What is Chondromalacia?
Chondromalacia is what we call damage or breakdown of the cartilage on the ends of your bones. When we are referring to chondromalacia patella, we are specially referring to the cartilage on the back of your knee cap. The knee cap does not move correctly in the groove and it starts to irritate and damage your cartilage.
What is Patellar Femoral Traction Syndrome?
Patellar Femoral Traction syndrome is the name we give to the knee cap not gliding correctly in its groove. The knee cap, or patella, is pulled to one side or the other and causes that back of the knee cap to wear abnormally. As it wears down, patellar Femoral Traction syndrome will cause chondromalacia patella.
What is Runner’s Knee?
If you go to your doctor, and they diagnose you with runner’s knee, that may not sound very official. You may think your doctor just made this up, especially if you are not a runner! Runner’s Knee is a term we use to describe a condition where your knee cap does not stay in its groove like it is supposed, also called patellar femoral traction syndrome. This causes early wear and tear to the cartilage on the back or your knee. That is called Chondromalacia patella. So when they say you have Runner’s Knee, you are actually getting 2 diagnosis in one.
What is the Best Treatment for Chondromalacia Patella?
If you have been told that you have Runner’s knee, and you want to fix it, you should think about the treatment in 2 steps. First, heal the damage to your knee cap. I get people asking all the time, “Can Chondromalacia be healed”? The answer is Yes! Absolutely. Pain killers and anti-inflammatories will not do it. In fact, there have been studies that suggest cortisone shots can actually make the problem worse! Prolotherapy is an injection that goes behind that knee cap and will help to body to heal that damage of Chondromalacia patella. Step 2 is eliminating that cause. We need to address the patellar femoral traction syndrome so that the knee cap doesn’t continue to grind and get irritated. If we fix the injury and remove the cause, you will have decades free of knee pain!
Is Walking Good for Chondromalacia Patella?
This is a great question. I also have people asking “Is cycling good for chondromalacia patella”? While we are going through our treatment, we need to reduce trauma or irritation to the knee cap to give it a chance to heal. That does not mean you have to sit on the couch the whole time. We do want some movement in the knee, because that will help to get the circulation around the area to help with the healing. Because the knee cap will tend to rub during exercise we want things that are low impact. Walking for 30mins can be great. Using an elliptical machine is also a really good idea. Low intensity cycling can also be very beneficial. If doing either of these exercises makes your knee feel worse, then we do need to eliminate it. Again, we want to give your knee the best chance we can to let it heal. That way it will not continue to cause you pain down the road.
What Does Chondromalacia Patella Treatment Look Like?
Prolotherapy has been proven to be able to help heal the damage from patellar femoral traction syndrome and fix chondromalacia patella. For mild to moderate cases (it is always best to treat this early), we would want to do 3 injections with 3 – 4 weeks in between each injection. This will give the body time to heal in between each injection. As stated before, we need to stop doing the activities that hurt your knee. Mild, low impact activity is okay, but we need 8 weeks to really give your knee a chance to heal. Since you won’t running any races and limiting your exercises, this is also a great time to focus on form. If your running gate is off, or your knees are doing something funky when cycling or lifting weights, now is when you want to drop the intensity of your workout, get back to the basics, and really nailing down your form. Again, if your activity continue to irritate your knee, we need to stop while doing the series of injections! Then after week 8 as you start to increase your activity, you are going to be moving in a way that will help you have a long healthy pain free life!
How do I get the Best out of my Prolotherapy Treatment?
The most important thing is to stop irritating your knee during prolotherapy treatment. As the body is healing the patella and laying down new cartilage, we need to give it every opportunity to heal. The next important component is nutrition. What you eat directly affects your health and your body’s ability to heal. Some of my patients add collagen peptides to their shakes and take glucosamine during their treatment period. That is not a bad idea. The body needs the proper nutrients to heal. Get plenty of rest. Your body does most of its healing and repair while you sleep. Getting a quality 8 hours of sleep a night will also help to support the treatments and give you the best chance to heal.
Image © Nevit Dilmen, CC BY-SA 3.0 <https://creativecommons.org/licenses/by-sa/3.0>, via Wikimedia Commons