Runner’s Knee


Chondromalacia Patella Pain (Runner’s Knee) 

 The easiest way to describe Runner’s Knee (chondromalacia patella) is damaged cartilage under the kneecap. 

runners knee
runners knee

Firstly, there are many names for Patellofemoral Pain Syndrome as it’s sometimes called “runner’s knee” or “jumper’s knee”.  These nicknames were adopted as this painful condition is common for people who participate in sports, particularly females and young adults. However, Patellofemoral Pain Syndrome or Chondromalacia Patella Pain can occur in nonathletes, as well.

Runner’s Knee Information

Secondly, runner’s knee is a condition where the cartilage on the undersurface of the patella (kneecap) deteriorates and softens.  Common causes for chondromalacia patella include: Acute trauma of the patella, especially fracture or dislocation. Muscular imbalance in groups around the knee. In addition, Patellofemoral Pain Syndrome is commonly described as pain on the front and sometimes the side of the knee. 

Moreover, a tight iliotibial band is usually part of this pain equation. The iliotibal band is a tight layer of tissue that runs along the side of the thigh. Runner’s knee can develop because this tight layer of tissue pulls the kneecap out of alignment. When the condition presents as pain on the front of the knee, on or under the kneecap, it is also known as Chondromalacia patella. Running, develops some muscles while others get little or no work, leading to weakness. This creates a muscle imbalance, often in the hip area. 

For example, muscle imbalance can cause a malalignment, affecting the body’s ability to control the appropriate tracking of the kneecap in the femoral groove during running. Continued running can lead to damage in the cartilage on the underside of the patella. In addition, lack of flexibility or muscle strength in the large muscles of the legs (glutes, hamstrings, quadriceps) as well as the Achilles tendon all can contribute to runner’s knee. 

Usually, in a healthy knee, the kneecap glides smoothly up and down the femoral groove (or trochlear groove, which is located on top of the femur. Unlike with runner’s knee, the kneecap doesn’t glide smoothly in the femoral groove, causing increased pressure and pain.  

How do you know you are experiencing Chondromalacia? 

Certainly, pain in your knees is the main symptom of runner’s knee. Sadly, This is a chronic condition caused by overuse. Unlike an acute, traumatic injury, the pain of this condition comes on overtime. The knee pain is usually present while running or during other activity, such as: 

  • Squatting
  • Kneeling
  • Walking up or down stairs
  • Running, specifically downhill 
  • Sitting for long periods 
  • Excessive training and overuse 
  • Increased training level 
  • Flat feet 
  • Poor running mechanics 
  • Foot over-pronation (feet that roll inward when walking or running, causing the kneecap to be pulled outward) 
  • Injury, trauma to the kneecap (e.g. dislocation, fracture) 
  • Obesity 
  • Improper or worn-out running shoes 
  • Prior knee or hip surgery  

Other symptoms of runner’s knee may include: 

  • Kneecap being tender to the touch 
  • Cracking or popping sound in the knee joint 
  • Swelling in the knee 

Preventative measures you can take to protect yourself from runner’s knee.

  • Wear supportive shoes, especially if your feet turn inwards 
  • Warm up and stretch before running, with a focus on the legs, before running. 
  • Rest or cross train between running sessions, especially if they are rigorous 
  • Supplement running with runner’s knee exercises: a targeted flexibility and strengthening program 
  • Consult an expert for an evaluation of your running form or running-related pain or other problems. Consider going to a physical therapist or professional trainer for a targeted stretching/strengthening program. 

If the condition lasts for longer than three weeks, interferes with walking or running, or gets worse, professional evaluation is indicated. Although rare, over time it may result in permanent knee cartilage damage. Seeing an orthopaedic specialist at UOA can provide a confirmed diagnosis, including ruling out other causes or injuries. 

Treatments for Runner’s Knee

  • R.I.C.E. (Rest, Ice, Compression, Elevation) 
  • Anti-inflammatory medications 
  • Stretching and strengthening of surrounding muscles and other structures of the knee, especially the glute and quadriceps muscles of the leg. 
  • Special shoe inserts (orthotics) if indicated 



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