5 Exercises to Defeat Chondromalacia Patella (and 3 to Avoid)

Chondromalacia patella knee pain is often caused by a lot of running and jumping. In fact, it’s often called “runner’s knee” because of the association. But having this mouthful of a condition does not mean you have to give up sports or exercising altogether. Quite the contrary…. You just have to be smart about what chondromalacia patella exercises you should do and which ones you avoid.

What’s Causing My Knee Pain?

Chondromalacia is where the protective cartilage covering the kneecap softens or wears down, often due to overuse and/or repetitive stress. (Find out about other causes here.) This cartilage change can make it tough for the kneecap to glide smoothly within its groove.

The resulting friction can cause inflammation and pain at the front of the knee and/or behind the kneecap. In some cases, the swelling and pain of chondromalacia patella may be so bad that it limits leg extension (your ability to straighten your knee).

Chondromalacia pain may increase during activities that stress your knee joint, such as:

• Climbing or descending stairs
• Squatting
• Kneeling
• Running
• Jumping
• Sitting for a long time with the knee bent
• Wearing high heels

Obviously, a great starting point for treatment is to avoid these irritating activities as best you can. You should also follow the steps of RICE (rest, ice, compress and elevate) and wear a chondromalacia knee brace that helps with kneecap movement. But while these steps help with the symptoms of chondromalacia patella, they do not fix the underlying problem.

The muscles of the leg and hip play an important role in making sure the kneecap moves (tracks) as it should. And tight or weak tissues and muscle imbalances can cause major movement problems. For that reason, doing exercises for chondromalacia patella can make a huge difference in terms of long-term relief.

5 Chondromalacia Patella Exercises

Generally speaking, chondromalacia treatment exercises focus on strengthening the muscles of the legs and hips without increasing the amount of pressure between the kneecap and the groove of the thigh bone. Following are a few great exercises for patellar chondromalacia, as well as exercise diagrams for additional clarification.

Straight Leg Lift

1. Lie down with one leg bent at a 90-degree angle with the foot flat on the floor and the other leg fully extended.
2. Tighten the quadriceps (thigh muscle) of the straight leg and raise it to a 45-degree angle.
3. Hold the leg in this elevated position for a second or two before slowly lowering it back to the ground.
4. Repeat for 20 repetitions then switch legs. You should do two or three sets per day.

External Hip Rotation (AKA, the Clam)

1. Lie on your side with the knees stacked and bent at 90-degree angles and the hips flexed at an angle of about 60-degrees.
2. Keeping your heels stacked together and the pelvis anchored and perpendicular to the ground, lift your top knee as high as you can, hold for a second or two then lower it.
3. Repeat this chondromalacia patella exercise 10 to 15 times per side for two or three sets.

Wall Slide

1. Begin by standing with the heels about 6 inches away from a wall and the feet about a foot apart. Your back and butt should be pressed against the wall.
2. Slowly slide the hips down the wall until the knees are bent at roughly a 45-degree angle. Hold that position for about five seconds, and then slowly slide back up to the starting position. It is important not to bend too quickly or too deeply as this can irritate the knee.
3. Repeat this motion 10 to 15 times for two to three sets.

Quadricep Contraction

1. Lay down with both legs extended in front of you. Slide a rolled up towel or blanket under one knee so that it is slightly bent.
2. Lift the foot off the ground so that the knee straightens fully.
3. Hold the knee locked in extension for five seconds, then relax the quadriceps and slowly lower the leg back to its resting position.
4. Repeat for 10 repetitions and then switch legs. This should be done three to five times a day.

Dumbbell Deadlift

A deadlift can also be an effective exercise for chondromalacia patella, but only if you exercise proper form. You will need a barbell with weights for this exercise. When starting out, you may want to use an elevated rack to limit pressure on the knee cap.

1. Pick up your dumbbells and hold them in front of you, standing with the feet shoulder-width apart.
2. Slowly lower the dumbbells by hinging forward at the hip. Be sure to keep your chest and head up, your back straight and the weights close to your body. Your knees should be bent slightly—they should not bend as much as you would during a squat.
3. When you have lowered the weights as far as you can without rounding the back, reverse the motion and slowly extend the knees, hips and waist until you are standing upright with the shoulders pulled back. Your abdominal muscles should be engaged throughout the lift.
4. Repeat three to six times for three to five sets if you are using heavy dumbbells. You can do higher repetitions if you are using lighter weights.

Best Cardio Exercises for Chondromalacia Patella

There are also some cardiovascular exercises for chondromalacia patella that are great because they put relatively low amounts of stress on the knee. For instance, swimming is a wonderful full-body exercise for chondromalacia because the water put very little stress is put on the joints.

Other “safe” exercises for chondromalacia patellae include:

• Walking (avoid hills)
• Cross-country skiing
• Kayaking or paddle boarding
• Lower-impact Pilates or yoga (you made need to modify certain poses)
• Barre workouts (with certain modifications, like shallower knee bends)
• Water aerobics
• Rowing
• Rollerblading
• Using an elliptical trainer

Some also incorporate riding a stationary bike into chondromalacia rehab, though you’ll have to take some special precautions, like placing the seat fairly high and using low resistance settings. Normal biking can be quite stressful for the knees. If strength training is more your style, you can use a hamstring curl or leg press machine. The caveat in doing so, however, is that when doing leg presses you must be careful to not let the knees bend farther than 90 degrees. Also, it’s important not to start any patella chondromalacia exercises/therapy until pain and swelling have abated. You should also stretch and warm up before doing any chondromalacia treatment exercises. Skipping those steps increase your chances of reinjuring the knee. As you do get back to normal activity, you should work back into exercising gradually. In addition, it’s important to incorporate some variety into your workouts. Doing the same thing over and over again can lead to muscle imbalances and continually stress the same areas.

Warning: Chondromalacia Knee Exercises to Avoid

While chondromalacia exercises can be great for fixing your kneecap pain, there are also some that should be avoided because they can do more harm than good. These generally include exercises that put a lot of stress on the knee. Some examples include:

• Lunges
• Deep squats
• Leg extension machine 

Generally speaking, you should avoid sports involving a lot of running, jumping,or contact when recovering from a chondromalacia knee injury since they place high amounts of stress on the knee joints.

Some “risky” sports that could make your chondromalacia pain worse:

• Volleyball
• Soccer
• Football
• Basketball
• Racquetball
• Distance running
• Stair stepper machines

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Top 5 Exercises for Chondromalacia Patellae

Chondromalacia patellae is a knee disorder characterised by deterioration and softening of the cartilage on the underside of the knee cap (patella). This condition is often called runner’s knee (although this is an incorrect term, and not related to chondromalacia patella, as runners knee causes lateral knee pain). In addition, it is often categorised patellofemoral pain syndrome. Chondromalacia patellae is characterised by pain and tenderness in the front of the knee, particularly during activities like running, stair climbing, and squatting. In some cases, when the knee is bent or straightened, it may “crack” or “pop” or “click”.

Patellofemoral pain syndrome is commonly associated with chondromalacia patellae. Patellofemoral pain syndrome is caused by irritation and inflammation of the cartilage beneath the kneecap (patella). Chondromalacia patellae is a painful condition in which the cartilage beneath the kneecap (patella) becomes soft and begins to deteriorate. This condition may play a role in patellofemoral pain syndrome.

Chondromalacia patellae’s exact cause is unknown, but it is believed to result from overuse or misalignment of the knee joint or muscles. However, misalignment is a statement that many physiotherapists do not subscribe to, and my personal belief is the patella does not misalign or “track badly”. CMP is most prevalent in athletes, particularly those who engage in repetitive knee bending activities such as running, cycling, and basketball. In addition, obesity, leg length discrepancies, and tight quadricep muscles are risk factors.

Chondromalacia patellae is diagnosed through a physical examination in most cases. Typically, treatment begins with the avoidance of activities that worsen symptoms. Physical therapy can strengthen the muscles surrounding the knee and improve joint alignment. Anti-inflammatory drugs may also be prescribed to alleviate pain and inflammation. In severe cases, cartilage damage may necessitate surgical intervention.

Chondromalacia patellae can be treated with physiotherapy and soft tissue therapy, activity modification, medications, and rarely surgical intervention. Therapy at Surrey Physio may include hip and knee strengthening exercises, stretching, and massage. Avoiding activities that cause discomfort, such as running, jumping, or squatting, may be part of activity modification. To reduce swelling and pain, your GP may prescribe nonsteroidal anti-inflammatory drugs (NSAIDs) such as naproxen.

Chondromalacia patellae can be a painful and debilitating condition, but it is typically treatable with by rehab therapists, physios and osteopaths. If you experience knee pain or swelling, you should seek support. We offer face-to-face appointments for those in London, and online consultations for our overseas patients.

Let’s look at our top five exercises for chondromalacia patellae:

1. Quadriceps Stretch: Lie face down, and bend your knee bringing your heel towards your bottom. Use your hand or a towel to create overpressure. You will feel a stretch into the front of your thigh.

2. Knee Swing on High Chair: Sit on a high chair or table (slightly on the edge) and let your leg dangle. Bend your knee as far as feels comfortable, then relax. Keep the movement controlled, not too fast. You can also straighten the leg as well. This exercise is especially useful for increasing mobility to a stiff knee. If you don’t have a high chair, sit on a sturdy table.

3. Ice the Knee: Apply an ice pack or frozen peas to your knee. Make sure you wrap it in a thin towel so its not too cold. Use this to reduce pain and inflammation. You may also find it useful to elevate the leg to further reduce swelling.

4. VMO Strengthening: First, identify your VMO – it’s the inside part of the front of your thigh, and makes up part of the quadriceps muscles. Contract your VMO by squeezing your inside thigh muscle, and slowly lift your leg off the floor/bed. When your leg is a few inches off the ground, rotate your leg outwards so your foot is pointing at a 45 degree angle to the side. You will feel a pull on the inside of the thigh muscle, from your groin to your knee.

5. Inner Range VMO Strengthening: Sit on a chair slightly towards the edge. Place a towel between your thighs. Cross your legs. Squeeze the towel with your thighs as you attempt to lift the bottom leg. The top leg will provide resistance. This is a strengthening exercise for the quadriceps (thigh) muscle.

Chondromalacia Patellae is a common knee problem that if left untreated, can develop into knee arthritis. Ensure you seek support and help from our team, as this condition is treatable.

If you are a therapist and like the exercises and information in this document, please go to www.rehabmypatient.com and sign up to this amazing exercise prescription software. If you are a patient and need some advice, treatment or a consultation, please go to www. surreyphysio.co.uk/bookonline. We provide virtual and face-to-face appointments with our expert team.

If you want to buy any equipment seen on these articles, please go to www.rehabme.com/shop.

For more advice on carpal tunnel syndrome, check out this page: https://www.rehabmypatient.com/knee/chondromalacia-patella

Chondromalacia patella

Chondromalacia of the patella is a common pathology of athletes, which must be treated.

Our clinic employs highly qualified doctors who quickly and correctly make an accurate diagnosis and prescribe adequate treatment. We have our own diagnostic base and the necessary equipment of the latest generation – CT , MRI , Ultrasound . The patient can, without leaving the walls of the clinic, undergo the necessary diagnostics and immediately visit a specialist.

What is chondromalacia patella?

Chondromalacia patella is a pathology of the articular cartilage of the lower part of the patella, as a result of which it wears out or softens. This leads to an inflammatory process, accompanied by limited mobility and pain in the knee.

Most often, this pathology is diagnosed in young people, especially in females. As a rule, chondromalacia of the patella begins in adolescence or young age, and is almost always asymptomatic in the initial stages.

The disease is characterized by wear of the cartilage of the joint under the kneecap due to friction of the kneecap against the femur. As a result of degenerative changes, the cartilage tissues lose their elasticity, while the hyaline cartilage becomes thinner, wearing down to the bone.

Species

In total, there are 4 stages of chondromalacia of the patella, which replace each other depending on the neglect of the process:

– Cartilage softens in the knee area.
– The cartilage softens and its surface is broken. This stage is a sign of the beginning of tissue destruction.
– The cartilage is thinning and its condition is actively deteriorating.
– Severe damage to the cartilage, in which bone tissue is exposed.

Causes

The following factors can provoke wear of the patella:

– weak muscle tone;
– congenital pathologies, for example, congenital displacement of the patella;
– injuries of the femur and tibia;
– dysfunction of the abductor and adductor muscles;
– deformity of the foot;
– weakness of the quadriceps femoral muscle;
– acute injuries of the patella.

At risk are professional athletes who experience increased stress when jumping, during direct blows to the patella, etc. Patellar chondromalacia is also diagnosed in people with flat feet, arthritis, and a removed meniscus.

Symptoms and signs

The main symptom of the disease is pain. It is present immediately on both sides of the patella and is chronic or acute. With flexion-extensor movements, characteristic clicks are heard.

The clinical picture is more pronounced when descending the stairs, while squatting and running. The intensity of pain increases slowly – from mild discomfort to severe pain. This process usually takes about a year.

Which doctor treats?

Chondromalacia of the patella is diagnosed by an orthopedist. He develops a treatment strategy individually in each case. Our clinic has

Methods of treatment

Before starting the treatment of pathology, the patient must undergo a thorough diagnosis. The disease is diagnosed with the help of special tests, and also used:

– x-ray in three projections;
– CT;
– MRI;
– arthroscopy;
– radioisotope scanning – in case of difficulty in making a diagnosis.

Conservative treatment of chondromalacia patella is as follows:

– anti-inflammatory therapy and the appointment of chondroprotectors to the patient;
– intra-articular injections of sodium hyaluron preparations;
– wearing a special fixing knee brace;
– physiotherapy.

It is important to know that:

– Chondroprotectors are best used in combination with physiotherapy, massage and exercise therapy.
– Osteopathy and reflexology can start the recovery processes in damaged cartilage due to the hidden reserves of the body.
– Surgical intervention is carried out endoscopically, that is, using minimally invasive techniques.

Important! The choice of treatment tactics depends on the stage of the disease. In the absence of the effect of conservative treatment, the patient is shown surgical intervention.

Results

Chondromalacia patella is not a sentence. By starting treatment in time, you can get stable positive dynamics. Of course, you will have to make a lot of efforts, but it is quite possible to make progress – the right treatment and adequate physical education will return the lost elasticity to the cartilage tissues, and the lost elasticity to the muscles. An integrated approach to solving the problem, as well as strict adherence to all the doctor’s recommendations, will lead to an almost complete restoration of cartilage.

Rehabilitation and lifestyle restoration

Rehabilitation of chondromalacia patella begins immediately after the diagnosis is established. The inflammatory process in the cartilage stops quickly, and since this pathology belongs to the category of degenerative-dystrophic changes, rehabilitation should be carried out in courses. Thus, it is possible to maintain and preserve the functionality of the joint. That is, the patient must periodically consult a doctor, undergo physiotherapy and monitor the dynamics of his disease.

Reference! Depending on the treatment (conservative or surgical), rehabilitation can take 1-4 months.

The main goal of rehabilitation is to strengthen the ligaments of the muscles of the knee joint, so the patient is prescribed physical therapy, massage, physiotherapy, kinesiotherapy.

Lifestyle with chondromalacia patella

Complications of chondromalacia of the patella are recurrent synovitis. If the disease bakes for a long time, the development of deforming arthrosis of the patella-femoral joint is possible. In order to prevent the occurrence of these complications, it is necessary not only to start treatment in a timely manner, but also to undergo its courses in the future. In addition, it is recommended to wear shoes with orthopedic insoles that compensate for problems with the knees and the musculoskeletal system, as well as to avoid overload and injury to the knee joint.

If chondromalacia of the patella is detected in a timely manner, the prognosis for the disease is favorable. Complete restoration of cartilage tissue or a significant slowdown in the progression of the pathological process is possible. Ability to work is preserved, a number of patients can return to active sports.

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All about chondromalacia patella and its treatment

Cartilage tissue is destroyed imperceptibly, since the cartilage lining has no innervation – in other words, it does not hurt. Pain occurs when the cartilage is deformed and thinned and the load on the joints located near it is increased. Chondromalacia of the knee joint is one of the types of damage to the cartilage lining – deformity of the posterior part of the patella. It is good if the disease is detected at an early stage. Since the advanced stage of deformation is a sad picture of a through lesion, up to the exposure of the joint.

Causes of disease.

Patellar chondromalacia may occur in athletes as a result of knee injury. But more often it is caused by chronic overload of the joint with improper or excessive prolonged load. The position of the kneecap is fixed by the quadriceps femoris muscle (quadriceps). The strength and tone of the muscles that form the quadriceps, with prolonged tension, come into imbalance. As a result, the position of the patella is incorrect, and the articular tissues are worn out.

Symptoms of the disease.

Chondromalacia of the knee joint manifests itself with the following symptoms:

• When walking, a crunch in the knee joints may disturb;
• Periodic aching pain in the knee, increasing during or after exercise, and even minor physical activity – squatting, climbing stairs;
• Edema of periarticular tissues.

Even a crunch in big-time sports is a reason to see a doctor. As a rule, the initial examination is not enough to assess the condition of the cartilage tissue, so the doctor will prescribe additional studies, most often an MRI. An additional diagnosis for an atypical course of the disease or an unclear picture is arthroscopy, which we will discuss below.

Treatment of chondromalacia of the knee.

Therapeutic treatments for chondromalacia are aimed at reducing inflammation and restoring joint mobility. Conservative actions will be as follows:

• Anti-inflammatory therapy and taking chondroprotectors;
• Administration of sodium hyaluronate preparations (Fermatron or Gialgan) intra-articularly;
• Wearing a special knee brace to fix the joint;
• Physiotherapeutic procedures.

Substances included in the drug Fermatron restore synovia (intravascular fluid that reduces friction and absorbs shocks in the joint). Thanks to this, the pain syndrome is eliminated, the mobility of the joint increases and the ability of self-regulation in the cartilage tissue is restored. Unfortunately, the drug has contraindications: when the skin around the joint is inflamed and infected, Fermatron cannot be administered. If other therapeutic methods of treatment have been exhausted, chondromalacia requires surgical intervention. And one of the surgical methods is arthroscopy. This is a minimally invasive method of treating and diagnosing any joints, and it is indispensable for athletes, as it guarantees a quick recovery. The operation does not require large incisions, two small holes are made: one for the arthroscope (optical device), the other for the surgical instrument. The surgeon observes the area of ​​the joint on the monitor and uses the instrument to perform the necessary manipulations. Arthroscopy allows you to operate on such complex injuries as torn ligaments, menisci, cartilage. Recovery after arthroscopy is quick, since the process is less traumatic.