Chondromalacia patella is caused by an abnormal breakdown of the cartilage that lines the underside of the kneecap. The kneecap bone is known as the patella and therefore the name chondromalacacia. Chondro means cartilage and malacia means softening. In this condition the cartilage under the knee fissures and basically breaks down. It leads to a grinding sensation and pain in your knee. It may also be known as runner’s knee.
This condition is common in adolescents and young adults. It can also occur in older adults who have arthritis of the knee.
This condition can be caused by:
- overuse of the knee joint, such as during certain types of exercise
- misaligned bones in the knee and foot
- a knee injury, such as a broken or dislocated kneecap
- other knee trauma
The risk of this condition is higher for:
- those with previous knee injuries
- participants in sports and other activities that stress the knee, particularly sports which involve jumping.
Chondromalacia patella can cause mild or moderate symptoms. These vary from person to person. Common symptoms include:
- pain in the back of the knee
- grinding sensation when you extend your knee
- knee tenderness
- swelling of the knee
Knee pain may worsen when you:
- walk up or down stairs
- rise from a seated position
See a doctor if you have knee pain that does not improve within a few days.
To determine the cause of knee pain, your doctor will perform a physical examination. Your knee will be examined for signs of tenderness and swelling. Your doctor will also flex or extend your leg and ask if you feel pain or grinding below the kneecap. The patella may be noticed to move to the side with knee movements.
A physical exam is usually enough to diagnosis this condition. However, your doctor may want to confirm the diagnosis with:
- X-rays—although they are not ideal. X-rays do not give good images of the soft tissue behind the knee.
- CT scan—a three-dimensional X-ray that produces better images of soft tissue
- MRI—a three-dimensional imaging tool that may be safer than an X-ray or CT scan
- Arthroscopy a procedure in which your doctor uses an instrument to look inside the joint. This can also sometimes be helpful in treating the condition.
Often, it is simple to treat chondromalacia patella pain. You may just need to:
- rest your knee and avoid activities that cause further pain
- take over-the-counter pain medications
- tape your knee with a bandage before exercising
- try wearing a supportive brace
- use an ice compress on your knee after exercise
- modify your exercise routine to select exercises that do not stress your knees
Exercises that can stress the knee include jumping rope and running. Replace these workouts with:
- light bicycling
Your doctor may recommend physical therapy to treat this type of knee pain. You will learn specific techniques to strengthen the muscles around the knee. Strong muscles help keep your kneecap aligned. This can reduce pain.
Some people need surgery to resolve their pain. It is generally only used when other options have not been successful. The most common surgery is arthroscopy. This is used to remove pieces of damaged cartilage. In more extreme cases, you might also need surgery to realign your kneecap.
This condition usually improves with:
- pain medication
- lifestyle changes
- physical therapy
- Physical therapy and exercises to strengthen the quadriceps muscle
- Surgery may be indicated if it is found that one of the supporting ligaments(the lateral retinaculum) is tight or if other abnormalities are causing the problem.
If surgery becomes necessary, the outlook is good. Most people experience relief from symptoms and can resume normal activities pain-free. However, surgical complications may include:
- inability to relieve knee pain
- increased knee pain
If you have this type of knee pain, it is important to treat it. If you do not, your pain may get worse. This can make it difficult to perform routine activities, such as:
- climbing stairs
- getting out of bed
- rising from a chair
Chondromalacia patella may be preventable. You should always warm up before participating in physical activities. Warm-ups include light activity or stretches to prepare your muscles and joints.
If you are participating in strenuous knee workouts such as jumping or running, wear a protective brace or tape your knee. Shoes with good shock absorption will also help protect your knees.
Finally, excess body weight may stress your knees. This can trigger chondromalacia patella. It could help to take steps to maintain a healthy body weight. You should:
- exercise at least 30 minutes three times a week
- reduce your sugar and fat intake
- eat plenty of vegetables, fruits, and whole grains