Chondromalacia patellae
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| ICD-10 | M22.4 |
|---|---|
| ICD-9 | 717.7 |
Chondromalacia Patellae (also known as CMP, Patello-femoral Pain Syndrome, or Runner's Knee) is a degenerative condition of the cartilage surface of the back of the knee cap, or patella. It produces discomfort or dull pain around or behind the patella. It is common in young adults, especially soccer players, cyclists, rowers, tennis players and runners. Rugby players are also prone to this injury, especially those playing in positions where the knees are under great stress, such as Prop. The condition may result from acute injury to the patella or from chronic friction between the patella and the groove in the femur through which it passes during motion of the knee. CMP specifically refers to a knee that has been structurally damaged, while the more generic term Patello-femoral Syndrome refers to the earlier stages of the condition, where symptoms might still be fully reversible.
[edit] Causes
CMP can be caused by discrete trauma or by chronic trauma, such as by applying excessive force to the patella via exercises such as squats, leg presses, or plyometrics. Biomechanical abnormalities such as over pronation of the feet can also result in incongruity between the direction the patella is pulled by the quadriceps muscle and the shape of the patellofemoral groove through which it travels.
In its early stages, subtle changes of CMP may be completely reversible. Eventually, changes wrought by inflammatory reactions within the cartilage produce structural damage which is much more difficult to treat.
[edit] Treatment
- Avoiding sports or activities suspected of causing the injury until recovered.
- Strengthening weak muscles with light and low-impact exercise. Especially important is strengthening the inner quadriceps (vastus medialis) to balance the forces on the knee cap.
- Avoiding overtraining.
- Ensuring enough leg room in the car and when sitting at a desk.
- Maintaining good posture, and avoiding crossing the legs for long periods.
- Avoiding twisting the knee joint, as when changing direction while walking.
- Stretching quadriceps, iliotibial band, hamstrings, back, and calves regularly.
- When lying, not allowing bodyweight to put pressure on or to shift the knee cap, and using a pillow to keep the knees slightly bent and knee-caps in place.
- Wearing comfortable shoes.
- Avoid applying excessive weight on the affected joint, by losing weight if necessary.
- Corrective exercises. ie. For Vastus Medialis weakness, doing Single Leg Extensions and Leg Presses. Ask a physiotherapist or personal trainer to demonstrate.
- Icing the knee(s) after workouts
- Knee Taping may aid recovery.
