Symptoms of Chondromalacia Patella

Chondromalacia patella, also known as runner’s knee, is a condition where the cartilage underneath the patella (kneecap) starts to deteriorate and wear out. With the cartilage worn out, the kneecap rubs against the thigh bone (the femur) and causes pain and discomfort.

This condition is common among athletes due to frequent activity involving the knee. Chondromalacia patella might also affect adults living with arthritis. Learn about the most common symptoms of chondromalacia patella, much rarer ones, complications, and when to reach out to your healthcare provider. 

Frequent Symptoms 

Some symptoms of chondromalacia patella are common, while others might indicate a more severe condition. 

Common symptoms of chondromalacia patella include: 

• Pain in the kneecap
• A clicking or grinding noise when bending or straightening the knee
• Discomfort and pain with movement
• Knee swelling
• Knee stiffness 

Pain 

The main symptom of chondromalacia patella is pain. This type of pain is often felt at the front of the kneecap. It might also be felt around or behind the kneecap. Pain is mild early on and can get worse with time.

Chondromalacia patella pain tends to be a dull, aching pain that is felt even when you are resting. Pain becomes more pronounced with movement and when there is a strain on the knee. You may even experience sharp pain when bending the knee, walking, or when running or exercising. 

Clicking or Grinding Noises 

Certain movements may cause you to experience a grinding or clicking sensation in the knee. This is called knee crepitus.

Knee crepitus is a common symptom of chondromalacia patella and other conditions of the knee joint. Words often used to describe crepitus are popping, snapping, catching, clicking, crunching, cracking, crackling, creaking, grinding, grating, and clunking.

In a study of people over 40 years of age, 38.1% of women and 17.1% of men reported crepitus. This survey didn’t mention specific causes of crepitus.

With chondromalacia patella, crepitus will occur after periods of rest, such as after sitting for a long period or when getting out of bed in the morning. Crepitus tends to improve or go away with movement. 

Discomfort and Pain With Movement 

People with chondromalacia patella will experience pain, knee friction, and popping noises when they are going up and down steps; with squatting, kneeling, or running; or when moving abruptly from a sitting position to a standing one. The pain will start as soon as movement starts and lessens once you stop moving the knee joint.

Knee Swelling

Swelling in the front of the knee from chondromalacia patella is common and may indicate some type of inflammation. This might occur when the underpart of the kneecap comes in contact with the thigh bone. Swelling can affect mobility (from pain and stiffness) and cause soreness.

Knee Stiffness 

People with chondromalacia patella may experience knee stiffness when their knee is bent and when they move the knee. This might occur with certain activities, such as riding in a car or sitting at your desk. 

Rare Symptoms 

It is possible to have symptoms of chondromalacia patella that don’t affect everyone or might be experienced if the condition worsens.

Less frequent symptoms of chondromalacia patella may include:

• Joint effusion (abnormal accumulation of fluid in or around a joint)
• Bone-on-bone pain
• Severe pain 

Joint Effusion 

Joint effusion is the result of too much fluid accumulating around the knee joint. When it occurs in the knee, healthcare providers sometimes refer to it as “swollen knee” or “water on the knee.”

Water on the knee might occur in cases where chondromalacia patella has become severe. Sometimes, bits of cartilage from this damage can float into the knee joint and irritate the cells lining the joint. The cells will respond by producing fluid in the joint.

Bone-on-Bone Pain 

Chondromalacia patella may eventually cause the knee to lose cartilage. With the cartilage loss, the knee joint will lose its ability to protect the bones of the knee as you move it.

When the ends of bones rub together, you experience what is called bone-on-bone pain. With chondromalacia patella, the kneecap is rubbing against the thigh bone.

Severe Knee Pain 

Chondromalacia patella is rarely a severe condition. In fact, most people can manage it with rest, elevation, ice, and stretching. However, for some people, the condition can worsen to the point where pain cannot be managed with over-the-counter pain relievers and other at-home treatments.

Complications 

Complications of chondromalacia patella are rare. Most complications related to the condition tend to be secondary and related to the effects of treatment. This can include gastrointestinal symptoms from using a nonsteroidal anti-inflammatory drug (NSAID) or skin symptoms from bracing of the knee joint.

Sometimes, physical therapy exercises can make knee symptoms worse. Any time exercise aggravates symptoms and pain, stop doing it and contact your healthcare provider.

Chondromalacia patella can also worsen, and articular cartilage doesn’t always heal. If this condition becomes a bigger and more painful problem for you, your healthcare provider might recommend surgery.

When to See a Healthcare Provider/Go to the Hospital

Chondromalacia patella is a condition that usually improves with at-home treatment. At-home treatment might include resting the knee, icing it, elevating it, and stabilizing with a brace or elastic bandage. 

You should make an appointment with your healthcare provider if you experience:

• Significant swelling
• Tenderness
• Warmth around the joint
• Severe pain
• Fever 

You should also make an appointment with your healthcare provider if pain and other chondromalacia patella symptoms haven’t resolved despite treatment, or if the pain affects your sleep, ability to walk, or performing activities of daily living (i.e., bathing, grooming, getting dressed, etc.). 

You should consider going to your local emergency room if: 

• Your knee joint appears deformed.
• There is a painful popping while exercising.
• You are struggling to bear weight on the knee.
• You feel intense pain.
• You have swelling that comes on suddenly and quickly gets worse.

A Word From Verywell

Unlike cartilage damage from arthritis, damage caused by chondromalacia patella usually heals. Treatment usually starts with rest and physical therapy to eliminate symptoms.

Your healthcare provider may also recommend NSAIDs to reduce swelling and pain. When conservative treatments fail, your healthcare provider might consider surgery to repair any misalignment or damage to the kneecap. 

Most people with chondromalacia patella make a full recovery. The timeframe for recovery will be different based on a person’s age, health, and how affected the knee is.

However, a successful outcome requires preventing further damage to the kneecap. With treatment, you can get pain relief and go back to enjoying your favorite activities once again.