Development of Chondromalacia Patellae (CP) in Martial Arts Athletes

Abstract

Attention to the development of Chondromalacia Patellae (CP) in endurance and aerobic athletes has developed, yet its progression in martial arts and anaerobic activities remains overlooked3. Chondromalacia Patellae characterized by the degeneration of cartilage behind the patella through excessive wear on the patellofemoral joint. This wear is a result of imbalanced and improper mechanics of the knee, hip, and foot in the greater kinetic chain4,5. Although cases of CP progression are well documented, its progression in non-aerobic athletes has not been granted the same attention3. Indiscriminate cartilaginous degeneration in aerobic and non-aerobic athletes ensues from universal mechanics of the musculoskeletal system4. Likened to how aerobic athletes are affected, repetitive stresses exerted on the body in martial arts can ultimately result in CP if an athlete’s body is compromised by vulnerable mechanics of the kinetic chain3.  Chondromalacia Patellae is insidious as it develops in subtle misalignments of obscured joint structures2; although martial artists and runners are exposed to different stresses and actions, they share the same kinetic relationships intrinsically governed by the musculoskeletal system. Functional, therapeutic, and morphological studies conclude CP is a chronic structural affliction. Imbalances of muscular strength, ligamentous integrity, and bone morphology each contribute to excessive pressure which causes cartilage wear and chronic knee pain associated with CP5. Its severity can be mitigated, or its progression reversed through correcting improper mechanics. Surrounding musculature can be strengthened to manage structural or functional imbalances through isotonic resistance training, isometric exercises, and isokinetic rehabilitation1,2,5. In addition to functionally balancing the patellofemoral joint, stabilization of the knee and the kinetic chain can be achieved with patellar tracking sleeves, orthotics, or a variety of surgical modalities5. Further study needs to be directed towards diversifying current understandings of CP beyond aerobic athletics, and martial arts provides a frontier where this can be achieved.

Department: Allied Health and Human Performance

Faculty Mentor: Dr. Dave Kato