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Chondromalacia patella is the name given to pain in the knee caused by abnormal wearing of the back of the knee cap. It is also named as a cause of the symptoms of patellofemoral pain syndrome. When compared to the number of patients who are seen with patellofemoral pain, and those with actual changes to the articular cartilage of the patella, chondromalacia patella is a rare condition though.
The patella is the medical name for the knee cap it acts as a pulley of the muscles in the front of the knee to obtain a greater mechanical advantage. It moves up and down a grove in the front of the knee bone (the Femur). Sometimes it is displaced laterally (towards the outside) out of the normal groove that it operates in this causes the cartilage to wear faster and gives rise to pain. There are several causes of this condition a weak muscle on the inside of the knee vastus medialis (VMO) often contributes to this problem, also a foot that pronates excessively can contribute to this pain also a high Q angle which simply means that the geometry of the upper and lower leg is not the way it should be.
Treatment it is most important the patient must begin to avoid activity that has caused the problem, which means for most athletes with chondromalacia patella, training has to be limited to cycling or swimming, activities that do not lead to chondromalacia patella Because abnormal patella tracking and quadriceps muscle is indicated as pathology in many cases of chondromalacia patella, treatment begins with exercises to deal with these areas first.
Control of symptoms, isometric exercises for quadriceps and most importantly vastus medialis. VMO exercises are done via straight leg raises against resistance. These are done with the patient sitting and the leg should be raised from 30 degrees to full extension.
The patient must continue quadriceps and especially VMO exercises even after cessation of pain, because recurrence of symptoms can easily happen otherwise. It is also important to address any other of the causes of chondromalacia patella. Custom orthotics may be prescribed by your Podiatrist as these will limit over pronation.
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Page last updated 14 October, 2007