1. What is it?
Chondromalacia is the destruction of the cartilage under the kneecap. Normally this cartilage is smooth and allows a gliding motion of the kneecap over the femur. However, with certain knee problems, the kneecap may not track smoothly over the femur. The result is that the areas in contact with each other become roughened and may cause knee pain.
2. What are the causes/predisposing factors of this injury?
Previous knee trauma, chronic muscle imbalances and weakness in the muscles supporting the knee can lead to this condition. Females can be more susceptible to this problem due to alignment issues between the knee and pelvis.
A common scenario I see is a chronically tight iliotibial band on the outside of the knee combined with a weak inner quadriceps muscle (vastus medialis obliquus or VMO).
3. What are the symptoms?
The primary symptom is pain underneath and around the kneecap that may be difficult to localize. Redness or swelling may also be present.
Usually the pain is aggravated by stair climbing, squatting or prolonged periods of sitting. There can also be a grating or crunching sound when the knee is bent.
4. What can be done to prevent or treat this injury?
Prevention is common sense. Do not let existing knee problems become chronic. If you have a problem and it is not responding to rest and ice get professional help sooner than later.
Treatment is case specific. A proper assessment should allow the clinician to determine what the imbalances or structural issues are. Therapy should be directed at these specific deficiencies.
Typically, anti inflammatories, relative rest, and an individually tailored rehabilitation program are used for this condition. If conservative measures fail, surgery is an option.