Chondromalacia patellae, often referred to as “runner’s knee,” is a common condition that causes pain in the front of the knee and around the patella (kneecap). It occurs when the cartilage on the underside of the patella softens and deteriorates, leading to discomfort and inflammation. This condition frequently affects young, active individuals and athletes, but it can also occur in older adults as cartilage naturally wears down. At Adaptive Physiotherapy & Massage in Booragoon, we focus on providing evidence-based treatment options, integrating manual therapy and exercise rehabilitation to alleviate symptoms and improve knee function.
What is Chondromalacia Patellae?
The patella plays a critical role in knee function, gliding smoothly over the femur as the knee bends and straightens. The cartilage under the patella acts as a cushion, reducing friction between the bones. In chondromalacia patellae, this cartilage becomes damaged and loses its ability to protect the joint, leading to pain and inflammation. Factors contributing to chondromalacia patellae include overuse, misalignment of the patella, muscle imbalances, or previous knee injuries.
Common symptoms of chondromalacia patellae include:
- Pain: A dull, aching pain around the front of the knee, often aggravated by activities like running, climbing stairs, or sitting for long periods.
- Grinding or Clicking Sensation: A feeling of grinding or clicking when bending or extending the knee.
- Swelling: Mild swelling around the knee joint.
- Knee Instability: A sensation of the knee “giving way,” especially during weight-bearing activities.
At Adaptive Physiotherapy & Massage in Booragoon, we understand the complexity of this condition and offer a tailored treatment plan that addresses the root cause of symptoms.
Evidence-Based Treatment Approach
The treatment of chondromalacia patellae requires a holistic and individualized approach that focuses on pain relief, improving knee mechanics, and strengthening the muscles that support the knee. Our physiotherapists at Adaptive Physiotherapy & Massage in Booragoon are equipped with the latest evidence-based practices to ensure optimal patient outcomes.
1. Pain Management and Education In the initial stages of treatment, managing pain and inflammation is crucial. Our physiotherapists may use ice therapy and recommend activity modifications to reduce stress on the knee joint. Educating patients about the condition and ways to minimize knee strain is a key component of our approach. This may include avoiding high-impact activities that exacerbate symptoms and learning proper techniques for movement and exercise.
Manual Therapy for Chondromalacia Patellae
Manual therapy is an essential part of our treatment protocol, as it helps reduce pain, improve joint mobility, and address muscle imbalances. At Adaptive Physiotherapy & Massage, our manual therapy techniques are carefully tailored to each patient’s needs.
1. Patellar Mobilization One of the primary techniques used is patellar mobilization, which involves gently moving the patella to improve its alignment and reduce pain. This technique helps the patella track more smoothly within the femoral groove, alleviating stress on the damaged cartilage.
2. Myofascial Release and Soft Tissue Techniques Muscle tightness in the quadriceps, hamstrings, and iliotibial (IT) band can worsen symptoms of chondromalacia patellae. Our physiotherapists use soft tissue techniques to release tension and improve flexibility in these muscles. Myofascial release, deep tissue massage, and trigger point therapy are effective in addressing these issues and promoting better knee mechanics.
3. Joint Mobilization Joint mobilization techniques may be used to improve the movement of the knee joint and the surrounding structures. By enhancing joint mobility, we help restore normal movement patterns and reduce compensatory stresses on the knee.
Exercise Rehabilitation
Exercise rehabilitation is the cornerstone of long-term management for chondromalacia patellae. Our exercise programs at Adaptive Physiotherapy & Massage in Booragoon are designed to strengthen the muscles around the knee, improve flexibility, and promote proper biomechanics.
1. Quadriceps Strengthening Strengthening the quadriceps, particularly the vastus medialis oblique (VMO), is critical for stabilizing the patella and ensuring it tracks correctly. Exercises such as straight leg raises, mini squats, and wall sits are incorporated to build quadriceps strength and control.
2. Hip and Glute Strengthening Weak hip and gluteal muscles can contribute to poor knee alignment and exacerbate symptoms. Our physiotherapists include exercises like clamshells, side-lying leg lifts, and hip bridges to strengthen these muscles and support the knee joint.
3. Core Stability Training A strong core provides a stable base for lower limb movements and reduces the risk of knee injuries. Core exercises, such as planks and bird-dog variations, are essential components of our rehabilitation programs.
4. Stretching and Flexibility Exercises Tight muscles, such as the hamstrings, calf muscles, and IT band, can increase pressure on the knee joint. Stretching exercises are prescribed to improve flexibility and reduce tension. Foam rolling and dynamic stretches may also be incorporated to promote muscle relaxation.
5. Proprioception and Balance Training Proprioceptive training helps improve the body’s awareness of joint position, which is often impaired in patients with knee pain. Balance exercises, like single-leg stands or stability ball work, enhance neuromuscular control and knee stability.
Our exercise programs are gradually progressed, taking into account the patient’s pain levels and functional goals. We emphasize proper technique and movement patterns to ensure a safe and effective recovery.
Additional Considerations for Managing Chondromalacia Patellae
- Footwear and Orthotics: Proper footwear is crucial for reducing stress on the knee. In some cases, custom orthotics may be recommended to correct foot alignment and improve overall biomechanics.
- Taping Techniques: Kinesiology taping or patellar taping can provide additional support to the knee and help reduce pain during activity. Our physiotherapists are trained in various taping methods to provide relief and promote healing.
- Activity Modification: We advise patients on modifying their activities to minimize knee strain. Low-impact exercises, such as swimming or cycling, are often recommended to maintain fitness without aggravating symptoms.
Conclusion
Chondromalacia patellae can be a challenging condition, but with the right approach, most individuals can experience significant improvement. At Adaptive Physiotherapy & Massage in Booragoon, we combine manual therapy and personalized exercise rehabilitation to address the underlying causes of knee pain and restore optimal function. Our evidence-based methods ensure that each patient receives the highest standard of care, promoting long-term knee health and reducing the risk of recurrence.
If you’re dealing with knee pain and suspect it may be chondromalacia patellae, contact Adaptive Physiotherapy & Massage in Booragoon. Our experienced team is here to guide you on your journey to recovery and help you get back to doing what you love.
References
- Dye, S. F. (2005). The pathophysiology of patellofemoral pain: a tissue homeostasis perspective. Clinical Orthopaedics and Related Research, 436, 100-110.
- Crossley, K. M., et al. (2016). Patellofemoral pain. Nature Reviews Disease Primers, 2, 16033.
- Powers, C. M. (2010). The influence of abnormal hip mechanics on knee injury: a biomechanical perspective. Journal of Orthopaedic & Sports Physical Therapy, 40(2), 42-51.
- Bolgla, L. A., & Boling, M. C. (2011). An update for the conservative management of patellofemoral pain syndrome: a systematic review of the literature. International Journal of Sports Physical Therapy, 6(2), 112-125.
- Collins, N. J., & Crossley, K. M. (2013). The foot orthoses vs. hip exercises for patellofemoral pain study (FOOT study). BMC Musculoskeletal Disorders, 14(1), 1-11.
Adaptive Physiotherapy & Massage in Booragoon is dedicated to helping you achieve lasting relief from knee pain through personalized, evidence-based care. Reach out to us today to start your journey to a pain-free life!
