Chondromalacia Patella (Runner’s Knee): Symptoms, Causes, Treatment & Prevention
- Dr. Ndidi Dagbue
- Sep 16
- 4 min read
A practical guide from Doxa Specialist Clinic in Gros Islet to keep your knees strong and pain-free
Knee pain can sideline anyone—from weekend walkers on the Castries–Gros Islet Highway to seasoned runners and netballers. One common culprit is Chondromalacia Patella, a condition involving softening or breakdown of the cartilage on the underside of the kneecap (patella). This irritation can lead to pain when you bend or load the knee—think stairs, squats, hills, or sitting for long periods.
At Doxa Specialist Clinic in Gros Islet, our team— (Orthopedic Surgeon) and (Registered Physiotherapist)—help patients diagnose the cause accurately and return to pain-free movement with a clear, step-by-step plan.
Educational note: This article is informational and not a substitute for a personalized medical assessment.
What is Chondromalacia Patella?
Chondromalacia Patella (CP) describes cartilage softening and wear on the back of the kneecap where it glides in the groove of the thigh bone (trochlea). As the surface becomes irritated, movement can feel painful, rough, or “grindy.”
Also called: Many people use “Runner’s Knee” or Patellofemoral Pain Syndrome (PFPS) to describe similar front-of-knee pain. Strictly speaking, PFPS is a broader term for pain around the kneecap without confirmed cartilage damage. In everyday use, they often overlap—what matters most is identifying your specific drivers and treating them.
Common Symptoms
Pain at the front of the knee, worsened by stairs (especially going down), squatting, kneeling, hills, running, or sitting with bent knees (“theatre sign”).
Grinding, clicking, or crepitus around the kneecap.
Stiffness after rest or first thing in the morning.
Occasional swelling or tenderness around the patella.
If symptoms persist, they can limit training, work duties, or even simple daily tasks.
Why It Happens (Causes & Risk Factors)
Chondromalacia Patella usually results from a mix of overload and alignment/strength issues:
Overuse or training errors: Sudden jump in mileage or intensity, hill repeats, frequent squats/lunges, hard surfaces, or insufficient recovery.
Previous injury: Direct blow to the kneecap or a fall can irritate cartilage.
Patellar tracking or alignment issues: Tight lateral structures, flat feet/over-pronation, high Q-angle, or shallow trochlear groove may increase joint stress.
Muscle imbalances: Weak hip abductors/external rotators, quadriceps weakness (especially VMO), tight hamstrings or calf muscles.
Footwear/equipment: Worn-out shoes or inappropriate support for your activity.
Age & lifecycle: Teens/young adults are common (sport + growth spurts). In older adults, similar symptoms may reflect patellofemoral osteoarthritis (age-related cartilage wear).
Diagnosis at Doxa
A precise diagnosis guides effective treatment. Your clinician will:
Take a detailed history: onset, training load, footwear, work demands.
Perform a movement exam: patellar tracking, hip/knee strength, foot mechanics, flexibility.
Consider imaging when appropriate: X-ray or MRI can support diagnosis if symptoms persist or surgery is considered. In select cases, arthroscopy may visualize cartilage directly.
Most patients don’t need immediate advanced imaging—a targeted rehab plan often reduces pain first.
Treatment Options
The good news: most cases improve with conservative care.
Phase 1: Calm It Down (Pain Control)
Relative rest, not total rest: Reduce painful loads (stairs, hills, deep squats) but keep gentle activity (walking, cycling with low resistance) if pain allows.
Ice or heat: Choose what feels best for 10–15 minutes.
Short-term medications: Over-the-counter pain relief if appropriate for you (discuss with your clinician).
Patellar taping or a simple knee sleeve: May reduce pain temporarily so you can move better.
Activity modifications: Shorter stride on runs, avoid deep knee bend angles early on, use handrails on stairs.
Phase 2: Fix the Drivers (Rehab with Physiotherapy)
Guided by our physiotherapist, your rehab typically includes:
Strengthening:
Quadriceps/VMO (terminal knee extensions, step-ups within pain-free range).
Hips (glute med/external rotators: clams, side-steps, single-leg work).
Calf & hamstrings as needed.
Mobility: Gentle stretches for quads, hamstrings, calves, and ITB; patellar and ankle mobility if restricted.
Motor control: Improve knee tracking over the foot during squats/step-downs; focus on alignment.
Foot mechanics: Foot orthoses or shoe changes when over-pronation contributes to pain.
Load management: Gradual return to running, squats, stairs using a “2–3/10 pain during, back to baseline by next day” rule of thumb.
Most people see meaningful improvement in 4–6 weeks, with steady gains over 8–12 weeks.
Phase 3: Performance & Prevention
Progressive loading: Deeper squats, lunges, step-downs, hills as tolerated.
Plyometrics & agility (if athletic goals): Introduced once pain and mechanics are controlled.
Sport-specific drills: Cadence work for runners, change-of-direction for field sports.
When Are Injections or Surgery Considered?
If pain persists despite a well-executed rehab plan, Our Orthopedic Surgeon may discuss further options:
Targeted injections (e.g., corticosteroid or other agents) to calm inflammation and open a “window” for rehab.
Arthroscopic procedures in select structural cases (e.g., unstable cartilage flaps, maltracking requiring realignment). Surgery is not first-line and is only considered after careful evaluation and shared decision-making.
Prevention: Keep Your Knees Happy
Strength twice weekly: Hips (glute med/max), quads (especially VMO), calves.
Smart training loads: Increase mileage or squats by no more than ~10% per week; alternate hard/easy days.
Warm-up primer (5–7 minutes): brisk walk or cycle → mini-squats → step-downs → banded side-steps.
Footwear check: Replace running shoes every 500–700 km or if visibly worn; choose support that matches your foot mechanics.
Technique tweaks: Slightly increase running cadence; keep knees tracking over second/third toe on squats.
Work & life ergonomics: Avoid prolonged sitting; take micro-breaks to extend and move the knee.
Weight management: A healthy body weight reduces patellofemoral load.
When to Seek Care
Pain that lasts beyond 3–4 weeks, limits daily life, or keeps recurring.
Swelling, instability, catching/locking, or night pain.
A recent trauma or fall onto the knee.
You’re unsure how to train without flaring symptoms.
Our Doxa pathway: rapid screening → personalized physio plan → progress review at 3–6 weeks → long-term prevention.
Ready to get moving—comfortably?
Call/WhatsApp: +1 (758) 285 1616Clinic: Doxa Specialist Clinic, Castries–Gros Islet Highway, Gros Islet, P.O. Box GI2155, LC01 101, Saint Lucia
We’ll help you return to stairs, squats, and sport with confidence—safely and step by step.
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