Chondromalacia patellae, often manifested as knee pain or knee joint playing soft leg when moving, usually after a lot of activities or when going up and down stairs or in a semi-squatting position with pain in front of the knee joint. Its treatment focuses on improving blood circulation in the knee, promoting nutrient supply and wound repair, preventing muscle atrophy, and enhancing joint stability.
In the introduction of the causes of chondromalacia patella, we know that chondromalacia patella is caused by long-term inappropriate exercise, lifestyle habits and occupational factors, therefore, the treatment of chondromalacia patella should first avoid excessive squeezing and friction of the patellar surface some activities, reduce the type and intensity of sports that cause knee pain, and pay attention to the cold and warmth of the knee joint.
The following methods of medication, exercise rehabilitation and physical therapy for the treatment of chondromalacia patellae are described.
1. Rest.
For acute onset, when the knee joint is swollen with oozing, rest is necessary, but absolute stillness is also not acceptable. This is because the articular cartilage relies on the action of the articular cartilage being squeezed by a certain amount of stress to obtain nutrition. If it is not subjected to stress compression, it will be “starved”, and because of the wear and tear of the joint surface, it also needs a certain amount of movement to obtain new adaptation and anastomosis.
2.Medication.
Oral non-steroidal anti-inflammatory drugs can be taken: can reduce pain and swelling. It is to protect the joint cartilage damage by reducing the synthesis of prostaglandins; glucosamine: helps the synthesis of protein mucopolysaccharide in cartilage, which is conducive to cartilage repair; topical drugs: to relieve local symptoms; knee joint drug injections: such as sodium hyaluronate injection helps to directly nourish and lubricate the knee joint.
3, physical therapy.
Up and down pushing, lifting the patella and passive movement of the knee joint, improving abnormal contraction of knee muscles, ligaments and other soft tissues, relieving pressure imbalance in the joint, reducing blood circulation stagnation leading to nutritional disorders and accumulation of metabolites, breaking the vicious cycle of inflammation, pain and muscle spasm;
Physiotherapy, chronic phase heat therapy and electrical stimulation therapy instrument treatment and other methods.
4.Movement rehabilitation methods.
1) Active movement of joints.
To be carried out under non-weight-bearing conditions, such as lying in bed actively extend and flex the knee joint, do not leave the bed when moving the heel. Adhere to the morning and evening once a day, 10 minutes each time. Adequate movement of the joint can make all parts of the patellofemoral joint surface are stimulated, synovial fluid nutrients can evenly penetrate into the cartilage tissue, and can enhance the lubrication of the joint.
2) Strength training of the muscles of the lower limbs.
Strengthen the strength training of the muscles of the lower limbs, especially the strength training of the medial femoral muscles. Because the muscle strength of the lower limb is very important for the stability of the knee joint, generally people with more developed quadriceps have a lower risk of knee arthropathy.
5. There are many methods of lower limb strength training, and the following methods are easier to master.
Quadriceps isometric contraction exercises.
Supine position, foot back extension, try to extend the knee, can feel the thigh muscle tense, 10-15s after relaxation; 10-20 groups per day, a total of 200-400 times;
Straight leg raise exercise: lying flat on the bed, foot back extension, lower limb in the knee straight position raised 20 ° – 30 °; keep in this angle for 10-15 s and then relax; 2-3 sets per day, each time 10-20 minutes;
Straight leg raising exercises can be performed in two ways: toe up position; 30-40° of external rotation of the toe; the latter method can better train the strength of the medial femoral muscles.
The above two sports rehabilitation exercises can also be trained in the sitting position.
Static squatting exercises: stand with your feet shoulder-width apart, toes and knees squarely forward, upper body straight against the wall, weight on the heels. Knee joints in the vertical direction can not exceed the toes, the knee angle of flexion can not be greater than 90 degrees. Hold the posture until exhaustion, rest for 10 seconds and then repeat, 10 consecutive times/group, 2-3 groups/day.
Clamp ball training: sitting position, will be a ball clamped to the north side of the two thighs, gradually clamped to the maximum they can bear, hold 15s.
Be sure to remind everyone: squatting is best done at an angle that does not cause significant pain, otherwise improper exercises will aggravate the injury.
Standing quadriceps training: the affected limb forward and bend the knee 30 °, the patient is instructed to selectively contract the medial femoral oblique head and adductor muscles, hold this position for 10 seconds.
Taping the patella reduces the pain during exercise and enhances the movement of the oblique head of the medial femoral muscle. Pull the patella inward while taping.
All exercises should be performed gradually, from few to many, from easy to difficult, from static exercises in a stationary position to power exercises in motion, from simple to complex movements. The above introduction is only the most simple and easy, the safest basic exercises. Excessive exercises will not only fail to relieve the symptoms, but will even aggravate the cartilage damage.
Daily attention points
1, before exercising or participating in sports, pay attention to the first warm-up, exercise before fully moving the joints;
2, activities should be gradual, avoid sudden changes in the intensity of exercise;
3, avoid continuous squatting and strenuous exercise, such as climbing mountains, stairs and other knee flexion exercise;
4. Avoid long-term, forceful, rapid flexion and extension exercises;
5.Walk with the aid of a cane if necessary
6, pay attention to warmth and cold: the weather is cold season, to keep the joints warm
7, knee pain can wear knee pads
8, wear appropriate shoes, preferably not too high heels