Chondromalacia Patellae

Chondromalacia patellae or Chondromalacia patella is quite common among healthy people.

 What is this “Patella”, and what is it for?

The kneecap, or patella, is a small bone that articulates with the femur, attached to the tendon of the quadriceps, and the patellar tendon attached to the tibia. Its principal function is to facilitate knee extension, allowing the tendon to exert a bigger leverage to the femur as it increases the action angle. It also covers and protects the anterior articular surface of the joint.

What is "Chondromalacia patellae"?

This patella, covered with a smooth cartilage that works as a shock absorber, glides along the knee when bending it. Some individuals have a problem with this action, as the kneecap rubs against one side of the joint, causing an irritation of the cartilage, damage in it, and a malfunction and pain as an ulterior result.
This pain typically occurs after long time sitting, that’s why is also called “movie sign” or “theatre sign”.

What are the causes?

Some of the causes are overuse, misalignment, bursitis, flat feet, core instability or patella maltracking. In my opinion, all these join into one: Wrong Leg Alignment, often due to a bad feet positioning.





How to treat “Chondromalacia patella”?

There are a few steps that you can do, besides corrective taping (very useful, a physiotherapist can teach you how to do this), but don’t hassle, it takes several weeks to get through the process:

-First step: Reduce/get rid of the pain: Avoid any motion which could irritate the kneecap (running, cycling, etc) and relieve the pain and the inflammation with anti-inflammatory medicines (e.g. Ibuprofen) and ice. It is possible and desirable to practise some physical activity like swimming (flutter kicks) or aquagym, strengthening the muscles under low impact exercises.

-Second step: It would be strengthening all the muscles around the area (Quadriceps, Hamstrings, Glutes, Calves and Kneecap muscles). (SEE IN THE NEXT POST).

*Of course, we need to check the cause of everything, and change it. It could be a wrong alignment of our bicycle (usually because the hips are too low so the knees need to bend further, causing the injury), our way of walking (bad alignment of the foot-knee-hip axis, leading to an imbalance), small chairs, flat feet (we can use shoe insoles), etc.

-Third step: After a while, and once we feel our knees are safer because of the improvement of our strength, we should combine those of strength with stretching exercises. (SEE IN THE NEXT POST).

-Fourth step: Balance and proprioception training. (SEE IN THE NEXT POST).

-Fifth step: Re-education of the altered functional patterns.

But, how do we do that?

I’m working on it at the moment, but you will need to wait until the next post (just a few days, I promise!).


Practise S.A.F.E.!

Strength training and Functional capacity - Article review

As read on "Role of the nervous system in sarcopenia and muscle atrophy with aging: strength training as a countermeasure" (Aagaard et al, 2010), there is a loss of spinal motor neurons due to ageing, as well as a reduction in muscle fibre number and size (sarcopenia), deteriorating the mechanical strength and performance and decreasing the functional capacity in everyday tasks.  This means that maximum muscle strength, power and capacity of force development will also diminish. Strength training results effective controlling all those, as it provokes muscle hypertrophy and improves neuromuscular function, even at a very old age (>80years). Both, growth in muscle mass and improvement in the nervous system function lead to a better functional capacity during everyday activities.


So it's clear that even when we get old, physical activity is a must, always kept under control and medical advise. Strength training is not just for young people worried about appearance, is helping at every age range.

Practise S.A.F.E.


Bibliography:


-Aagaard, P., Suetta, C., Caserotti, P., Magnusson, S. P. and Kjær, M. (2010), Role of the nervous system in sarcopenia and muscle atrophy with aging: strength training as a countermeasure. Scandinavian Journal of Medicine & Science in Sports, 20: 49–64. doi: 10.1111/j.1600-0838.2009.01084.x

First day - Easy job

Today has been my first day at the gym. My routine has been simple and fast. It's only taken 55 minutes. As it was my first day since a long time, I just wanted to get used to the new machines, and to loosen up the muscles. I have done a circuit where I've been able to exercise most parts of my body.

1st day:

Total duration: 55'

Warm up: 10' Light jog (Increasing speed)

12 reps at an easy weight for the following exercises (30-45" between exercises):

• Leg extension
• Lat row
• Chest press
• Upper chest press
• Leg curl
• Shoulder press
• Back extension
• Biceps curl
• Calf raise
• Dumbbell alternating front raise
• Crunch
• Peck deck fly
• Triceps dip
• Dumbbell rear lateral raise

After doing this, I've done all of them again except shoulder exercises (FIRST DAY, REMEMBER?)

At the end, 5 minutes more of medium intensity in the stepper.

It has been easy, but I don't want to rush and get injured. One step at a time, and we will have nice results.

Practise S.A.F.E.!

Getting back to gym

How many times do we take up exercising again? Going back to gym, swimming pool or any other physical activity that we haven't practised for a while? And, no matter how long we've been out of it, when we can back something deep inside us is pushing ourselves to get into the same shape as soon as possible, forgetting about this break time...

Then, we realised that our endurance or strength is not the same, but still we are enjoying the effort, feeling alive pumping blood again far from the sofa. So we do what we can, although we don't keep in mind that our bodies are just used to sitting down, watching TV, maybe going for a short walk, and that's all. And as a result of it we end up with a strange grimace of pain the day after.

Well, this has happened to me now and then, even though I have quite a long and experienced sport career. Not this time. I'm going to follow my own instructions. I am going to be my own personal trainer. So from now on, I will post everything I'm doing to exercise, some tips to do it safe and with a purpose.

Practise S.A.F.E.

I'm just piling up all the info to get started as soon as possible

Sorry for any inconvenience