Chondromalacia patellae: symptoms, causes and management
Chondromalacia patellae is the softening and wear of the cartilage that covers the back of the kneecap. It causes pain at the front of the knee, especially when climbing stairs or after sitting for a long time.
Educational information prepared by Dr. Belinda Martínez, physician and surgeon. Last updated: October 3, 2026. It does not replace an assessment by a doctor.
What is chondromalacia patellae?
The kneecap glides over the femur every time you bend and straighten your knee. If it does so with poor alignment or load, the cartilage on its back surface softens and wears. The term is often used as a synonym for patellofemoral pain syndrome, although that term describes the pain and does not always imply visible cartilage damage.
It is common in young people and athletes, and also in people who sit for long periods or who suddenly increased their activity.
Symptoms
- Diffuse pain around or behind the kneecap.
- Worse when going up or down stairs, squatting, running or sitting with the knee bent (the "movie-goer sign").
- A crunching or grinding feeling (crepitus) when moving the knee.
- Discomfort when standing up after sitting for a while.
Causes and risk factors
- Overuse or a sudden increase in activity.
- Weakness of the quadriceps and hip muscles.
- Poor alignment of the kneecap or leg.
- Inadequate footwear or surfaces, and tightness of the muscles at the back of the thigh.
- Previous blows or knee injuries.
How it is diagnosed and what grades exist
Diagnosis is based mainly on the exam. An X-ray rules out other causes and an MRI can show the state of the cartilage. Damage is classified into four grades (I to IV): from simple softening to exposed bone. The grade does not always match the intensity of the pain.
What helps control it
- Temporarily reducing the activities that trigger the pain.
- Strengthening the quadriceps, glutes and core with a physical therapy program.
- Stretching tight muscles at the back and outer side of the thigh.
- Appropriate footwear and adjusting sports technique.
- Ice and pain medication only as prescribed by a doctor.
Most cases improve with conservative management. Surgery is reserved for selected cases that do not respond after an adequate period of rehabilitation.
When to see a doctor
Seek medical care soon if you have any of these signs:
- Significant swelling or the knee locks.
- Pain that does not improve after several weeks of rest and exercises.
- A feeling that the knee "gives way" when bearing weight.
Frequently asked questions
Is chondromalacia the same as osteoarthritis?
No. Chondromalacia mainly affects the kneecap cartilage and is common in young people; osteoarthritis is more generalized joint wear. They can coexist, especially with age.
Does chondromalacia go away?
Symptoms usually improve a lot with rehabilitation and changes in activity. Cartilage that is already damaged does not fully rebuild, but pain can be controlled and function maintained.
Can I keep running?
It depends on how intense the pain is. Many people reduce impact and distance while they strengthen the knee. Your doctor or physical therapist can tell you how to return gradually.
Book your free assessment
Dr. Belinda Martínez reviews your case at her office in Guadalajara. The assessment is free of charge and does not commit you to any treatment.
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This content is informational and educational; it is not a diagnosis or a treatment recommendation. If you have any symptoms, consult a health professional.