Chondromalacia Patellae Symptoms and Treatment

Knee Pain Associated With Overuse in Young Athletes

Chondromalacia patellae is a term used to describe the damage or softening of the cartilage on the underside of the kneecap. It is similar to patellofemoral pain syndrome (runner's knee) in which the pain is felt under and around the kneecap.

This condition is common among young athletics but may also occur in older adults who have arthritis of the knee.

Men playing soccer
Hans Neleman / Photodisc / Getty Images 


Chondromalacia patellae is caused by an irritation of the underside of the kneecap. It may be the result of the simple wear-and-tear on the knee joint as we age. In younger people, it is more often due to an acute injury such as a fall or a long-term overuse injury related to sports.

Chondromalacia is often related to improper knee alignment. There can be many reasons for this:

  • A congenital misalignment of the knee
  • Flat feet (pes planus)
  • Repeated stress to the knee joint due to running or jumping
  • Weak quadriceps and hamstrings on the front and back of the thigh
  • An imbalance of the adductor and abductor muscles on each side of the thigh

Among adolescents, chondromalacia can be caused by the uneven development of bone and muscles during growth spurts. This can cause a transient misalignment that will later correct itself.


The underside of the kneecap and the top of the thigh bone are both covered with a smooth (articular) cartilage that allows the two bones to slide easily over the other. If the cartilage is damaged, the surface of the joint can become rough and easily irritated whenever the knee is flexed or extended. Depending on the extent of the damage, the pain can be anywhere from minor to severe.

The most common symptom of chondromalacia patellae is a dull pain under or around the kneecap that increases when walking down the stairs. There may also be pain when climbing stairs or rising out of a chair.

A person with chondromalacia will often describe the sensation of grinding or cracking whenever the knee is moved. The pain will often be worse after sitting or standing in place for a long period of time or during activities that place extreme pressure on the knees, including exercise. Swelling and inflammation of the kneecap are also common.

Diagnosis and Treatment

Chondromalacia patellae is diagnosed with a combination of a physical exam and imaging tests such as an X-ray or magnetic resonance imaging (MRI) scan. The X-ray can typically reveal bone damage and arthritis, while an MRI is good at spotting deterioration of the articular cartilage.

Based on the severity of the condition, the doctor may prescribe rest, ice application, restriction of movement, and a nonsteroidal pain reliever as first-line treatment. In some cases, an orthopedic knee brace may be needed to keep the knee in a fixed position.

If these conservative measures do not provide relief, arthroscopic surgery may be recommended. For this procedure, the surgeon would use specialized debriding tools to smooth the surface of the articular cartilage and clean out any fragments that may be causing the joint to catch during movement.

In both cases, physical therapy would be recommended to strengthen the quadriceps and surrounding muscles so that the knee is better protected from further injury. This usually involves low-impact exercises such as swimming or a stationary bicycle. Isometric exercises, which involve the controlled flexing and releasing of specific muscles, may also be used to build muscle mass.

Frequently Asked Questions

  • Can chondromalacia patella be treated?

    Yes, chondromalacia patella is typically treated with rest, ice, and non-steroidal pain relievers. You may also need an orthopedic knee brace for a while, which will keep the joint still to help it heal. 

    If this doesn't relieve the pain, your doctor may recommend arthroscopic surgery to smooth the cartilage and remove debris causing the knee joint to catch.

  • How long does it take for chondromalacia patella to heal?

    Knee pain from chondromalacia patella can take anywhere from a month to years to fully heal. Children often outgrow chondromalacia patella in the teen years when the bones are finished growing.

  • Is walking good for chondromalacia patella?

    It depends. Walking is a low-impact exercise that is easier on your joints than running or other types of exercise that stress the knee. However, you should take it easy to start and stop if you experience any pain. Stick to flat walking paths or roadways, and avoid hills or rough terrain.

6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Habusta SF, Griffin EE. Chondromalacia Patella. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-.

  2. Caplan N, Kader DF. The Etiology of Chondromalacia PatellaeClassic Papers in Orthopaedics. July 2013:185-187. doi:10.1007/978-1-4471-5451-8_45.

  3. McCarthy MM, Strickland SM. Patellofemoral pain: an update on diagnostic and treatment optionsCurr Rev Musculoskelet Med. 2013;6(2):188–194. doi:10.1007/s12178-013-9159-x

  4. Vijayalakshmi A, Sangeetha S, Ranjith N. Chondromalacia Patellae: A ReviewResearch Journal of Pharmacy and Technology. 2019;12(1):412. doi:10.5958/0974-360x.2019.00075.1

  5. Cleveland Clinic. Knee pain (chondromalacia patella).

  6. American Academy of Orthopedic Surgeons. OrthoInfo. Patellofemoral pain syndrome.

Additional Reading
  • Kusnezov, N.; Watts, N.; Belmont, P. et al. "Incidence and Risk Factors for Chronic Anterior Knee Pain." J Knee Surg 2016; 29(03):248-53. DOI: 10.1055/s-0035-1554921.

By Elizabeth Quinn
Elizabeth Quinn is an exercise physiologist, sports medicine writer, and fitness consultant for corporate wellness and rehabilitation clinics.