Pinnacle Presents
Chondromalacia Patella
What is the chondromalacia?
Chondromalacia is a softening or wearing away and cracking of the cartilage under the
kneecap, resulting in pain and inflammation. The cartilage becomes like sandpaper
because the kneecap is not riding smoothly over the knee. Chondromalacia Patella is
more commonly referred to as Patella Femoral Syndrome or knee cap pain.
Quadriceps Muscle
Patella Tendon
Quads Tendon
Patella
What are the causes?
There are many potential causes of knee cap pain. Excessive pronation at your ankle and
foot can cause the kneecap to twist sideways resulting in abnormal pressures at the knee
cap. Unnatural forces at the hip can also cause patella femoral syndrome. Fatigued or
weak quadriceps muscles, which aid in proper tracking of the kneecap, can prevent the
kneecap from tracking smoothly thus causing grinding of the cartilage. Furthermore, a
muscle imbalance between weak quads and tighter hamstrings can also pull the kneecap
out of its groove. For athletes, particularly runners, hill running, continually running on
the same side of a the road, and, over training can lead to problems.
Treatment should only be performed under the direction of a therapist from
Pinnacle Rehabilitation
What are the symptoms?
The most common complain is pain beneath or on the sides of the kneecap. Pain can
worsen over a year or so and is most severe after running up hills, climbing stairs, sitting
for prolonged periods or kneeling directly on your knees. Swelling is also present. In
some cases, you can feel and eventually hear grinding as the rough cartilage rubs against
the two bones that make up the knee joint.
What is the treatment?
The most successful treatment is to stop the aggravating activity as soon as possible and
start physiotherapy. This is not feasible for some athletes or occupations so along with
physiotherapy a patella stabilizing brace may be appropriate.
Phase 1 – Control Pain and Inflammation
• P – Protect
• R – Rest
• I – Ice
• C – Compression
• E – Elevation
Phase 2 – Restore Function and Strength
• Range of Motion Stretches
• Gait Retraining
• Quadriceps and Hamstring Strengthening
• Eliminate Muscle Imbalances
Phase 3 – Return to Exercise and Sport
• Jogging
• Proprioception/Balance Retraining
• Sport Specific Retraining
Bracing may be necessary for some work and sporting activities but the ideal is to allow
the muscles of the leg to stabilize the knee cap. Orthotics are also a possibility if the
problem is arising from poor foot mechanics or over pronation.
How do you prevent Chondromalacia?
It is important to stretch and strengthen the muscles of the thigh and calf. Proper foot
wear is also important as well as good overall conditioning. A registered physiotherapist
can help provide you with exercises to prevent the beginning of chondromalacia patella.
Treatment should only be performed under the direction of a therapist from
Pinnacle Rehabilitation