The most common way to treat symptoms of chondromalacia patella is to immobilize the knee.
Bracing the patella and the knee joint helps to reduce pain and symptoms, but alters patella tracking and reduces the active function of the quadriceps. Bracing may be useful to offer patients some support and pain relief in the short term and also helps to avoid antalgic movements and normalize gait as much as possible. The brace should allow variation in a medial pull on the patellar and pressure and thus can be used for patient’s pre-and postoperatively. Patellar realignment brace can also be used.
Foot orthoses also help for pain relief, but in cases where lower limb mechanics are deemed to be contributing to the knee pain, which may be due to excessive lower limb internal rotation during weight-bearing, poor pronation control, and increased Q-angle.
Ice therapy may be used for reducing pain in an acute stage but not in long-term treatment. It is used to relieve inflammation and reduce pain. Ice massage is done by applying ice to the area of inflammation, it can be used as a cold pack for 5-7 minutes, but care should be taken to avoid frostbite.
Transcutaneous electrical nerve stimulation (TENS):
Transcutaneous electrical nerve stimulation (TENS) is an electrotherapy modality that provides pain relief by pain modulation. Transcutaneous electrical nerve stimulation closes the gate mechanism at the anterior grey horn in the spinal cord and stimulates the endogenous opioid system which prevents the release of substance p at the anterior grey horn.
Short wave diathermy (SWD):
Short wave diathermy is a deep heating modality that uses heat to provide pain relief, it improves the blood supply to the muscles and removes waste products.
Interferential current therapy (IFT):
Interferential current therapy produces a low-frequency effect on the tissue. It inhibits the transmission of pain impulses and stimulates the endogenous opioid system, increases blood supply, relieves edema, and also removes waste products.
Kinesio-Taping of the patella is done to influence its movement to provide some short-term relief.
Exercises like gentle Isometric quadriceps exercise, relaxed passive or active knee swinging to maintain a full range of motion, single-leg raise, strong hip ankle-foot movements.
Strengthening and stretching exercises such as hamstring stretching exercise, hip strength, and stability training, hip abductor strengthening exercise program, stretching exercise for rectus femori, gastrocnemius, and tensor fascia lata, strengthening exercise of vastus medialis oblique muscle.
The foam roller is used to relieve tight musculature and reduce pressure over the patella such as foam roller exercise for hamstring muscle, gastrocnemius muscle, iliotibial band, and tensor fascia lata.