Chondromalacia is a condition that affects the cartilage under the kneecap, also known as the patella. This cartilage is a smooth, protective layer that allows the kneecap to glide easily over the bones in the knee joint when you bend or straighten your leg. In chondromalacia, this cartilage softens, weakens, and can become damaged, which disrupts the smooth movement of the kneecap and causes pain.
The knee joint is made up of the femur (thigh bone), tibia (shin bone), and the patella (kneecap). The underside of the patella is covered with cartilage that acts like a cushion and a smooth surface for movement. When this cartilage deteriorates, it can no longer protect the bones from rubbing against each other, leading to discomfort and inflammation.
Chondromalacia most commonly occurs in young athletes who put repetitive stress on their knees, such as runners, cyclists, or those involved in jumping sports. It is also seen in older adults, especially those with arthritis, and tends to affect women more often than men. The exact cause of the cartilage damage is not always clear, but it is often linked to improper alignment of the kneecap or muscle imbalances around the knee. When the muscles that support the kneecap are tight or weak, the patella may not track correctly over the femur, causing uneven pressure and wear on the cartilage.
Injuries like fractures or dislocations of the kneecap can also lead to chondromalacia. Over time, normal aging can contribute to the breakdown of cartilage as well.
The main symptom of chondromalacia is pain around or behind the kneecap. This pain often worsens with activities that put pressure on the knee, such as climbing stairs, squatting, kneeling, or sitting for long periods with bent knees. People may also notice a grinding or cracking sensation when moving the knee, sometimes described as a feeling or sound of roughness under the kneecap. In some cases, swelling or fluid buildup in the knee joint can occur, but this is less common.
Because the cartilage is damaged and no longer smooth, the kneecap does not glide properly, which can cause irritation and inflammation in the joint. This leads to the characteristic pain and discomfort associated with chondromalacia.
Treatment for chondromalacia focuses on reducing pain, improving knee function, and preventing further cartilage damage. Rest and avoiding activities that worsen the pain are important first steps. Physical therapy plays a key role by strengthening the muscles around the knee, especially the quadriceps, to help stabilize the kneecap and improve its alignment. Stretching tight muscles and correcting any biomechanical issues can also relieve pressure on the cartilage.
Weight management is another important factor because excess body weight increases the load on the knee joint, accelerating cartilage wear. Using supportive aids like knee braces or taping techniques can help reduce pain and improve patella tracking during movement.
In some cases, if conservative treatments do not relieve symptoms, medical interventions such as injections or surgery may be considered. Surgery might involve smoothing the damaged cartilage or realigning the kneecap to reduce pressure on the affected area.
Living with chondromalacia means being mindful of knee health by avoiding repetitive stress and maintaining strong, balanced muscles around the joint. With proper care and management, many people can reduce their pain and maintain an active lifestyle despite this condition.