Runner's Knee (Chondromalacia)

Does your poor knee always hurt? Chronic pain behind or around the kneecap is often diagnosed as chondromalacia, or “runner's knee.” In runner’s knee, an abnormal softening of the cartilage makes it difficult or painful to move your knee. 

Chondromalacia, also known as patellofemoral stress syndrome, occurs when the kneecap rubs against the lower end of the femur – the thighbone – instead of gliding smoothly over it. This repetition roughens the cartilage underneath the kneecap. The damage can range from a slight abnormality of the cartilage surface to a surface that has been completely worn away to the bone. 

Traumatic chondromalacia occurs when a blow to the kneecap actually tears off a piece of articular cartilage or bone. 

The disorder most commonly appears in: 

• Runners 
• Skiers 
• Cyclists 
• Soccer players 

Causes

Softening of the kneecap's articular cartilage can be caused by: 

• Trauma 
• Overuse 
• Muscle weakness 
• Malalignment 
• Age 

Over-pronation can lead to malalignment, which means the lower leg twists inward while the quadriceps tendon pulls the patella outward. A tight hamstring, tight heel cords, and tight quadriceps also contribute to the problem. 

Young people who develop chondromalacia can usually blame trauma or overuse; if the condition appears in someone older, this person may also have osteoarthritis. 

Symptoms

Chondromalacia usually presents itself as a dull pain around or under the kneecap, and can worsen when engaging in any of these activities: 

• Walking up or down stairs 
• Walking on a hill 
• Taking part in any activity that forces the knee to bear weight as it's straightened 
• Running and sports activities 

Relief and Prevention

Chondromalacia can be treated with rest and ice to reduce swelling. 

In addition, doctors recommend: 

• Engaging in low impact exercises that strengthen muscles, particularly within the quadriceps 
• Swimming or riding a stationary bike 
• Stretching and strengthening the hamstrings and quadriceps 
• Using a knee brace to provide relief 
• Wearing stable shoes with added arch supports, especially during exercise or walking 
• Taking over-the-counter pain relievers and anti-inflammatory drugs 

If the pain and swelling persist, consult your physician. Orthotics and/or surgery may be required. 

This information is not intended to be a substitute for professional medical advice, diagnosis or treatment. Please consult your health care provider on all matters relating to this or any other condition that may affect your health.