So far, no one has found the ideal therapy for chondropathia patellae, but conservative and surgical treatment suggestions abound. Often, the knee complaints are simply based on muscle weakness, which loosens the stability of the kneecap and causes it to begin sliding in an abnormal path, usually outward.
Therefore, all patients with complaints from the side of cartilage damage behind the kneecap should first be treated with physiotherapy.
Patients with patellar complaints can make a decisive contribution to the improvement of their symptoms through consistent physiotherapeutic exercises. As simple as some of the exercises may be, the patient must have an iron will to cooperate consistently, otherwise there will be no success. It is important to strengthen the muscles as early as possible. The simplest exercise: after 5 seconds of relaxation, lift the stretched leg 25-50 times up to 60 cm from the base and tense it for 8 seconds at the maximum. The series should be performed three times a day.
If weak muscles are the cause of patellar instability, physical therapy can make the symptoms disappear within as little as one to two months. The condition of the extensor muscles on the thigh in particular, especially the middle and inner muscle belly, plays an important role in stabilizing the patella in its normal gliding path. Strengthening the knee extensors is therefore given special emphasis in a 4-phase program. In extensive mechanical studies, the direction of pull of the individual thigh extensor muscles was precisely determined and the influence of the individual muscle pulls on the sliding path of the kneecap was investigated. If the muscle portion located toward the inner side of the thigh is too weak, it cannot perform its important function, which is to prevent the patella from shifting and tilting outward during extension.
The muscle weakness may cause occasional outward dislocation of the kneecap. Therefore, in order for the kneecap to slide normally again, it is imperative to strengthen this muscle.