Overview

Another knee condition that falls under the “runner’s knee” injury umbrella, Chondromalacia Patella is one of the most common causes of chronic knee pain. Also known as Patella Tracking Syndrome, this condition is more likely to occur in women, young adults and teenagers. Athletes, sportspeople and older people with arthritis are also susceptible.

This injury is often a result of overuse and a period of rest can be all that is needed. However, the condition can be caused by a more serious issue – such as unnatural movement of the kneecap (patella) when the affected leg is bent or straightened.

Causes

The cause of pain is a result of cartilage under the kneecap becoming abnormally softened due to poor alignment of the kneecap. As the kneecap slides over the femoral bone, it grates over the bone due to the kneecap’s misalignment, causing irritation, swelling and pain. Common causes include:

  • Overuse and repetitive strain (especially twisting motions) in the knees through increased running distance or training intensity.
  • Muscular imbalances between the muscles on the thighs (adductors and abductors) and weak hamstrings and quadriceps. This is common in young people and adolescents during growth spurts.
  • Running or jumping on uneven and hard surfaces such as concrete and bitumen. This is a particularly high risk activity for people who are overweight.
  • A genetic abnormality that affects the way the kneecap moves.
  • Previous injuries to the kneecap, such as a dislocation.
  • Direct trauma to the kneecap that pushes it to either side of the leg. This could be from a fall or car accident.

Symptoms

  • Pain or discomfort in the front of the knee most likely to occur when you run, jump, kneel down, squat, use stairs or perform any other activity that involves repeated bending of the knee.
  • Swelling of the knee
  • Unusual sounds or feeling in the knee during movement such as popping, grating or grinding. It may feel like the kneecap is catching on something during movement.
  • Feeling like your knee might be about to suddenly give way or collapse underneath your weight.
  • Pain at the front of the knee that gets worse during extended periods of sitting or standing.

Diagnosis

Dan Everson Podiatry can diagnose Chondromalacia Patella by assessing your health and exercise history and conducting a thorough physical examination of the affected knee, combined with further testing to assess damage to the cartilage under the knee. A blood test and X-ray can be used to rule out arthritis and inflammation. MRI scans will provide a more complete picture of the knee joint. An arthroscopy may be performed by inserting a tiny camera into the knee to get a closer look at the cartilage.

Treatment

The aim in treating this condition is to provide or create a straight pathway for the kneecap to travel during movement. This will help prevent pain and discomfort and also rehabilitate the knee. With proper rest and rehabilitation, a patient can expect to fully recover and return to normal function.

Dan Everson Podiatry may suggest one or more of the following treatment methods:

  • A period of rest from exercise or activity causing pain in the knee.
  • Anti-inflammatory medication to reduce swelling.
  • Applying ice to the area after exercise or movement that causes pain.
  • Taping the kneecap to help guide the way it moves.
  • A knee brace can be useful if it is designed to realign the kneecap during movement.
  • Kinetic Orthotics can be prescribed to correct abnormalities or imbalances in the subtalar joint of the foot and rotation of the tibia bone of the leg.

Prevention

Dan Everson Podiatry recommends the following activities to help prevent an onset or recurrence of Chondromalacia Patella:

  • Carefully monitor and reduce any activity that involves squats, especially with weights.
  • Ensure your shoes or joggers are not damaged or worn out, and distribute your weight evenly across the foot. Schedule an appointment with your podiatrist to ensure you have appropriate footwear for your needs and lifestyle.
  • Stretch and strengthen the quadriceps and hamstrings to rehabilitate the knee and kneecap.
  • Kinetic Orthotics may be prescribed to help prevent Chondromalacia Patella for those at risk.

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