CHONDROMALACIA PATELLA is a condition wherein there is degeneration and softening in the cartilage underneath the patella (knee cap). It is the most common cause of chronic knee pain among young, athletic individuals, runners, jumper, skiers, cyclists and soccer players who exercise often, people who have injury, dislocation, fracture or other injury to the knee cap, people who are overweight and older people with arthritis.

The problem is in the knee mechanism. Muscle imbalances such as when quadriceps are weak and pull the patella to one side causing pressure on the articular cartilage on that side, weakness of the hamstrings or on the hip muscles lead to imbalances to the alignment of the entire leg, knee joint, muscle imbalance of the muscles around the knee, flat feet, wear and tear allows the knee cap to rub on the lower parts of the thigh bone that damage the patellar cartilage.

One common symptom is anterior knee pain with grinding sensation when the knee is flexed. Symptoms are noticeable with walking up and down stairs, sitting with a bent knee for long periods of time, kneeling, squatting and running downhill.

Treatment goal is to reduce the pressure on your knee cap and joint. Resting, stabilizing and icing the joint. Physical therapy focuses on strengthening quadriceps, hamstrings, adductors and abductors can help improve muscle strength and balance. Muscle balance improves proprioception (brains perception of where joints/limbs are in space) and hence prevents misalignment. Isometric exercises to increase muscle mass. Non-weight bearing exercises such as swimming, ergonomic/stationary bike are recommended in the early stages of recovery.

The following recommendations help to reduce the risk of developing chondromalacia patella.

Maintain ideal body weight to unload pressure on knees and other joints. If needed lose weight by exercising at least 30 minutes three times a week, reduce carbohydrates and substitute by eating plenty of vegetables, fruits and whole grains. We have a nutritionist/dietician Joelle Farha who will devise food plans aim to help you reach your weight loss as well as helping you feel healthier.

Wear orthotics to address flat feet by allowing you to have an arch, thus will decrease the amount of pressure placed on your knees and this will realign the kneecap. We have custom made orthotic system in our clinic. These can be made from a foot scan done in the clinic.

Luzviminda Habon, PTRP