Runner's Knee

I have been forced to admit that my problem is a bit more serious than overrunning this August. I am having more and more pain from sitting and stair walking. So it is Chondromalacia patellae or Runner's Knee. I suffered through this 3 years ago. It would seem that my training with my niece was too much for my old man legs. So I am confined to a sofa, with no running or biking. Below is more details as to what ails me, and I hope everyone is ignorant of this condition. Though my peers probably aren't.

Chondromalacia patellae (also known as CMP) is a term that originates in the early 20th century. It originally meant "soft cartilage under the knee cap", a presumed cause of pain at the front and especially inner side of the knee. This condition often affects young, otherwise healthy individuals.

The WHY?

Chondromalacia is due to an irritation of the undersurface of the kneecap. The undersurface of the kneecap, or patella, is covered with a layer of smooth cartilage. This cartilage normally glides effortlessly across the knee during bending of the joint. However, in some individuals, the kneecap tends to rub against one side of the knee joint, and the cartilage surface becomes irritated, and knee pain is the result.

That pain is at the front/inner side of the knee and common in young adults, especially soccer players, gymnasts, cyclists, rowers, tennis players, ballet dancers, basketball players, horseback riders, volleyball players, and RUNNERS. The pain of chondromalacia patellae is typically felt after prolonged sitting, like for a movie, and so it is also called "movie sign" or "theater sign." Though I have never heard those terms. But the pain is inescapable.

The condition may result from acute injury to the patella or from chronic friction between the patella and the groove in the femur through which it passes during motion of the knee. Possible causes include a tight iliotibial band, neuromas, bursitis, overuse, malalignment, core instability, and patellar maltracking.

WHAT to do?

Pain at the front of the knee due to overuse can be managed with a basic program consisting of RICE (rest, ice, compression, elevation), anti-inflammatory medications, and physiotherapy, however; if there is cartilage damage this is not easily repairable.

Usually chondromalacia develops with no swelling or bruising. The treatment of chondromalacia remains controversial, but most individuals can undergo effective treatment by resting the knee and adhering to a proper physical therapy program. My plan is in accordance with the usual treatment: allow the inflammation to settle is the first step of treatment. Avoiding painful activities that irritate the knee for several weeks, followed by a gradual return to activity is important. In this time, cross-training activities, such as swimming, can allow an athlete to maintain their fitness while resting the knee. The next step in treatment is a physical therapy program that should emphasize strengthening and flexibility of the muscles of the hips and thighs. Use of nonsteroidal anti-inflammatory medication is also helpful to minimize the pain associated with chondromalacia.

Thankfully, surgery as a remedy is declining in popularity for two reasons: good outcomes without surgery, and the small number of patients who actually benefit from surgical treatment.

 

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