Understanding Chondromalacia Patella: Why Your Kneecap Hurts and How Physio Can Help
Chondromalacia patella, often called “runner’s knee”, is one of the most common causes of anterior (front) knee pain. It occurs when the cartilage on the underside of the kneecap becomes soft or damaged, leading to pain, inflammation, and difficulty with everyday movements like climbing stairs, squatting, or sitting for long periods.
Thankfully, physiotherapy is one of the most effective ways to manage and treat this condition, without surgery.
What Is Chondromalacia Patella?
The underside of your kneecap (patella) is lined with smooth cartilage that glides over the thigh bone (femur). In chondromalacia patella, that cartilage becomes irritated or worn down, often due to poor tracking of the patella or repetitive stress.
Common Causes Include:
Overuse from running, jumping, or stair climbing
Muscle imbalances, especially weak quads or glutes
Poor kneecap alignment or biomechanics
Flat feet or abnormal foot mechanics
Trauma or previous knee injuries
Symptoms to Look Out For:
Dull, aching pain at the front of the knee
Pain when climbing stairs, squatting, or standing from a seated position
Clicking or grinding under the kneecap
Pain after sitting for long periods (“movie-goer’s knee”)
How Physiotherapy Can Help
Physiotherapy focuses on reducing pain, correcting mechanics, and building strength to support your knee. Here’s how:
1. Pain Relief & Initial Management
Your physio will guide you through:
Activity modification (reducing aggravating movements)
Ice therapy and anti-inflammatory strategies
Patellar taping or bracing for alignment and pain relief
2. Correcting Muscle Imbalances
Often, pain stems from poor patellar tracking due to weak or tight muscles.
Key targets include:
Quadriceps, especially the VMO (vastus medialis oblique)
Glutes and hip abductors for better pelvic control
Hamstrings and calf flexibility
Foam rolling and manual therapy may also help release tight tissue
3. Kinetic Chain Focus
The knee doesn’t work in isolation, your hips and feet play a huge role.
Your treatment may include:
Hip and core strengthening
Foot posture correction (orthotics or barefoot retraining)
Gait and running analysis, if relevant
4. Functional Rehab & Return to Activity
We’ll gradually reintroduce activity with:
Pain-free squats and step-downs
Controlled lunges and balance work
Sport- or job-specific movement retraining
When to See a Physio
If your knee pain persists for more than two weeks or worsens with daily activity, a physiotherapist can provide a thorough assessment and targeted treatment plan. Early intervention prevents long-term issues like cartilage degeneration or chronic instability.
Final Word from the Physio
Chondromalacia patella doesn’t have to sideline you. With the right physio approach, most people recover fully and return to their normal routines pain-free. You’ll not only treat the symptoms, but also fix the root cause.
Lesley Lowe leads the Sports Physio Clinic. She has worked with multiple sports clubs over the years including rugby, football, hurling and hockey clubs and she has worked at the Dublin city Marathon.
Sports Physio Clinic
Cycling physiotherapy plays a crucial role in injury prevention and recovery, helping cyclists improve posture, mobility, and strength to reduce strain and enhance performance..