Chondromalacia

As you may recall from our intro post on kinesiology taping, we’re going to focus on each muscle group/joint and show you how to use kinesiology tape in three distinct ways:

  1. Immediately after injury  (for swelling and pain

  2. During the healing process (correction techniques to restore normal position and allow for healing)

  3. Techniques to help improve strength + function

In this post we’re going to be using the tape to help restore normal position to the patellofemoral joint (aka where the knee cap meets the thigh and lower leg bones underneath). The goal of this taping applications is to facilitate the VMO to restore normal muscle balance between the quadricep muscles and to restore alignment to the patellofemoral joint itself to decrease pain and inflammation. In the case of chondromalacia, irritation develops under the knee cap. This typically happens when the knee cap is pulled out of alignment and the bottom surface then scrapes against the underlying bones. Typically, chondromalacia is caused by soft tissue restrictions and muscle imbalances, but can also be caused by irregularities in the bones themselves.

Anatomy

 

When looking at the knee and patella (knee cap in particular) it is important to remember that the tendon starts above the knee where the individual quad muscles end (there are four quad muscles). This tendon then travels from the end of the femur, over the joint line and inserts onto the tibial tubercle. The knee cap itself sits in the tendon with no direct attachment to those bones. All three bones are lined with cartilage to prevent breakdown and damage to the knee cap. On either side of the knee cap, the tendon is attached to fibrous bands called the retinaculum. These help keep the knee cap from moving too far from side to side. Together, these attachments all help the patella stay in it’s groove as the knee bends and straightens. It is also why this are is such a common spot for injury. In the presence of muscle imbalances or soft tissue restrictions, the knee cap can be pulled out of alignment and inflammation/injury can occur.

What you will need:

 

1) Roll of kinesiology tape

2) Sharpest scissors in the house.

Prep work:

 

1) Clean skin. This means no oils or lotions of any kind. You want your skin to be clean and more importantly dry. Moisture of any kind = tape will fall off or fail to stick altogether.

2) Hair care. Ideally, the less hair the better. Guys, this means that for best results you will need to trim any long leg hair or shave the calf area.

3) If clean, dry, and hairless skin still = no sticking of tape. Time to get some adhesive spray like Tuf Skin.

4) The tape should last 3-5 days. You can get it wet and shower with it on. Just towel dry it after. No hair dryer! The tape is heat activated.

Taping Techniques

1) Chondromalacia Patella (VMO facilitation + 2 correction strips)

http://youtu.be/PqaPEvlC0cE

Key Points:

  • Prep the skin first and then measure out your tape. You will need three strips: 1) the first is for the VMO muscle (the smallest, tear drop shaped muscle) which you can find by tightening up your quad and rolling your leg out to the side and 2) two strips that measure from the tibial tubercle all the way around the knee as shown in the video.

  • Apply the VMO strip first. You will need to cut two strips in this piece with 1-2" at the end to be the anchor. Apply the anchor with zero tension at the top of the muscle. Tighten the quad and roll your leg out as shown in the video and wrap the two strips around either side of the muscle with medium tension on the tape.

  • The secondary strips are applied with medium tension along the side of the knee cap itself with the knee straight. From here, you will bend up the knee so that your foot is flat on the floor (approx 90 degrees of knee flexion). Wrap the remainder of the tape around and then lay the edges down WITHOUT tension. You will do this for both sides of the knee and should have part of the knee cap visible between the two pieces.

  • See the video above for full details.

References

1) Capobianco, Dr. Steven and van den Dries, Greg. (2009). Power Taping, 2nd Edition, Rock Tape Inc, Los Gatos, CA.

2) Hammer, Warren. (2007). Functional Soft-Tissue Examination and Treatment by Manual Methods, 3rd edition. Jones and Bartlett Publishers, Inc, Sudbury, MA.

3) Kase, Kenzo, Wallis, Jim, and Kase, Tsuyoshi. (2003). Clinical Therapeutic Applications of the Kinesio Taping Method.

4) Muscolino, Joseph. (2009). The Muscle and Bone Palpation Manual. Mosby, Inc, St. Louis, MO.