Chondromalacia patella, aka runner's knee, is a condition where the soft cartilage that supports the floating knee bone, or patella, deteriorates on the underside of the kneecap. In young, healthy athletes early stages of this can often be healed within a few days to weeks of rest from athletic activities. In older people and those for whom weight is a big reason for the problem, the breakdown of cartilage can get bad enough that surgery is required. When there is less cartilage below the kneecap, there is an increased chance of grinding, and it can begin the breakdown of bone. The missing lower cushion can also allow the kneecap to move out of place, to the outside, more easily. This can lower protection during a fall.
Treatment of Chondromalacia Patella
Many people come to the doctor when the grinding sensations begin during exercise, which is usually a sign that the runners knee has progressed. Treatment is usually multi-faceted. A knee brace can keep the patella in the most central part of the knee, limiting the risk of it migrating to the outside where grinding is more likely. Rest, ice, heat and compression protocols are usually prescribed. Ultrasound treatment may be used by a physical therapist to help speed healing. Finally, exercises will be prescribed.
Vastus Medialus Oblique Strengthening
The vastus medialus oblique muscle is the main muscle that physical therapists target regarding patella problems. This muscle winds diagonally from the inside of the knee to the outside hip, and a strong version of this muscle will naturally pull the patella to a more central position on the knee, minimizing grinding. The main way to work this muscle is by teaching you how to recognize, isolate, and contract it. This begins with you lying down and can progress to sitting and standing. With regular practice and repetition, the muscle becomes an easy thing to flex whenever you are having knee issues. Though it may never replace an ace bandage or patella tape for athletes, it is one more way to prevent surgery or bone deterioration.
The other exercises that may be prescribed will be based on the reasons for the injury. If it is a case of an athlete who is already in good shape, and the sporting activity they do, the physical or sports therapist may try and find ways to mitigate for knee damage while continuing to play the sport. In the worst cases, they may recommend a transition to a lower intensity activity. For those who have patella problems due to weight issues, then an exercise and flexibility regime that allows a person to more more comfortably in an optimal posture will be favored instead. In the case of walking or hiking workouts to lose weight, they may recommend hiking poles to reduce knee impact on downhill terrain.