthwhile investment for your knees. It takes only 5 minutes twice a day (except for the stationary bike). And don’t forget: warm up before sports!
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