The patella (knee cap) is a triangular bone covering the knee joint Tibiofemoral Joint and forming a joint itself with the femoral condyles (patellofemoral joint). It is considered the largest sesamoid bone (independent bone in a tendon) since it is immersed in the infrapatellar tendon that attaches the Quadriceps muscle to the tibia (leg bone).
The posterior surface of Patella is covered by cartilage to ensure gliding of the patella against the femoral condyles when the knee flexes (bends) and extends (straightens). The eruption of this layer of cartilage will expose the underlying bone which is painful.
Pain interferes with some activities of daily living which requires bending of the knee ( i.e. kneeling, squatting, going up or downstairs, …. Etc).
Causes include:
- Patellar mal tracking.
- Trauma.
- Degenerative changes with aging.
- Overweight.
- Subluxation and dislocation.
Treatment of Chondromalacia is based on determining the causative factor(s) which is vital to avoid recurrence and in order not to hinder recovery.
Physiotherapy intervention includes:
- Patellofemoral joint mobilization.
- Stretching hamstring muscle.
- Quadriceps and Hamstring muscle strengthening exercises.
- Balance training.
- Bracing and taping.