Runner's Knee - Chondromalacia Patella
Chondromalacia Patella, or "Runner's Knee", occurs when repeated stress on the knee causes inflammation and a gradual softening of the cartilage under the kneecap (patella). The inflammation of the cartilage prevents the kneecap from gliding smoothly over the end of the thigh bone (femur) and therefore causing pain and swelling of the knee. The underside of the kneecap should be smooth and move within the femoral groove (a groove on the thigh bone). If the kneecap is pulled sideways, it becomes rough like sandpaper and the symptoms appear.
Runner's Knee is typically associated with a pain that increases gradually over a period of time, often a year of longer, until it is severe enough that the athlete seeks medical attention. Symptoms usually occur beneath or on both sides of the kneecap. Pain may be intensified with activities such as a short run, squatting or jumping. Stiffness may occur simply from prolonged sitting or descending stairs.
Runner's knee accounts for 25% of the overuse injuries treated in sports clinics. Teenage girls are most commonly affected, but any active person age 14 or over may experience this pain syndrome.
Causes of Injury:
Short Term Treatment:
- Decrease activity and consider swimming. When recovering avoid any exercise that puts weight on a bent knee.
- Rest if the knee is painful and swollen.
- Ice treatment for 15 minutes twice daily after activity to reduce pain and inflammation.
- Treat with the use of anti-inflammatory pain medicines. The most acceptable over-the-counter medications of this type is Ibuprofen and should be taken in the dosages indicated on the packaging.
Long Term Treatment:
- Physiotherapy including stretching and strengthening
exercises for the quadriceps, hamstrings and calves. Exercises
- Quad Squeeze.
- 1) Place pillow under knee, tighten quadriceps, push knee down into pillow and lift foot up. 20 times
- 2) Repeat exercise as above with foot turned out in order to strengthen the inside of the quadriceps muscle. Repeat ×20.
- Squats. Perform with back against wall. Bend knees slowly to between 45 - 60°. Ensure that knee travels over line between bigand second toes. Hold for a count of 5 seconds. Relax slowly. 20 times
- Step-downs. Stand on step or box. Tighten quadriceps and lower opposite leg slowly to the ground.Ensure that knee travels over line and between big and second toes.Then raise the leg up onto the step,relax. Repeat × 20. Increase the number of repetitions in increments of 5 every two days, all the way up to 60 reps.
- Stretching - of the quadriceps, hamstring, iliotibial band (ITB) and gluteal muscles
- Quad Squeeze.
- Orthotic devices to correct abnormal foot mechanics.
Once the causes are determined and the appropriate steps have been taken to treat the condition, Runner's Knee should not keep the athlete from activity.
- Stretch the quadriceps, hamstring, iliotibial band (ITB) and gluteal muscles. Hold each stretch for 30 seconds, relax slowly.
- Repeat stretches 2 - 3 times per day. Remember to stretch well before running.
- Strengthen quadriceps, hamstring and calf muscles.
- Wear corrective shoes if necessary, specifically motion-control shoes and orthotics to correct overpronation.
- Avoid excessive downhill running, and cambered roads (stay on the flattest part of the road).
- Gradual progression of training. Incorporate rest into the training program.