The kneecap withstands a lot of pressure from activities, such as running, and jumping. Even everyday activities, such as stair climbing and squatting movements place stress on the kneecap. Luckily, the cartilage under the knee cap acts as a shock absorber and is one of the thickest cartilages in the body. But over time the cartilage can become irritated or damaged resulting in a condition called chondromalacia.
Causes
Chondromalacia usually is caused by a gradual irritation and breakdown of the cartilage behind the knee. As the cartilage breakdowns, it can cause the bones to rub together.
Participation in activities that put extra stress on the knee, such as lunging, running and jumping place force on the knee and increase your risk of developing the condition.
According to Cedars-Sinai Medical Center, surprisingly, chondromalacia tends to affect young adults, who are otherwise healthy. Women are also more likely to develop the condition because their wider pelvis places greater lateral pressure on the knee.
Symptoms and Natural History
The main symptom of chondromalacia is pain in and around the knee. Although it can vary, the pain is usually described as dull. It may be more severe when performing activities that stress the knee, such as squatting and walking up and down stairs.
Pain may also be felt more after sitting for an extended amount of time. Some people also have swelling on the knee and hear a grinding sound when they straighten their leg.
The condition usually starts out with gradual pain that can become more intense over time, especially if you are still engaging in activities that stress the knee. If the pain becomes severe enough it can make everyday activities, such as walking and climbing stairs difficult and uncomfortable.
Diagnosis
The first step in diagnosing chondromalacia is usually an exam. During an exam, your doctor may apply pressure to the knee as your leg is extended to check for pain. She will also examine the knee for swelling and tenderness.
Additional imaging tests may be ordered. Although an x-ray will not show cartilage damage, it may be ordered to rule out arthritis or other problems with the bones. An MRI can show soft tissue damage and may be advised.
Self-help Treatments for Chondromalacia
Limiting activities that cause knee pain, such as running, is one self-help treatment, which may help. Applying ice a few times a day and taking over the counter pain relievers may also reduce pain. Using a knee brace may improve the alignment of the kneecap and provide support.
Standard Clinical Treatments for Chondromalacia
Physical therapy may be recommended to teach exercises to strengthen muscles around the knee including the quadriceps and hamstrings. Strengthening these muscles can take the pressure off the knee.
Surgery may be helpful if symptoms are interfering with everyday activities, and other nonsurgical treatments have not worked. Surgery may involve removing fragments of damaged cartilage. The procedure can often be done arthroscopically, which means only tiny incisions are needed.
Sources
Cedars Sinai Medical Center. Chondromalacia. https://www.cedars-sinai.edu/Patients/Health-Conditions/Chondromalacia.aspx
Harvard Medical School. Chondromalacia. http://www.health.harvard.edu/pain/chondromalacia-
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