Femoral-Patellar Syndrome (Chondromalacia)

Description

  • In 50% of cases, secondary injuries are due to exercise abuse.
  • Result of irritation of the external portion of the patella following a compression against the femur.
  • Emphasized by the flexion movements of the knee involving the quadriceps.
  • It manifests itself very often in children and adolescents and almost always disappears with age.

Presentation

  • Dull pain that seems to originate inside the knee.
  • Usually presents without trauma but can follow a knee injury.
  • Shows up and down stairs after prolonged sitting, kneeling, jumping or wearing high-heeled shoes.
  • Without proper treatment, this condition can become recurrent and chronic. Dislocation of the patella is possible and arthritis at the joint may develop.

Causes

  • Incorrect alignment of the patella in the femoral gutter
  • Anterior or repeated knee injury
  • Flat or pronated feet
  • General misalignment of the lower limb
  • Abuse of exercises (“too much effort, too early” syndrome)
  • Sports involving racing and jumping
  • Weakness of the quadriceps and muscles stabilizing the pelvis
  • Muscles stretched on the outside and at the back of the knee

Treatments

  1. Reduction of inflammation
  2. Improvement of the dynamic ratio between the femur and the patella
  • Rest and change of activities
  • Sports to avoid: volleyball, basketball, running, football, racquetball, squash
  • Decreased inflammation with ice and complementary therapies such as neurocrystal therapy and kinesio taping.
  • Articular manipulations and soft tissue work (Active Release Techniques and Graston) to correct knee biomechanics and reduce scar tissue
  • Stretching and strengthening exercises to stabilize the knee
  • Drugs (anti-inflammatory) as needed
  • Plantar orthoses and knee orthotics possible
  • Cortisone injections as needed
  • Surgical procedures very rarely indicated