Runner’s knee (Chondromalacia patellae)

Despite rehabilitation after chrondromalacia patellae, you should still be aware of training the rest of the body, so you do not lose your current mobility, stability and strength. Then find out what you can do from workout programs and work out according to the level you have. Exercise of the rest of the body accelerates healing of your injury, among other things due to increased nerve activity and circuits..

Description of chondromalacia patellae

This type of injury exhibits the same tissue damage as caused by patellofemoral pain syndrome. In the case of chondromalacia patellae (knee cap / head of the thigh bone pain), the knee cap may have been subjected to recurrent imbalance and wear from biological asymmetry, which means that the hyaline cartilage on the back of the knee cap is damaged. Patellofemoral pain syndrome occurs due to trauma, thusly patellofemoral pain syndrome can cause chondromalacia patellae. Chondromalacia patellae is not differentiated from patellofemoral pain syndrome, neither by symptoms, tests, arthroscopic or x-ray, both tests and treatments are identical. However, there is a differentiated rehabilitation as patellofemoral pain syndrome comes from trauma rather than an imbalance in muscles, joints etc.

Frontal (anterior) knee pain may be due to many different diagnoses, and they constitute approximately 25% of total sports injuries. Although “tons of literature” has been written and the symptoms are clear and easy to diagnose, the conditions are often frustrating to treat, and permanent remediation of the symptoms is often impossible to achieve. For this reason, many who are affected by anterior knee pain must significantly reduce or completely abandon their leisure activities, to prevent recurrent problems.

It must be made clear that there will always be a superficial degree of hyaline damage on the back of the knee cap in these cases, and there may also be direct hyaline injuries.

Chondromalacia patellae is a disease state in which the hyaline cartilage becomes soft, rough, or cracking occurs. Often there are no precise indications of why the damage occurs as the knee cap suffering from chondromalacia has not been exposed to external violence. It is probable that the back of the knee cap does not fit the femur head (facies articularis does not fit into the intercondylar fossa of the femur), thereby breaking the cartilage as the knee cap is pulled. Cartilage does not contain pain sensitive nerves, but pain develops when the knee cap rubs against the head of the femur. In case of sustained stress, inflammation can develop in the area.

We assume, on this page – that the name chondromalacia patellae is a form of biomechanical asymmetry, which can have several possible causes, and which in one way or another overloads the hyaline cartilage in the knee cap.

Classification and causes of chondromalacia patellae

The list of possible causes is long when it comes to chondromalacia patellae, this list therefore constitutes the most frequent causes.

  • Uneven collagenous tissue.
  • Basic degenerative changes.
  • Many repeated minor hits against the knee cap.
  • Dietary factors.
  • Ekstra ossificanisering (knogle udvækst.
  • Muscular atrophy or elevated tonus of m. vastus medialis.
  • General hip, knee, lower leg muscle asymmetry.
  • The iliotibial tract or band is too rigid along with m. Vastus lateralis.
  • General ligament laxity (loose ligaments around the knee cap).
  • The back – excessive curvature.
  • L3 dysfunction (lumbar vertebra 3).
  • Bone dysfunction.
  • Leg length difference.
  • Foot and ankle deficits due to for example flat foot or overweight.
Symptoms of chondromalacia patellae
  • Diffuse pain in the knee and back of the knee cap connected to exertion or strain.
  • Slowly developed without trauma.
  • Tight muscles and asymmetry.
  • Discomfort exacerbated when walking or running on hills or stairs, especially downwards.
  • Pain and stiffness experienced when moving from sitting to standing after a rest period.
  • Discomfort is exacerbated by squatting position.
  • Occasionally accumulation of fluid in the knee joint occurs.
Examination of chondromalacia patellae
  • Negative X-ray.
  • Inspection of the joint through arthroscopic examination provides the final diagnosis.
  • Positive clamping test of the knee cap.
  • Stress test.
Treatment of chondromalacia patellae
  • Active rest.
  • Specific rehab training focusing on the cause.
  • Termobehandling.
  • Kinesiology tape
  • K-Laser.
  • Knee bandage with a hole to support the knee cap.
  • Sportstapening
  • Sports Taping
  • Ultrasound (continuous / pulsating), 3 Mhz, 2 W cm2 in the joint, pointed towards knee cap.
  • 3rd and 4th grade chondromalacia patellae can’t be treated and usually requires surgery.
  • Traumeel tablets – You can watch a video about Traumeel here
  • Ultrasound (3 Mhz with 2 w / cm2 pulsating and continuous 7.5 min each).

The doctor may do an arthroscopic examination in order to diagnose and determine the degree of the condition. In severe or prolonged cases, surgery may be necessary. Through arthroscopy changes can be removed or the irregularities smoothed out. Generally the discomfort caused by damage to the cartilage in the knee cap often alleviates spontaneously, but it may last for up to a couple of years. For periods at a time, the athlete may have to change his training habits to avoid the most pain provoking movements.