From the SAYSO Trainer’s Notebook

 

Chondromalacia Patella,

Patello-Femoral Syndrome,
and Patellar Tendonitis

 

These are conditions related to overuse, trauma, and/or abnormal forces on the knee. They are more common in girls than boys. Very often, chondromalacia is a result of an ongoing mechanical imbalance. As feet pronate (flatten out) during normal weight-bearing/walking/running, the leg rotates inward, placing mechanical stress on the front and inside of the knee. In people whose feet flatten out to excess, these forces are magnified and, over time, patellar tendonitis and chondromalacia can develop. Females, as a natural part of their development, often become somewhat knock-kneed (genu valgum) as their pelvis begins to widen. This adds to the biomechanical stresses even more. (This may also be a part of the reason that female athletes seem to suffer more torn ACLs than the males.)

Proper biomechanical support early on, including both proper shoes that are in good condition and some form of orthotics in the shoes, can very often relieve these stresses on the knee joint, effectively dealing with the underlying cause of the problem. Physical therapy and exercises (along with the medication and potential surgery) are a part of the rehabilitation to strengthen and stabilize the structures about the knee, but they deal more with the symptoms and results than the underlying causes.

Here is some information from Medline http://www.nlm.nih.gov/medlineplus/ency/article/000452.htm on this topic.

"Temporarily resting the knee and taking nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen, or aspirin may help relieve pain [but these medications have side effects too]. Physical therapy, especially quadriceps strengthening and hamstring stretching, may be helpful. Participation in sports or strenuous activity should be limited until the pain has gone away. Activities that increase the knee pain, such as deep knee bends, should be avoided until the pain improves. If the alignment of the patella that cannot be corrected with therapy, surgery may be an option. Depending on the nature of the misalignment, the surgery may be arthroscopic (using a camera, which allows a smaller incision) or open. Chondromalacia patella usually improves with therapy and use of NSAIDs. For the few people who need it, surgery is successful about 90% of the time."

 

For another discussion, see this article: http://www.rice.edu/~jenky/sports/pfs.html

 

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