Chondromalacia Patella occurs when the tissues (cartilage) on the underside of the patella (kneecap) start softening and breaking down. In other words, when your kneecap rubs against your femur (Thighbone), the posterior portion of the patella goes through degenerative changes like fraying, swelling, or erosion. This results in deterioration of the patella, causing Chondromalacia Patella.
Facts about Chondromalacia Patella
- The term comes from Greek words – Chrondros, meaning cartilage, and Malakia, meaning softening.
- Anterior knee pain because of biomechanical and physical changes
- Eventually leads to fibrillation, fissuring, and erosion
- Rest can often repair cartilage damage caused.
Also known as ‘Runner’s Knee’, this condition is majorly found among young athletes. Nevertheless, a Chondromalacia Patella may also occur in adults suffering from knee arthritis.
Phases of Chondromalacia Patella
Stage 1
The first stage starts with softening and swelling of the tissue or cartilage due to broken vertical collagenous fibers. On arthroscopy, the cartilage appears spongy.
Stage 2
Here, in the 2nd stage, the formation of blisters in the articular cartilage results from the separation of the superficial and deep cartilaginous layers. Cartilaginous fissures with a surface area of less than 1.3 cm ² and no extension to the subchondral bone.
Stage 3
Fissures, ulceration, fragmentation, and fibrillation of cartilage extend to the subchondral bone but affect less than 50% of the patellar articular surface in this stage of Chondromalacia Patella.
Stage 4
The final stage witnesses the crater formation and eburnation of the exposed subchondral bone, with sclerosis and erosions of the subchondral bone, with more than 50% of the patellar articular surface exposed. This stage also transpires to Osteophyte formation.
Causes of Chondromalacia Patella
Chondromalacia Patella may be caused due to the following malfunction of the knee anatomy:
- Due to a congenital condition, poor alignment
- Hamstring and quadriceps weakness (the muscles in the back and front of your thighs, respectively)
- Adductors and abductors muscle imbalance (the muscles on the outside and inside of your thighs)
- A sudden blow to your kneecap from running, skiing, or jumping repeated stress on your knee joints, such as from running, skiing, or jumping
Symptoms of Chondromalacia Patella
Symptoms you may experience in case your knee is affected by Chondromalacia Patella:
- Grinding or cracking sensations when bending or extending your knee
- Pain after prolonged sitting
- Pain may worsen during activities that put extreme pressure on your knees, such as standing for an extended period of time or exercising.
If you observe that the symptoms mentioned above do not subside within a few days, we recommend you to consult our knee expert Dr. Tushar Ubale who is well-versed in knee pain treatment in Mumbai.
Line of Treatment
The first line of treatment in the condition of Chondromalacia Patella is to reduce the pressure on the knee cap. Resting and applying ice packs around the distressed area may relieve you of the pain. However, if the pain gets severe, your knee specialist may advise anti-inflammatory drugs to tackle inflammation. Moreover, in extreme cases, arthroscopic surgery can be an option.
However, Chondromalacia Patella has a high chance of being curbed through proper exercises.
Exercises that can help Improve Chondromalacia Patella condition
Leg Stretching exercise
To carry out this exercise:
- Lie on your back, one leg bent and one extended.
- To tighten your leg and lockout the knee joint, contract your quadriceps muscles in the extended leg.
- Lift your leg up while maintaining this contraction, keeping your leg straight the entire time.
- Next, lower your leg slowly while maintaining a quadriceps contraction to keep your knee straight.
- Repeat 10–15 times, then take a break.
- For each leg, perform three sets of 10–15 repetitions.
Increase the intensity of this exercise by wrapping ankle weights around your ankles to activate your quadriceps muscles.
Side-Lying Leg Raise
This is one of the best Chondromalacia Patella exercises to strengthen the side muscles of your hip.
To carry out this exercise:
- Lie on your side, hips, knees, and ankles stacked on top of each other, top leg straight, and bottom leg bent.
- To tighten your leg and lockout the knee joint, contract your quadriceps muscles in the top leg.
- While maintaining this contraction, slowly raise your top leg, keeping your leg straight the entire time. Allow neither your body nor your hips to roll backward.
- For one second, keep your leg in the top position.
- Lower your leg slowly while maintaining a quadriceps contraction to keep your knee straight.
- Rest for 10–15 seconds after 10–15 repetitions.
- For each leg, perform three sets of 10–15 repetitions.
Remember
High-impact activities like running and jumping, as well as exercises that put pressure on the kneecap with a higher degree of force, such as squats or lunges that involve deep knee bending, should be avoided until the pain subsides. This is also important because the strength of the muscles surrounding the hip and knee joints must improve in order to stabilize the knee with activity.
Clamshell
To carry out this Chondromalacia Patella exercise:
- Lie on your side, hips, knees, and ankles stacked on top of one another, knees bent.
- Lift your top knee up slowly while keeping your ankles together. Allow neither your body nor your hips to roll backward.
- For one second, keep your leg in the top position.
- Lower to the starting position, then repeat 10–15 times.
- Repeat three sets of 10–15 repetitions.
Hip Extension Leg Raises
When the gluteal muscles are weak, the knee joint is subjected to more stress and repetitive forces. Therefore, to strengthen these muscles, such Chondromalacia Patella exercises are ideal. Follow these steps to practice it:
- Lie on your stomach, legs stretched out.
- To tighten your leg and lockout the knee joint, contract the quadriceps muscles in one leg.
- Lift your leg up while maintaining this contraction, keeping your leg straight the entire time. Isolate the movement with your hips rather than your lower back.
- Lower your leg slowly while maintaining a quadriceps contraction to keep your knee straight.
- Rest for 10–15 seconds after 10–15 repetitions.
- Repeat three sets with 10–15 repetitions.
To increase the intensity, wrap a resistance band around your thighs above your knees to increase glute activation.
Conservative treatment of Chondromalacia Patella is both physically and psychologically beneficial. Short-wave diathermy can help relieve pain and increase blood flow to the area, improving nutrition supply to the articular cartilage. Thus, it must be done under professional guidance.
Although these Chondromalacia Patella exercises mentioned here are accurate enough to perform, it is always advisable to consult a medical professional or a physical therapist beforehand.For a detailed diagnosis, a specialized and tailored path of treatment, and long-term healing, feel free to contact our Knee pain specialist in Mumbai Dr. Tushar Ubale.