Chondromalacia Patella

Chondromalacia Patella

John Miller Physiotherapist

Article by John Miller

What is Chondromalacia Patella?

Chondromalacia patella is a condition that causes anterior knee pain, commonly affecting young, otherwise healthy athletes. Chondromalacia patella occurs when the undersurface of the kneecap becomes irritated, leading to cartilage softening. The kneecap, or patella, is usually covered with smooth cartilage, allowing it to glide smoothly during joint movement. However, the kneecap may rub against one side of the knee joint in individuals with malalignment issues, causing irritation and knee pain.

When knee pain occurs without cartilage softening, medical professionals refer to it as patellofemoral pain syndrome.

What are the High-Risk Sports?

High-risk sports include football, cycling, rowing, tennis, ballet, equestrian, gymnastics, volleyball, weightlifting, skiing, snowboarding, and running. These sports involve running, jumping, squatting, and landing, which increases the likelihood of experiencing kneecap pain. Additionally, even non-sporting individuals may experience kneecap pain when climbing up or down stairs.

The condition typically arises from either an acute injury to the patella joint surface or chronic friction between the patella and the groove in the femur (thigh bone), occurring during knee bending. Potential causes of this condition include tight lateral knee structures like the ITB, weak medial quadriceps (specifically the vastus medialis oblique – VMO), overpronation of the feet, and weak lateral hip rotator muscles. These muscle imbalances result in rotational instability, causing the patella to align laterally in the femoral groove and leading to pain due to malalignment.

The good news is that physiotherapy assessment and intervention can effectively address patellar maltracking. Many patients experience relief from pain after just one treatment session, and they can often leave the clinic pain-free. Please consult with a physiotherapist for proper guidance and advice.

Chondromalacia Patella Treatment

Physiotherapy intervention has been confirmed by researchers as a highly effective solution, both in the short and long term, for treating kneecap pain associated with chondromalacia patella.

Exercise-based treatments have shown favourable results in over 90% of individuals suffering from patellofemoral syndrome. It is common for patients to experience significant pain relief and become pain-free within six weeks of starting a rehabilitation program guided by a physiotherapist.

In cases where conservative treatment does not respond, an orthopaedic surgeon may consider surgery to repair severely damaged or arthritic joint surfaces.

The primary goal of treatment is to reduce pain and inflammation in the short term and, more importantly, to address the condition’s underlying cause to prevent its recurrence in the long term.

The progression from one stage of treatment to the next depends on individual factors. Your physiotherapist will determine progress during the clinical assessment. It is essential to carefully monitor exercise progression, as advancing too soon to the next level can lead to reinjury and delay recovery.

The treatment process involves several phases:

Phase 1 – Injury Protection:

This phase focuses on pain relief and includes rest, ice application, and protective measures such as kinesiology supportive taping. During this phase, physiotherapists may use pain-relieving techniques, joint mobilisations, massage, strapping, and acupuncture.

Phase 2: Regaining Full Range of Passive Motion:

Range of motion exercises and techniques are employed to restore normal kneecap and knee joint movement.

Phase 3: Restoring Full Muscle Length:

Stretching exercises and foam rollers will address tight thigh, hamstring, and calf muscles that may be causing tension or pressure on the kneecap.

Phase 4: Normalising Quadriceps Muscle Balance:

The physiotherapist assesses and addresses any muscle imbalances in the quadriceps, usually through a specific knee strengthening program.

Phase 5: Hip and Foot Control

During the treatment process, the physiotherapist assesses foot and hip control to normalise foot and hip biomechanics. They may recommend interventions such as foot orthotics or hip stabilisation programs to improve biomechanics.

Phase 6: Normalising Movement Patterns:

Correcting poor movement habits, such as abnormal gait, jumping, landing, running, or squatting techniques, is essential to prevent a recurrence of kneecap pain.

Phase 7: Restoring High Speed, Power, Proprioception, and Agility:

Balance, proprioception, and sport-specific training are incorporated to prepare individuals for a safe return to high-intensity activities.

Phase 8: Return to Sport:

Sport-specific exercises and a progressed training regime to facilitate a safe and complete return to the chosen sport.

Sometimes, a patellofemoral brace may help as an alternative to taping for managing chondromalacia patella.


In conclusion, chondromalacia patella can cause knee pain, especially in high-risk sports. However, physiotherapy intervention offers effective treatment options.

Exercise-based treatments deliver positive outcomes for over 90% of individuals, while doctors consider surgery for severe cases. Consulting a physiotherapist is vital in addressing the chondromalacia patella and achieving a successful recovery.

Related Articles

  1. Effective Management Of Fat Pad Syndrome: Offers insights into knee conditions like Chondromalacia Patella and treatment options​​.
  2. Patella Enthesopathy: Discusses treatments for knee pain arising from various conditions, including Chondromalacia Patella​​.
  3. Knee Bursitis: Explains conditions leading to knee pain, including Chondromalacia Patella, and treatment methods​​.
  4. Patellar Tendinopathy: Provides information on conditions causing kneecap pain, relevant for those with Chondromalacia Patella​​.
  5. Patellofemoral Pain Syndrome (PFPS): Offers a comprehensive overview of kneecap pain, including conditions like Chondromalacia Patella​​.

John Miller Physiotherapist

Article by John Miller

Knee Pain Causes

Knee Pain Causes: An In-Depth Guide from a Physiotherapist's Perspective

Knee pain is a common complaint that can significantly impact your daily life. Understanding the causes of knee pain is crucial for effective treatment and prevention. This guide explores various knee pain causes and provides insights from a physiotherapist's perspective.

Common Knee Pain Causes and Treatment
Knee Pain Causes

Common Causes of Knee Pain

Knee pain can stem from a variety of sources, ranging from acute injuries to chronic conditions. Let's explore some common causes:

Ligament Injuries

Ligament injuries are a significant cause of knee pain. These injuries often occur during sports or high-impact activities.

  • ACL Injury: The Anterior Cruciate Ligament (ACL) is crucial for knee stability. ACL injuries can result from sudden stops or changes in direction. Symptoms include pain, swelling, and instability. Treatment often involves surgery and rehabilitation.
  • PCL Injury: The Posterior Cruciate Ligament (PCL) can be injured in direct trauma to the knee. This injury also leads to pain and swelling, with treatment options ranging from physical therapy to surgery.
  • MCL and LCL Sprains: Medial Collateral Ligament (MCL) and Lateral Collateral Ligament (LCL) sprains result from direct blows to the knee. These injuries cause pain and instability, often requiring rest, bracing, and physiotherapy.

Meniscus Injuries

Meniscus tears are another common knee injury. The meniscus is a cartilage that cushions the knee joint.

  • Meniscus Tear: This injury often occurs from twisting or rotating the knee while bearing weight. Symptoms include pain, swelling, and difficulty moving the knee. Treatment options vary based on the tear's severity, ranging from rest and physiotherapy to surgery.
  • Discoid Meniscus: This congenital condition results in an abnormally shaped meniscus, leading to pain and instability. Treatment may involve surgery to reshape or remove the meniscus.

Kneecap Pain

Several conditions can cause pain in the kneecap area, affecting your ability to perform daily activities.

  • Chondromalacia Patella: Also known as "runner's knee," this condition involves the softening and breakdown of the cartilage on the underside of the kneecap. It causes pain and swelling, particularly when walking up stairs or sitting for long periods.
  • Patellar Tendinopathy: Also called "jumper's knee," this condition results from overuse, causing pain at the front of the knee. Treatment typically includes rest, physiotherapy, and strengthening exercises.
  • Patellofemoral Pain Syndrome: This condition involves pain around the kneecap, often resulting from overuse or misalignment. Treatment includes rest, physiotherapy to improve the patellar tracking, and proper footwear.

Knee Arthritis

Arthritis is a leading cause of knee pain, particularly in older adults. It causes inflammation and stiffness in the joints.

  • Knee Osteoarthritis: This degenerative condition involves the wearing down of cartilage, leading to pain and swelling. Treatment includes physiotherapy, medication, and sometimes surgery.
  • Rheumatoid Arthritis: This autoimmune condition causes inflammation in the knee joints. It requires medical management and physiotherapy to manage symptoms.

Knee Tendon Injuries

Tendon injuries can result from overuse or sudden, high-impact activities.

  • Patellar Tendinopathy: This injury involves the patellar tendon, causing pain below the kneecap. Treatment includes rest, physiotherapy, and strengthening exercises.
  • Quadriceps Tendinopathy: This condition affects the tendon connecting the quadriceps muscles to the knee, leading to pain above the kneecap.

Muscle Injuries

Muscle strains and related conditions are common knee pain causes, especially among athletes and active individuals.

  • Hamstring Strain: This injury involves the muscles at the back of the thigh. It causes pain, swelling, and difficulty bending the knee. Treatment includes rest, ice, and physiotherapy.
  • ITB Syndrome: The Iliotibial Band (ITB) can become tight and inflamed, leading to pain on the outer side of the knee. Stretching and physiotherapy are essential for recovery.

Knee Bursitis

Inflammation of the bursae, small fluid-filled sacs around the knee, can cause significant pain.

  • Knee bursitis: Suprapatella bursitis is a common knee bursitis.
  • Pes Anserine Bursitis: This condition involves inflammation of the bursa located on the inner side of the knee. It causes pain and swelling, with treatment focusing on reducing inflammation through rest, ice, and physiotherapy.

Children’s Knee Conditions

Young athletes can experience specific knee conditions related to growth and activity levels.

  • Osgood Schlatter’s Disease: This condition involves inflammation of the area just below the kneecap where the tendon from the kneecap attaches to the shinbone. It causes pain and swelling, especially during activities.
  • Sinding Larsen Johansson Syndrome: This condition affects the growth plate at the bottom of the kneecap, leading to pain and swelling.

Other Knee-Related Conditions

Various other conditions can lead to knee pain, necessitating a broad understanding of potential causes.

  • Runner’s Knee: This condition involves pain around the kneecap, often resulting from overuse or misalignment. Treatment includes rest, physiotherapy, and proper footwear.
  • Plica Syndrome: Inflammation of the plica, a fold in the knee lining, can cause pain and swelling. Physiotherapy and anti-inflammatory medications are common treatments.

What to Do?

If you're experiencing knee pain, seeking professional advice from a physiotherapist is essential. They can provide a personalised assessment and treatment plan to address your specific needs. Early intervention can significantly improve your outcomes and help you return to a pain-free, active lifestyle.


Understanding the causes of knee pain is the first step towards effective treatment. By addressing the root cause, you can find relief and prevent future issues. Consult a physiotherapist to develop a tailored plan for your knee health.

Knee Pain Causes FAQs

  1. What are the main causes of knee pain?
    • Common causes include ligament injuries, meniscus tears, kneecap pain, arthritis, tendon injuries, muscle strains, and bursitis.
  2. How can I tell if my knee pain is serious?
    • Serious knee pain often involves significant swelling, inability to bear weight, or visible deformity. Consult a physiotherapist or doctor if you experience these symptoms.
  3. Can knee pain be treated without surgery?
    • Yes, many knee pain causes can be treated with physiotherapy, rest, and non-surgical interventions.
  4. What is the best treatment for knee pain?
    • The best treatment depends on the cause. Physiotherapy, rest, strengthening exercises, and sometimes medication or surgery are effective options.
  5. How can I prevent knee pain?
    • Prevent knee pain by maintaining a healthy weight, staying active, wearing proper footwear, and doing strength and flexibility exercises.
  6. When should I see a physiotherapist for knee pain?
    • See a physiotherapist if your knee pain persists for more than a few days, is severe, or affects your ability to perform daily activities.

Related Articles

  1. Knee Osteoarthritis - Discover effective treatments for knee osteoarthritis.
  2. ACL Injuries - Learn about symptoms and treatment options for ACL injuries.
  3. Meniscus Tear - Understand the causes and treatments for meniscus tears.
  4. Patellar Tendinopathy - Explore treatment options for patellar tendinopathy.
  5. ITB Syndrome - Find out how to manage and treat ITB syndrome.
  6. Hamstring Strain - Tips for recovering from a hamstring strain.
  7. Runner’s Knee - Effective strategies to reduce knee stress for runners.
  8. Knee Arthroscopy - Learn about this surgical option for knee injuries.
  9. Quadriceps Tendinopathy - Understand the causes and treatments for this condition.
  10. Knee Bursitis - Discover ways to reduce inflammation and pain from knee bursitis.

These articles provide detailed information on various knee conditions and their treatments.

Knee Pain FAQs

Knee pain is a widespread issue, impacting individuals of varying ages and lifestyles. Causes range from injuries and wear and tear to conditions like arthritis. This FAQ section aims to provide insights into knee pain, covering diagnosis, ligament issues, ACL injuries, meniscal injuries, age and arthritis concerns, and pain relief methods through exercise and treatment.

Feel free to click on the questions to for deeper discussions into each topic.

knee pain faqs
Knee Pain Faqs

Diagnosis Related

How Can I Determine If My Knee Injury Is Serious?

  • Learn to assess the severity of your knee injury based on symptoms and situations.

How Can I Identify The Type Of Knee Injury I Have?

  • Discover how different knee injuries manifest and what signs to look for.

When Should I Seek a Physiotherapist or Doctor for My Knee Injury?

  • Find out the right time to consult professionals for your knee concerns.

Is Knee Clicking a Sign of a Serious Condition?

  • Understand what knee clicking indicates about your joint health.

When Should I Consider Getting a MRI for My Knee?

  • Learn about the circumstances when an MRI becomes necessary.

Why Has My Knee Suddenly Started Hurting?

  • Explore potential reasons behind sudden knee pain.

Why Does My Knee Hurt On The Inner Side?

  • Identify causes of inner knee pain and when to seek help.

Knee Ligament Related

What Are The Common Symptoms of a Torn Ligament in the Knee?

  • Recognise the signs of a torn knee ligament.

Can I Walk With A Torn Ligament In My Knee?

  • Understand the feasibility and risks of walking with a torn ligament.

ACL Related

What are the Consequences of Not Getting Surgery for an ACL Injury?

  • Learn about the long-term effects of untreated ACL injuries.

What Are The Symptoms Of An ACL Tear?

  • Identify the key signs of an ACL tear.

Meniscus Related

Is Surgery Necessary for a Meniscal Injury?

  • Discover when surgery is essential for meniscal injuries.

Can a Torn Meniscus Heal Without Surgery?

  • Find out if meniscal tears can heal naturally.

Age & Arthritis Related

At What Age Do Knee Problems Typically Begin?

  • Learn about the onset age for common knee problems.

What are the Common Symptoms of Arthritis in the Knee?

  • Identify arthritis symptoms in the knee.

Running Related

What are Some Ways that Runners Can Reduce Knee Stress?

  • Explore methods for runners to minimise knee stress.

Knee Treatment & Exercise Related

Is Walking Good For Knee Pain?

  • Understand the benefits of walking for knee pain.

What are Some Effective Ways to Relieve Knee Pain?

  • Discover various methods to alleviate knee pain.

How Much Walking is Recommended for Individuals with Knee Pain?

  • Learn the ideal walking duration for those with knee pain.

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