chondromalacia patella (also known as CMP) is an injury affecting the knee; namely the cartilage that protects the back of the patella (the front of the knee). This injury involves damage to the cartilage that causes pain as the damage inhibits the ability for the cartilage to act as a natural shock absorber. It is a common cause of knee pain.
The causes of chondromalacia patella can be as simple as overuse of the knee from physical sports like football, martial arts, gymnastics, ballet, tennis and running. In a healthy knee, the chondromalacia patella glides in a smooth movement. In cases where CMP exists, the patellae grind against the femur or tibia which causes the pain. In some cases, slight swelling can be seen on the knee.
In most cases, the condition is easily treatable with a program of RICE—rest, ice, compression, elevation. However, where there is major cartilage damage treatment by physical therapy or exercise is often required. Before any of this, however, the first step must be to ensure the swelling or bruising has gone down and the joint is able to be moved again.
Treatment by exercise involves ensuring two things are fixed:
- The strengthening of the surrounding muscles to support the damaged patellae.
- Ensuring the patellae and cartilage is exercised in a controlled manner while it heals.
To strengthen the surrounding muscles, an exercise plan must consist of exercise that works the surrounding muscles but avoids added pressure on the knee joint. Exercises that strengthen the inner sides of the quadriceps muscles are often popular as are those that focus on the calf muscle (soleus). “Quad sets” are another popular exercise that involves contracting the quadriceps muscles with straight legs and at the same time holding the contraction for an extended period of time – this has no stress on the knee joint but will help to support it.
To make sure the correct exercises are being utilized, the exercises must be chosen carefully and progress monitored. Exercises that keep stress off the knee joint must be of primary consideration. Popular examples include swimming, pool running and sit downcycling (on low resistance). Exercises such as squats can be performed once some strength has returned but should be done under supervision and with support. Knee supports can be used to help with everyday activities and spread the workload of the knee across a wider area.
The prognosis of chondromalacia patellae is generally very positive even in the most severe of circumstances. While there may be some long discomfort, it usually is not painful and can be monitored quite easily. Contrary to popular belief there is no association to arthritis. While the recovery can often be frustrating and slow, it is not likely to be something that will stop most people from getting on with their daily lives. Most athletes will need to slow down their training and anybody with the condition will need to be cautious to avoid a repeat of the same injury in the future.