Read More >
James McCormack is a Physical Therapist who specializes in foot & ankle injuries. james-mccormack.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.
Chondromalacia patella is a painful condition of the knee where the underside of the patella is irritated and the cartilage softens and its structure can deteriorate, to the point that it is worn away to expose the underlying bone. Learn more about this condition in our related article: Chondromalacia Patella.
Here we will answer some of the commonly asked questions about this condition.
Biomechanics play a large role in this condition. Elements such as a high Q angle from the hip, knee valgus, tibial portion and over-pronation of the foot and ankle, all increase risk. Additionally, poor control of movements due to weak muscle groups or tight muscles can impact the alignment of the patella and cause greater pressure on specific facets of the retro patella cartilage.
Activity and sports selection, frequency, duration and intensity can also continue to chondromalacia patella development.
Acute pain from chondromalacia patella can last 4-6 weeks if diagnosed accurately managed well and if the correct exercises are prescribed with good adherence.
If damage has started to occur, symptoms are severe, or have persisted for a long time, then chondromalacia patella pain can last a lot longer.
The retropatella cartilage of the patellofemoral joint does have the capacity to heal. Therefore if appropriate rest is given, and if there is good health in the tissue, symptoms might significantly improve without much intervention.
However, if there are factors that cause the onset of chondromalacia patella that have not been addressed, there is a strong change that it will occur again.
A knee brace or compressive sleeve can help with proprioception and symptom relief.
Depending on your biomechanics you might benefit from a simple elasticated brace (as shown), or if there is significant inward movement of the knee you may need a hinged brace which offers more medial support.
In the majority of cases, Chondromalcia patella does not need surgery and will recover with conservative management. Conservative management must include appropriate rest and must address the risk factors that may have contributed to the onset of this condition.
Some exercises put more stress on the retropatella surface, which if already irritated or damaged by chondromalacia patella, can make the condition worse in the acute phases:
Depending on the severity and duration of pain, walking can be an issue and may need to be reduced. However, if you only get your pain related to higher impact or intensity sports then walking might be ok to continue unlimited (within reason). Specifics such as walking down hills or steps may be more aggravating than on the flat, and footwear can play an important role.
If you have felt pain during or after cycling it is best not to continue with this exercise, but to take a rest period and seek guidance from an experienced physical therapist. A good bike fit can make a big difference. For example, a saddle that is too low or too far forwards will put more pressure on the retropatella surface. For this same reason low cadence with high resistance, and hills should be avoided.
Running is often painful to do with chondromalacia patella and in almost all cases will need to be stopped or reduced significantly. If it is pain free, your physical therapist might suggest reducing duration, frequency and/or intensity. And they will be able to guide you on how to safely, and gradually return to running once you have addressed other biomechanical factors and given your knee rest.
This is not medical advice. We recommend a consultation with a medical professional such as James McCormack. He offers Online Physiotherapy Appointments for £45.