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.

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