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Patella Chondromalacia
Authored by Orthopedic Surgeon, Edward G. Loniewski, DO and posted here with his permission.
This disease is also known as softening of the cartilage of your knee cap or "anterior knee pain". This is a big medical word for a condition where the shiny cartilage surface of your patella (knee cap) is softened due to many factors including abnormal pressure across the joint surface or hormonal changes in your body.It is sometimes associated with mild or moderate swelling of the knee and some people report a grinding feeling in their kneecap. It is more common in younger females especially after a growth spurt where the knee must carry more weight.
Many times this problem can be due to "excess lateral pressure syndrome"; that is, the kneecap tends to sit too far out to the side of the knee. Usually, this problem is related to how one's bones are shaped and determined by genetics. In this case, the kneecap is most tender when pushing on its outside ("lateral") surface.
It is usually pretty simple to diagnose chondromalacia. Mostly it is diagnosed based on your complaints. On physical examination, your doctor may push back on your kneecap. That often causes pain in people with this problem. The physician may also move your kneecap from side-to-side. If the patella does not move easily inwards (toward the other knee), the knee is described as having "lateral tightness", which is indicative of excess lateral pressure syndrome.
Chondromalacia patella is the most common cause of pain in the front of the knee.
Control: Get your pain under control
Cryotherapy (ice, cold therapy) is an excellent way to control your pain. Do not apply ice directly to your skin for more than 5 minutes as it can cause burns. A device specially designed to cool your joint (see our Iceman Clear) can be used for longer periods, as long as you carefully follow the directions for knee injury treatment and discontinue its use if you have pain or a burning sensation.
Over-the-counter pain medications can be of use. These include anti-inflammatories such as Ibuprofen and Mediproxen (naproxen), and pain medications, such as APAP (acetaminophen).
Occasionally heat can be of benefit after the initial pain has resolved. Heat is sometimes useful to combat stiffness. You can apply a heating pad on a low setting for approximately 10-20 minutes at a time. If you do not have a heating pad, you can use a soft terry cloth hand towel placed under warm (not hot) tap water.
Bracing. In addition to providing stability, braces provides pain relief by stimulating some of your nerve fibers which make you feel that your joint is more stable and secure. These are the same nerve fibers you compress when you grab your finger after you hit it with a hammer. Even though your finger was just smashed, you squeeze it with your other hand as hard as you can and it makes it feel better. If support helps, sometimes a simple elastic bandage is all you need; however, some people will feel better with a knee brace. Our DonJoy Comfort Knee Brace will give you the gentle support that you need.
In addition, with chondromalacia, bracing may help to better centralize your patella in its groove so that it "tracks" more centrally, thereby decreasing your pain. The DonJoy Lateral "J" Brace and the DonJoy Tru-Pull Advanced Patellar Knee Brace are specifically designed to help your patella tracking. Both are far superior to the simple "neoprene sleeves" one can obtain in the supermarket or drugstore. Both are exceptionally useful for ACL knee injury treatment and people with excessive lateral pressure syndrome that causes pain on the outer (lateral) undersurface of the kneecap. The DonJoy Lateral "J" Brace is perhaps one of the most popular patella stabilizing braces in the world. We also really like both the DonJoy Tru-Pull Advanced Patellar Knee Brace, and its more supportive cousin, the DonJoy Tru-Pull Advanced Hinged Patellar Knee Brace
Avoid activities that cause your pain
- Keep your knee bent for long durations.
- Kneel on your knees
- Walk up and down stairs/hills unnecessarily
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Try to sleep with your legs out straight at night instead of curling up into a ball.
Rehabilitate your knee
- Motivation to actually do the exercises.
- Deluxe Knee Therapy Kit
- The correct exercises for your knee injury treatment. See your doctor or physical therapist if you need advice in this regard.
- Proper equipment. This equipment can either be at your therapists office, at your health club, or items that you purchase for use at home. We have found that people who do their knee injury treatment exercises at home are much more likely to benefit from the program as they more frequently perform the exercises.
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