Patient :I'm an athlete and have chondromalacia patella in both my knees, and need to get some advice on treatments. I rested the knee completely from all exercises for about 5 months once, but after I started doing exercises the pain came back again. I need to get advice.
Symptoms: Knee pain in both knees, tendinitis in both quadricep tendons
Thank you for your medical query at AskTheDoctor.com
I understand your concern.
Chondromalacia of the patella occurs due to excessive use of the knee joint putting strain on the patella.
Though the primary reason is not known, some people have a slight misalignment of the patella and they are more prone to this condition.
The first recommended step is to avoid overuse, and also lose weight.
The treatment of this problem is usually non-operative and includes; weight loss, medications involving painkillers, activity modifications, softer soled shoes, physical therapy and occasionally injections. If these modalities are unsuccessful then surgery is an option. The goal of treatment if to improve pain and improve the function. None of these options will change the underlying wear and there is nothing at this point that will re-grow cartilage. The patella helps to improve the biomechanics of the quad muscle.
You already stopped all exercises for 5 months, but the pain is still back. Now, you need to go for regular physiotherapy and learn a few quadriceps strengthening exercises. You also need to maintain your BMI within 18-22, as in patients with Chondromalacia, 1 pound gained is equivalent to 4 pounds of pressure put on the patella. There are specific grading based exercises which your physical therapist can guide you with.
If none of these measures help, surgery is the only option.
Hope this was helpful,
Feel free to discuss further,
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