Chiropractor Chandler AZ

Carson Robertson
Google Plus

Chondromalacia Patella Treatment with Cold Laser

Chondromalacia patella is a common condition affecting runners or jumpers. The patella is a small bone that transmits forces from the quadriceps to the tibia. Running and jumping places tremendous amounts of stress on the patella tendon, which transmits that force through the patella bone. During a normal jumping motion, the knee bends and straightens during the explosion stage, and the legs absorb the forces as the body lands. Much of the force travels through the patella tendon and patella.

knee model lateral view labeled

Under normal circumstances, the patella bone slides comfortably in a groove on the femur. However, running and jumping can cause injury to the quadriceps muscle which results in the medial (inside) of the quadriceps weakening, causing the lateral (outside) muscles to spasm. This causes the patella to shift towards the outside of the knee. The groove was not designed for this type of movement, and there is increased rubbing and grinding of the patella surface on the femur.

Thankfully, the patella bone and the femur both have cartilage on the joint surfaces, which normally reduces friction and irritation during knee flexion and extension. However, as the patella surface shifts to the side and friction is increased, the cartilage becomes irritated and injured. Injury to the patella cartilage is called chondromalacia patella.

Chondromalacia patella is commonly treated with physical therapy modalities including heat, ice, electric, ultrasound, stretching, and exercise. As mentioned before, the inside part of the quadriceps becomes weak and the outside becomes spasmodic. Strengthening focuses on increasing the inside aspect of the quadriceps muscle, or vastus medialis. Stretching and lengthening emphasis is placed on the outside the quadriceps, or vastus lateralis. Running gait mechanics may be addressed if a poor gait is causing unnecessary stress on the knee and contributing to the chondromalacia patella. Proprioceptive or balance exercises are also commonly incorporated into a treatment plan.

Cold Laser Therapy Treatments

1. ACCELERATED TISSUE REPAIR AND CELL GROWTH

Photons of light from lasers penetrate into tissue and accelerate cellular growth and reproduction. Laser therapy increases the energy available to the cell so it can work faster, better, and quickly get rid of waste products. When cells of tendons, ligaments, and muscles are exposed to laser light they repair and heal faster.

2. FASTER WOUND HEALING

Laser light increases collagen production by stimulating fibroblasts. Collagen is the building block of tissue repair and healing. Laser therapy increases fibroblast activity and therefore collagen production to speed healing.

reduced fibrous tissue formation
3. REDUCED FIBROUS TISSUE FORMATION

Low level laser therapy decreases scar tissue formation. Scar tissue can be a source of chronic pain and poor healing. By eliminating excessive scar tissue and encouraging proper collagen production, painful scars and chronic pain is reduced.

4. ANTI-INFLAMMATION

Laser therapy causes vasodilatation (increases size of capillaries) which increases blood flow. The treatments also increases lymphatic drainage to decrease swelling or edema. Therefore, laser therapy reduces swelling caused by bruising or inflammation while speeding the recovery process.

5. PAIN RELIEF

Cold laser therapy decreases pain by blocking pain signals to the brain. Some nerve cells sense pain and send signals to the brain. Chronic pain can be caused by overly active pain nerves. Specific wavelengths help "shut off" the pain signals, thereby; eliminating your pain.

Low level lasers are excellent at decreasing inflammation, which also increases pain nerve activity. Cold laser therapy also increases endorphins and enkephalins, which block pain signals and decrease pain sensation. Overall laser therapy reduces painful nerve signals and reducing your perceived pain.

6. INCREASED BLOOD FLOW

Blood carries nutrients and building blocks to the tissue, and carries waste products away. Increased blood flow to tissues increases and enhances cellular healing. Cold laser therapy increases the formation of capillaries in damaged tissue. Specific laser frequency also increases blood flow to the area treated, to enhance injury repair.

7. INCREASED REPAIR AND REGENERATION

Low level lasers increases enzyme activity to improve metabolic activity that affects cell repair and regeneration. The enzymes are turned on "high" to speed the healing.

8. NERVE FUNCTION AND REPAIR

Nerves heal very slowly. Lasers speed up this process. Damage to nerves causes numbness, pain, muscle weakness, and altered sensations. Laser therapy treatments enhance nerve function, healing, and reduce pain.

9. INCREASED ENERGY PRODUCTION - ATP

ATP is like gasoline for cells, it is the energy source that cells operate. Injured cells often have low levels of ATP, which decreases their ability to heal and repair. By increasing ATP and "gasoline storage levels," cells have more ATP for healing and repair. Increased mitochondrial production is very important with nerve pain.

10. ACUPRESSURE AND TRIGGER POINTS

Low level laser therapy decreases trigger points and stimulates acupuncture points to decrease muscle and joint pain.

We combine low level laser therapy with a variety of techniques and treatments. Cold laser therapy can be used alone as a single treatment modality, or in conjunction with other Chiropractic, Physical Therapy, massage therapy, or medical treatments.

GT therapy
Conservative Treatments

Therapeutic treatments for addressing soft tissue injuries involve massage therapy, manual therapy, trigger point therapy, Graston Technique, or Active Release Technique. These treatments increase blood flow, decrease muscle spasms, enhance flexibility, speed healing, and promote proper tissue repair.

When these treatments are incorporated into a treatment plan patients heal faster and are less likely to have long-term pain or soft tissue fibrosis or scar tissue in the injured muscle. These soft tissue treatments are incorporated with therapeutic exercise and flexibility programs.

Medical Treatments

NSAIDs are often prescribed for the initial acute injury stages. In severe cases that involve multiple joint regions, muscle relaxers or oral steroids can be given. Trigger point injections, botox, or steroid injections can be treatment options. Pain management is not usually required unless stronger medications or joint injections are required for treatment.

MRI and X-rays will not usually be ordered to evaluate mild to moderate muscle, tendon, and ligament injuries. Severe cases may utilize advanced imaging to rule out bone fractures, edema, nerve entrapments, tendon or muscle ruptures. NCV testing may be utilized in cases that also involve muscle, sensory, or reflex loss.

Sciatica is the term for radiating pain down the leg. Most commonly it comes from the back and radiates down the leg. Several back injuries and nerve entrapment injuries can cause sciatic pain in the leg. The pain patterns from a lumbar disc, lumbar joint sprain, sacroiliac sprain, or piriformis syndrome produces different patterns of radiating pain than trigger points. Proper identification of the pain pattern, along with reproduction of pain from palpation of trigger points allows the provider and patient to feel comfortable with the diagnosis.

knee model patella labeled

Many leg injuries are associated with radiating pain. The two legs function as a system for movement. Injuries in one area area of the system are commonly associated with poor joint stabilization in the foot, knee, or hip. This leads to poor alignment and excessive forces being placed onto muscles and tendons. Knee injuries and IT band syndrome is common in runners because of weakness and poor stabilization of the leg and hip muscles. These runners have a combination of muscle weakness, poor coordination, and altered gait mechanics. Leg sprains and strains usually cause injuries in multiple areas in the leg, one spot usually just hurts more than the others.

Your chiropractor, physical therapist, occupational therapist, or physician will evaluate your condition and make a proper diagnosis and treatment recommendations. Ask them any questions you might have about your injury.

In Conclusion

The lower extremity works as a comprehensive unit performing many of the repetitive tasks at home, work, and recreational sports. Injuries to one area of the musculature often indicate that additional damage has been incurred by other muscles.

wobble board squatting two feet

Many therapeutic exercises can help restore proper strength and endurance to the leg muscles muscles. Isometric exercises are often the initial treatment exercises. Followed by single plane rubber band exercises for hip, knee, and ankle; flexion, extension, adduction, abduction, circumduction, inversion, and eversion. Dynamic exercises involving stability foam, rubber discs, exercise ball, and BOSU balls can be performed on the floor. The more unstable of the surface the more effort and stabilization is required of all the lower extremity muscles.

Vibration plates enhance neuromuscular learning throughout the ankle, knee, foot, hip, and back muscles. Additional strength exercises can be found on the hip, knee, and foot strengthening pages. More information for injuries and treatments for knee pain and foot pain.

Our Chandler, AZ Chiropractic & Physical Therapy clinic treats patients with a variety of muscle, tendon, joint, and ligament injuries. The clinic provides treatment for runners, tri-athletes, and weekend warriors in addition to common headache, neck, and back patients traditionally seen in Chiropractic, Physical Therapy, Massage Therapy clinics. We work with all ages and abilities of the residents in Phoenix, Tempe, Gilbert, Mesa, and Chandler AZ.