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What is it?

Chondromalacia is a softening or wearing away and cracking of the cartilage under the kneecap, resulting in pain and inflammation. What happens is that the cartilage becomes like sandpaper because the kneecap is not riding smoothly over the knee.

What Are the Symptoms?:

Pain beneath or on the sides of the kneecap. "It's a soreness, a nagging discomfort," says Dave Apple, M.D., an orthopedic surgeon at Atlanta's Piedmont Hospital. Pain can worsen over a year or so and is most severe after you run hills. Swelling is also present. In severe cases, you can feel--and eventually hear--grinding as the rough cartilage rubs against cartilage when the knee is flexed

What Are the Causes?

Excessive pronation (when the arch collapses too much and the foot rotates too far inward) can cause the kneecap to twist sideways. Fatigued or weak quadriceps muscles, which aid in proper tracking of the kneecap, can prevent the kneecap from tracking smoothly. A muscle imbalance between weak quads and tighter hamstrings can also pull the kneecap out of its groove. Hill running (especially downhills) can aggravate the condition, as can running on the same side of a cambered road, or, in general, overtraining.

What Should You Do?

You should stop running. Try icing the knee for two or three times a day. The frozen gel pack or a bag of frozen vegetables works well. Taking aspirin three times a day can help as Aspirin has been found to block breakdown of cartilage. Massage the sore spots around the knee. Once pain and swelling are gone, you should strengthen quadriceps by doing what is called, step-downs.

Stand on a step or book that is 10 centermetres high. Keep right quadriceps tight and lower the left leg slowly toward the floor. Then raise it back up and relax. Repeat 30 times with each leg. Increase repetitions in groups of five after 2 days. Stop at 50 times.

Also stretch quadriceps and hamstrings. You also might also try wearing a rubber sleeve with a hole that fits over the kneecap.

You should be back to easy running in a month and a half.

Alternative exercises are swimming, deep water running, rowing.

Now What to Do?

Stretch quadriceps, hamstrings and calves.

If you are an over-pronator switch to motion-control shoes with firmer midsoles

Never run in worn-out shoes.

Consider orthotics.

Avoid running downhill, and stay off uneven roads

If chondromalacia isn't responding after four weeks, see an orthopedic surgeon.




Women in Motion

Women in Motion March 2001