Chondromalacia Patella - Treatment

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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 be helpful.

Selective strengthening of the inner portion of the quadriceps muscle helps 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. Infrequently, surgical correction of knee alignment is considered.

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 physical therapy 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.

Return to Chondromalacia Patella (Patellofemoral Syndrome)

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Comment from: Wendy, 45-54 Female (Patient) Published: July 26

I hurt my knee about 5 weeks ago and have been limping around ever since. I did all the R.I.C.E. home treatments and nothing worked for more than a couple hours. Yesterday I saw a knee specialist who diagnosed me with chondromalacia patella. He gave me a cortisone shot and prescribed physical therapy for 4 weeks. For the first time in 5 weeks, I have almost no pain. Praying that the cortisone & therapy help get me back to my normal, active lifestyle.

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Comment from: KMY, 45-54 Female (Patient) Published: May 01

I was diagnosed with chondromalacia patella when I was in 8th grade. I was a cheerleader in 7 to 8th grade as well as on my volleyball team. I wasn"t overly active but a normal kid; liked riding my bike, but it hurt to do so for a long time and that is why. I had my first knee surgery when I was a sophomore in high school, an arthroscopy scraping of my right knee and again my senior year of the left. I had lateral release of the left in 2001, and on countless medications since the beginning, starting with Clinoril. I was on it for years, as well as endless Advil. When that didn"t work anymore, I was on prescription anti-inflammatories from Celebrex to the current one of Piroxicam and that is starting to wane as well. I had cortisone shots that did not work at all as well the Orthovisc shots that cost $600 each. A series of three, and that also didn"t work at all. I am now 46 and my orthopedist told me that I"m a candidate for partial knee replacement. I have 2 children and work on my feet all day every day. I am a tool and die maker so I squat and bend down quite a bit and in constant pain. I guess I just kind of ignore it and move through it as I really don"t have a choice. I can"t stop my life. I am not able to retire or sit and do nothing at all. A couple of doctors that I have gotten second opinions from said that they would have to remove my knee cap and replace it in a different position to get it to track well. It is now to the point that I have to address the problem again and any physical therapy makes the problem worse too. My options are pretty limited as well. I"ve heard of experimental cartilage replacement therapy. Pretty sure that insurance won"t cover that. Any other ideas out there, I"m all ears.

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