MARCH RETURN PATIENT Flashcards
WHAT IS CHONDROMALACIA PATELLA?
Softening and breakdown of the cartilage on the underside of the patella
WHAT ARE THE CAUSES OF CHONDROMALACIA PATELLA?
- When the cartilage of the knee breaks down causing the bones to rub together leading to pain and infalmmation of the knee
- Overuse and repetitive stress
- Patella maltracking
- Weak quads and tight hamstrings/ITB
- Direct trauma or injury
- Flat-feet or knock knees (valgus)
- Arthritis and degeneration
WHAT IS CHONDROMALACIA PATELLA ALSO CALLED?
Runners knee
SIGNS AND SYMPTOMS OF CHONDROMALACIA PATELLA
- Patellofemoral pain (aching behind the kneecap)
- +ve clarks
- Grinding, popping or clicking sensation
- Swelling and inflammation around the knee
- Pain after prolonged sitting with knees bent
- Instability or giving way
WHAT ARE THE 4 STAGES OF CHONDROMALACIA PATELLA?
- Softening of the cartilage (mild)
- Cartilage begins to breakdown (moderate)
- Deep ache in the cartilage (severe)
- Complete cartilage loss, exposing bone (advanced)
WHAT IS THE TREATMENT FOR CHONDROMALACIA PATELLA?
- Rest and activity modification
- Use low impact activity like cycling or swimming
- RICE
- PT and strengthening (quad strengthening; hamstring, ITB and hip flexor stretching)
- NSAIDs
- Orthotics
WHAT IS THE PREVENTION METHODS FOR CHONDROMALACIA PATELLA?
- Strengthen quads, hamstrings, and glutes
- Stretch ITB, hamstrings, hip flexors
- Avoid deep squats, lunges and high-impact sports
- Wear appropriate shoes and/or orthotics
WHAT IS THE PROGNOSIS FOR CHONDROMALACIA PATELLA?
Mild to moderate chondromalacia patella prognosis is very good
WHAT IS THE AIM OF REHAB FOR CHONDROMALACIA PATELLA?
- Decrease pain
- Increase patella tracking
- Strengthen supporting muscles
WHAT IS PHASE 1 REHAB FOR CHONDROMALACIA PATELLA?
Decrease pain and activate muscles
* Quad isometric hold
* Straight leg raise
* Clamshells
WHAT IS PHASE 2 REHAB FOR CHONDROMALACIA PATELLA?
Increase quad, glute and hip strength
* 1/4 wall sit
* Step ups
* Side lying leg raise
WHAT IS THE MAIN QUADRICEP MUSCLE THAT IS OFTEN AFFECTED WITH CHONDROMALACIA PATELLA?
Vastus medialis
RECTUS FEMORIS ATTACHMENTS
ORIGIN: ASIS, superior rim of the acetabulum
INSERTION: Tibial tuberosity via the patella ligament
RECTUS FEMORIS NERVE SUPPLY
Femoral nerve (L2-4)
VASTUS LATERALIS ATTACHMENTS
ORIGIN: Greater trochanter and lateral lip of the linea aspera
INSERTION: Tibial tuberosity via the patella ligament
VASTUS LATERALIS NERVE SUPPLY
Femoral nerve (L2-4)
VASTUS INTERMEDIALIS ATTACHMENTS
ORIGIN: Anterior and lateral shaft of the femur
INSERTION: Tibial tuberosity via the patella ligament
VASTUS INTERMEDIALIS NERVE SUPPLY
Femoral nerve (L2-4)
VASTUS MEDIALIS ATTACHMENTS
ORIGIN: Intertrochanteric line and medial lip of the linea aspera
INSERTION: Tibial tuberosity via the patella ligament
VASTUS MEDIALIS NERVE SUPPLY
Femoral nerve (L2-4)
BICEPS FEMORIS ATTACHMENTS
ORIGIN:
LONG HEAD: Ischial tuberosity
SHORT HEAD: Linea aspera and lateral supracondylar line of femur
INSERTION: Fibula head
BICEPS FEMORIS NERVE SUPPLY
LONG HEAD: Tibial division of the sciatic nerve (L5-S2)
SHORT HEAD: Common perineal division of the sciatic nerve (L5-S2)
SEMIMEMBRANOSIS ATTACHMENTS
ORIGIN: Ischial tuberosity
INSERTION: Posterior surface of the medial tibial condyle
SEMIMAMBRANOSUS NERVE SUPPLY
Tibial division of the sciatic nerve (L5-S2)
