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Stretches & Exercises for Chondromalacia Pain

by Jaydee Vykoukal, PT, DPT August 19, 2020 0 Comments

Wearing knee brace

Stretches and Exercises for Chondromalacia a part of a complete recovery process to treat the poor knee function, pain, and other symptoms of this difficult patella condition. However, it can be hard to know where to start with a home program for chondromalacia patella. Keep reading to learn more about stretches and exercises that are easy and effective.

Stretches for Chondromalacia

The knee can get significantly stiff when pain and swelling are present, affecting patellar tracking and your ability to properly sequence everyday activities. Addressing these problem areas with a well-rounded stretching program can make a big difference.

Standing Quad Stretch

If you need help with your balance, stand near a counter, wall or chair to stabilize yourself with one hand. To stretch your right thigh, bend your right knee and grab the ankle with your right hand while keeping the toes pointed. Bring the heel toward your butt as far as possible until you feel a stretch in the quadriceps muscle and hold. Repeat on the other side.

Hold for 30-60 seconds on each side for 2-3 sets. Focus on keeping good form by keeping the lower back flat, abs tight, and hip neutral.

Alternatively, try lying down on your stomach with a stretch strap or kneeling while completing the same general motion as above with your knee.

Hip flexor stretch

Start by standing in a lunge position with the body in good alignment. To stretch the right hip flexor, bring the right leg back as far as is comfortable in a lunge. Then, to get a deeper stretch by putting your hands on your left thigh as you shift your weight slightly forward. You should feel a deep stretch in the front of the right hip and down the thigh. Do not let the low back arch. To further deepen the stretch, you can place both hands on the floor to the left of your right thigh and hold.

Hold 30-60 seconds for 2-3 sets. Switch sides to get a balanced stretch.

TFL stretch

Start by lying on your back with both legs out straight on the floor. To stretch your left leg, bring the left leg up toward the ceiling while keeping the knee straight. Then, let the left leg fall across your body to the right until it you feel a stretch in the side of the hip and thigh. Try to keep the low back and hips touching the ground as much as possible. To get a deeper stretch, rotate the toes down toward the floor. Repeat with the right leg.

Hold for 30-60 seconds for 2-3 sets on each leg.

Hamstrings

Grab a stretching strap and lie on your back on the floor. Wrap the strap around the bottom of one of your feet and hold each end with your hands. Then, straighten the knee before bringing the entire thigh up toward your chest as far as possible. You should feel a nice stretch in the back of the thigh.

Hold for 30-60 seconds for 2-3 sets on each leg.

Alternatively, you can long sit or stand and reach for your toes.

Calf Stretch

Since the calf muscles, specifically the gastrocnemius, cross the knee joint stiffness can cause knee problems. Stand at a chair or counter for balance. To stretch the right calf, step the right foot back to a comfortable position and place the entire bottom of the foot flat on the floor with the toes facing straight forward. Then, while keeping the heel on the ground, shift your weight into your toes as you bend the ankle. Go until you feel a stretch in the calf. Repeat on each side.

Hold for 20-30 seconds for up to 5 sets on each leg.

Strengthening Exercises

Re-gaining appropriate knee strength is crucial for restoring knee function and promoting healing. It is important to start simple with a focus on general problem areas like the quads and hips. Then, more advanced moves can be progressed from there.

Terminal Knee Extension

Attach a looped or straight resistance band to a sturdy surface and place it at the back of the knee. You should be facing the secured end of the loop and there should be enough tension in the band to keep it in place and provide adequate resistance. Start with the knee slightly bent and foot flat on the floor. Then, let the knee bend as you lift the heel off the ground. Next, reverse the motion as you tighten your thigh muscles, straighten the knee, and touch the heel back to the ground. Hold that straight position for 5-10 seconds.

Repeat 10 times for up to 3 sets on each leg. Focus on keeping good form (only movement at the knee and foot) and adequately tightening the thigh with each repetition.

Hip Abduction

Stand facing a chair or counter for balance. To strengthen the right hip abductors, simply lift the right foot of the ground. Then, move the entire out to the side away from your body. Keep the kneecap and toes pointing forward. Focus on slow and controlled movement. Do not lean to the side as you kick out. To progress add weight, repetitions or stand on a foam pad.

Repeat 15-20 repetitions on each leg for 2-3 sets.

Alternatively, you can do this same move while lying on your side.

Bridge

Hip extension mechanics play a big role in knee health. If you are hamstring dominant, this can create imbalances at the knee. The glutes should be the primary hip extensors. To assess and practice this, try a bridge. Lie on your back with the knees bent, feet flat on the floor and feet hip-width apart. Then, simply lift the butt off the ground. You should feel this primarily in your butt. If not, focus on keeping the abs tight and squeezing the butt as you lift.

Hold for 2-5 seconds with each repetition. Complete 15-20 repetitions for 2-3 sets.

Progression: Mini Squats

For this exercise, make sure to always start with a small range of motion to avoid unnecessary aggravation of knee pain. Keep the upper body in good posture and spine relatively straight. Then, with the feet about hip-width apart and toes straight forward complete a squat motion. Your weight should stay in your heels to keep your knees behind your toes. For an in-depth explanation of form, see the video below.

Repeat 10-15 times for up to 3 sets. Focus on keeping the range small and controlled, then build from there.

Progression: Single Leg Balance

Simply lift the opposite limb and keep your balance for 30 seconds or more. Keep a slight bend in the knee and focus on keeping the toes pointed forward. If the knee starts to feel unstable or tries to collapse inward, stop the exercise and try again when you’re ready. To progress, add a mini single leg squat or stand on a balance bad or soft surface.

Balance for 30-60 seconds on one leg and repeat 2-3 times.

Benefits of Stretching and Exercising

The benefits of a good exercise program are endless, especially when dealing with patellofemoral knee function. Here are just a few to keep in mind:

  • Better hip stability to promote optimal lower leg alignment

  • Improved muscle coordination between the quads, hamstrings, and hips for good knee function

  • Increased blood flow to affected areas to promote healing

  • Reduce stiffness in affected muscles to promote better movement patterns with daily activity

  • An exercise program is great paired with other home treatment options such as taping, RICE, and meds for pain relief  

  • Overall improved quality of life with less risk of injury or loss of knee function

Exercises to Avoid

While there are no specific exercises that have to be explicitly avoided, there are some general guidelines for optimizing your knee function while recovering. In fact, there is a debate among medical professionals over which exercises are best for promoting quadriceps strength and knee health. These quick tips will help prevent further injury and get you back to your activities quicker.

  • If your pain is severe, avoid weight-bearing any unnecessary activities to start

  • Do not complete any exercise that aggravates your symptoms, this will prevent continued overuse of the joint

  • High-level exercises that you can’t control, resulting in knee instability or poor alignment

  • High impact exercises, until you’re cleared by your doctor of physical therapist

When and How Often Should I Exercise

Typically, a period of rest will be required to allow proper healing of the knee before proceeding.  Otherwise, activity will just cause further pain and swelling and perpetuate the problem. Use your symptoms as a gauge for your exercise program. Here is a general sequence to follow:

  • Initiate a stretching program to address tight muscles for 1-2 weeks

  • When tolerated, add basic leg strengthening exercises that you can tolerate at least 3 times per week (typically more if you are in physical therapy)

  • Usually after 2-6 weeks, you are ready to progress your program to functional weight-bearing moves, such as squatting and single-leg balance

  • When your knee function has been regained and you are happy with your progress, you can decrease your program frequency to 1-3 times per week for maintenance

  • Continue some form of a leg strengthening program for your health 1-2 times per week indefinitely

Long-Term Maintenance

Having a long term home program for the legs is important for your overall health. Having a consistent lower leg strengthening program has so many great benefits. It will continue to provide balance to the joints of the lower body while optimizing coordination, strength and flexibility for living the quality of life you deserve.

Practicing Chondromalacia Exercises Safely

With an understanding of how to rehabilitate your knee from chondromalacia patella, you should feel in control of the healing process. The biggest rule is paying attention to your form and symptoms. If you feel unsure of how to begin or progress, seek medical advice from your doctor or physical therapist as needed. Ultimately, with a good exercise program you can feel confident in your road to recovery.

Sources:

https://www.physio-pedia.com/Chondromalacia_Patellae

https://pubmed.ncbi.nlm.nih.gov/17615174/

SHOP Chondromalacia Pain

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Jaydee Vykoukal, PT, DPT
Jaydee Vykoukal, PT, DPT

JayDee Vykoukal is a Doctor of Physical Therapy, owner of the healthy habit platform Health Means Wealth, and freelance medical writer. She loves traveling and spending time with her family in nature. Her passion is helping others continue to participate in the activities they love through education and proper exercise.



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