Charleston Orthopaedic Charleston Orthopaedic Charleston Orthopaedic
Charleston Orthopaedic
Charleston Orthopaedic
Charleston Orthopaedic
Charleston Orthopaedic Charleston Orthopaedic Charleston Orthopaedic
Charleston Orthopaedic Charleston Orthopaedic Charleston Orthopaedic
Charleston Orthopaedic
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The patella is a bony structure which rides in the groove of the femoral condyles. It is surrounded by a tough tendon sheath from the quadricep muscle. The normal patella has a smooth cartilage surface which permits frictionless motion in the femoral groove.

Patellar Chondromalacia

Mechanical "overuse", of the patella may produce an inflammatory reaction of the patellar under surface and surrounding tissue of the knee. The active adolescent with knee "soreness or an ache" usually feels pain in the front and on one or both sides of the kneecap. Often a "giving out" sensation is mentioned. Difficulty with stair-climbing, kneeling, prolonged or excessive bending as well as clicking and grinding can be present. Rarely is swelling noted. Complaints can be in one or both knees. Preceding these symptoms may be a period of increased activity, such as the beginning of a season or an increase in training or running mileage. A synonym for this condition is "runner's knee."

CAUSES Some patients have minor underlying bony alignment discrepancies of the knee, leg, or foot. A "high riding" patella, situated more atop the femur can contribute. Patellar "squinting", where the caps point inwardly as well as bowlegs or knock-knees can be factors. Hypermobile (loose) or hypomobile (tight) kneecaps can also be significant. Flat feet, (hyperpronation) is another common underlying feature.

The symptoms occur from irritation and inflammation to the undersurface of the patella. Microscopically, this surface can look shaggy, irregular or even blistered. Symptomatic periods often wax and wane, lasting days or even weeks on end.

 

 

 

 

 

 

 

1. Quad Sets: (In Seated Position)

Have one leg straight in front of you with the knee completely extended (not bent) -tighten your thigh (Quads) for 5 -10 seconds on count to 10. Relax for 3- 5 seconds and repeat. Complete this without irritation occurring. No pain should be felt.

2. Straight Leg Raises: (In Seated Position)

As in the Quad Sets, the thigh is tightened. Lock the knee straight. It is then raised off the table and held up 2" from the floor for 10 seconds and lowered back down to the floor. No pain should be felt!

3. Terminal Extensions: (In Seated Position)

Using a towel roll to lift the knee 8 -10" off of the floor (causing the knee to be bent 10 -15 degrees), straighten the knee (lifting the foot into the air), and hold this position for 3 seconds, then return to the starting position and repeat. No pain should be felt!

Prevention

  • Continue quadricep exercises.
  • Use "exercise strategy". If you feel knee pain developing, do not push.
  • Some persons benefit from foot support. Modern athletic shoes with a "varus wedge" or custom built orthotic supports may help to reduce stress to the knee.

Two Factors Which Promote Patellar Chondromalacia Include:

  • Excessive “activity” overuse: Ballet, Basketball, Dancing, All jumping sports, Running, Stair-Climbing, Bicycling, and Hiking are examples
  • Excessive “static” overuse: Squatting, Sitting Cross-legged, Sitting in a Lotus position, Normal sitting, and Kneeling are examples

Treatment

  • Rest: Discontinue, or at least decrease, any aggravating static positions. This should continue until tenderness is gone.
  • Medications: Anti-inflammatory medications may be prescribed. They act to block the chemical activity of inflammation which damages the patellar surface.
  • Support: Compression wraps may help mainly by restricting motion.

Charleston Orthopaedic
Charleston Orthopaedic
Charleston Orthopaedic
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