Chondromalacia Patella
What is chondromalacia patella? It literally means the cartilage (chondro) malacia (bad or soft) patella (kneecap).
The kneecap (patella) has a ridge under it that rides up and down in a groove of the leg bones. If for any reason the ridge runs up and down the side of that groove, it will slowly grind away the cartilage, causing pain whenever the kneecap “rubs you the wrong way”.
There are a number of ways to treat the issue. The easiest way is to buy a CHO PAT strap, something that controls the motion of the kneecap, so that it doesn’t slide up and down. Symptom relieved!
The cause, however, is the real issue. The patella is essentially a part of the quadriceps muscle, which has four muscle heads. Two of the muscles are straight up and down, and two of them pull obliquely, pulling the kneecap out of alignment and causing the condition. More than 90 percent of the patients I have seen exhibit a weakness of the quadriceps muscle on the inside of their knee. This muscle, called the vastus medialis, is responsible for the last 15 degrees of extension of the leg. This means that to work it out, and make it stronger, only the last 15 degrees should be worked. The easiest way to do this?
Get on the leg extension machine and lift less weight, only lifting the last little bit. Build the muscle, change the direction of the patella, and get rid of your problem! Woo Hoo!
Shoe Selection
Okay, I have this conversation about shoes probably once a week: how to choose running shoes. I have a four part method to choose running shoes. First, you have to understand that the primary goal of both running shoes and orthotics is to supply support to the (hold on to your butt) talocalcaneonavicular joint. It’s called the “subtalar joint” to those in the know.
The subtalar joint is a torque converter, converting pronation to internal rotation of the leg, and supination to external rotation. Blah blah blah, right? What it really means is that the subtalar joint controls the rigidity of the foot. That means that the amount of force a runner can exert to the ground. (faster)
The subtalar joint is located in the middle of the foot, so this is an area of the shoe that needs to be supported. The only problem is that modern running shoes often feature a cutout in this area, weakening it. Sooooo. Now you have the reasons, let’s get down to how to choose choose, I mean SHOES.
FIRST, look at how the shoe is constructed, or the “last” of the shoe. There are really two major ways to make a shoe… one is to make a moccasin that fits the foot, and then glue it to the last, or the shoe can be made like a tent, and stitched around the outside.
On some support shoes, there will be a piece of cardboard that runs about halfway along the shoe. It helps with the shoes’ resistance to twisting… nice, if you weigh 200 pounds or more.
The next “step” is to take the shoe and bend it from the front to the back. If it bends in the middle at all, PUT IT BACK ON THE SHELF. Shoes should only bend in the forefoot.
Then, twist the shoe. If it twists in the middle of the shoe, then PUT IT BACK ON THE SHELF.
Lastly, squeeze the heel. It should be firm. If it’s too flexible, it won’t do you any good, so PUT IT BACK ON THE SHELF. If after all of these tests the shoe still looks good, by all means buy it… you’ve found a good one!!