Patellofemoral Syndrome (cont.)
How is chondromalacia patella treated?
The primary goal for treatment and rehabilitation of
chondromalacia patella is to create a straighter pathway for the patella to
follow during quadriceps contraction. Initial pain management
involves avoiding motions which irritate the kneecap. Icing and
anti-inflammatory medications (for examples, ibuprofen
[Advil/Motrin] or
naproxen [Aleve]) can also be helpful.
Selective strengthening of the inner portion of the
quadriceps muscle will help normalize the tracking of the patella.
Cardiovascular conditioning can be maintained by stationary bicycling (low
resistance but high rpms), pool running, or swimming (flutter kick). Reviewing any changes
in training prior to chondromalacia patella pain, as well as examining running
shoes for proper biomechanical fit are critical to avoid
repeating the painful cycle. Generally, full squat exercises with weights are avoided. Occasionally, bracing with
patellar centering devices are required.
Stretching and strengthening the quadriceps and hamstring
muscle groups is critical for an effective and
lasting rehabilitation of chondromalacia patella. "Quad sets" are the
foundation of such a program. Quad sets are done by
contraction the thigh muscles while the legs are straight
and holding the contraction for a count of 10. Sets of 10
contractions are done between 15-20 times per day.
What is the prognosis (outlook) with
chondromalacia patella?
Under optimal circumstances, the patient should have a
rapid recovery and return at full functional level.
Chondromalacia Patella At A Glance
- Chondromalacia patella is
the most common cause of chronic knee pain.
- Chondromalacia patella has also been called patellofemoral syndrome.
- The pain of chondromalacia patella is aggravated by
activity or prolonged sitting with bent knees.
- Abnormal "tracking" allows the kneecap (patella) to
grate over the lower end of the thigh bone (femur) causing chronic
inflammation and pain.
- Treatment involves improving the alignment of the patella
during contraction of the thigh muscle.
Reference:
Koopman, William, et al., eds. Clinical Primer of Rheumatology. Philadelphia: Lippincott Williams & Wilkins, 2003.
Kelley's Textbook of Rheumatology, W B Saunders Co, edited by Shaun Ruddy, et al., 2000.
Last Editorial Review: 1/28/2008
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