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Ask Dr. Rick – January 2012 – CHODROMALACIA PATELLA

January 6, 2012

Chondromalacia patella, also known as patellofemoral pain syndrome, is technically a softening of the articular cartilage under the kneecap. It is the most common cause of knee pain. It is also known as anterior knee pain. Chondromalacia in general is a pathological term that means there is damage of the joint surface or cartilage. Chondromalacia patella (CP) is a general term for patella or kneecap pain. It is most commonly seen in young females, but can be seen in both men and women of all ages.

The symptoms include vague knee pain in the area of the kneecap, difficulty with stairs, the knee giving way, popping or grinding under the kneecap and pain with prolonged sitting – especially if the knee is in one position for a period of time. CP is normally caused by malalignment or a pulling of the kneecap to the outside. It can be caused by overuse like running or biking, and sometimes there is no obvious reason or etiology. It can be seen in flat-footed people, people who are knock-kneed and people who have an abnormal shape to their kneecap. It is more common in females.

Treatment consists of ice, strengthening and antiinflammatories. Common medicines would include things like Ibuprofen or Naprosyn. Physical Therapy is the hallmark of treatment. As the leg gets stronger and the vastus medialis pulls the kneecap to the center of the knee, the patients’ pain should get better. Exercises are the main treatment for CP. Other forms of treatment include Hyaluronic acid injections, cortisone injections and PRP injections. Taping and bracing and muscle electrical stimulation can also be helpful. Stretching and strengthening of the quadriceps and gluteus (knee and hip) muscles are very helpful, too, as is iliotibial band stretching.

This is a common problem and it should be treated early in its course to ensure a safe return to sports.

Ask Dr. Rick

“I have popping in my neck; it is loud and very bothersome, but it does not hurt. S hould I be concerned, Dr. R ick?” J enna S ., Town and C ountry, Mo.

Jenna, popping is very common, and unless you are having pain, have numbness in your arms or experience weakness, I would not be concerned. If it persists or becomes painful, you should see a doctor, but this is quite common and usually not a problem.

“Dear Dr. R ick, I have numbness in the outside of my thigh. I have had it for five months and it is weird. What do you think causes this?”– Larry B ., B elleville, Il.

Larry, this is usually from compression of a nerve in your outside pelvic area called the Lateral Femoral Cutaneous nerve. That is a big name, but it is due to compression of that nerve. It can be treated with medication and sometimes an injection. It rarely can you need to see your doctor to see if it is something serious.

January Medical Tip: Limit simple sugars, bump up your protein and cut your carbs.

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