Chondromalacia

What is it ? Chondromalacia or Patellofemoral pain syndrome is a medical condition characterized by the softening and degeneration of the tissue (cartilage) underneath the kneecap or patella. Also known as the Runners’ Knee, the term is typically used to describe damage to or softening of the articular cartilage on the underside of the kneecap. Though chondromalacia can affect any joint, the most common location of the disorder is the knee. It usually begins as a small area of painful and softened cartilage behind the kneecap. With further softening, the cartilage can crack or shred into a mass of fibers. This type of injury is most common in runners, skiers, cyclists and soccer players. Any knee pain lasting for more than two weeks should be examined for a possible condition of chondromalacia.

  Symptoms

• Continuous discomfort and irritation located behind the kneecap or throughout the front of the knee
• Pain on extending the leg or while walking and running
• Discomfort or pain after sitting or keeping the knee motionless in a flexed position for an extended period of time
• Sensation of grinding, popping or snapping in the knee during motion
• Pain that aggravates with squatting or kneeling

  Causes

In young people, it occurs mostly due to an acute injury, such as a fall, overuse, and problems with knee alignment or muscle weakness. In older people, simple wear and tear and arthritis can be the cause.

The underside of the kneecap and the top of the thighbone (known as femur), are both covered with a smooth and slippery cartilage. This allows these two bones to slide easily over one another when the knee flexes. In case of damage to this cartilage, the surface becomes rough and gets irritated with movement.

Here are some of the main possible causes:

• Trauma, such as a fracture or dislocation of the kneecap
• An imbalance of the muscles around the knee
• Injury to the meniscus .i.e. C-shaped cartilage inside the knee joint
• Rheumatoid arthritis
• Infection in the knee joint
• Repeated bleeding inside the knee joint
• Repeated steroid injections into the knee
• Repetitive actions that impact or stress the knee
• Over-pronation of the foot
• Weak quadriceps

  Prevention

To prevent the occurrence of the condition, the following measures can be adopted:

• Take up strengthening and stretching exercises for:

-Quadriceps (thigh muscles)
-Calf muscles (muscles on the back of the lower leg)
-Hamstrings (muscles on the back of the thigh)
• Get your footwear fitted with orthotic devices, to correct the abnormal mechanics of feet and musculoskeletal alignment in the legs and knees
• Wear comfortable shoes

  Self Treatments

The first step of treatment for chondromalacia is to decrease physical activity in order to allow the mechanical irritation and inflammation to subside.

It is also advisable to follow the below listed treatment and self-care measures:

• Take anti-inflammatory medicine such as ibuprofen or naproxen, in order to reduce inflammation and pain
• Ice the kneecap area for 15 minutes, twice per day after physical activity
• Wear an elastic or neoprene brace on the knee. This will help in keeping the kneecap in proper alignment

  Medical Treatments

Arthroscopic surgery is considered as a surgical remedy in extreme cases. Surgery is used to smooth the surface of the articular cartilage. The procedure is aimed at cleaning out the cartilage fragments that cause the joint to catch during bending and straightening