What Is Chondromalacia Patella? A Chiropractor’s Guide to Knee Pain in Active Adults

Knee Pain While Running or Climbing Stairs? It Could Be This.

You’re halfway through a workout—or just walking up the stairs—and your knee starts to ache. Not sharp, just that deep, nagging pain behind the kneecap.

That’s a classic sign of chondromalacia patella, also known as runner’s knee. It’s incredibly common in active adults, especially those who run, squat, jump, or play sports.

The good news? It’s treatable. At Walsh Wellness Center, we help patients recover naturally using chiropractic adjustments, soft tissue therapy, and functional rehab.

What Is Chondromalacia Patella?

A Simple Definition

The word breaks down like this:

• “Chondro” = cartilage

• “Malacia” = softening

Chondromalacia patella occurs when the cartilage on the underside of the kneecap becomes irritated or worn down. Over time, this causes discomfort during movement—especially activities that load the joint.

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Uh, chondromalacia patella—so what it is, is a condition of the articular cartilage. You can see it on the backside of the kneecap with the femur, and that articular cartilage can be good or bad.

Mainly, it's a breakdown or a tearing of that cartilage off the bone. That could be from forceful movements, explosive movements, jumping, running—those kinds of things.

Symptoms basically are knee pain—knee pain more concentrated on the kneecap with pressure. Pushed on the kneecap or pressure and movement on the kneecap—which is another orthopedic test—those are positives.

Treatments for these can vary depending upon the severity. Sometimes it might be bad enough to require surgical intervention, but most times what we can do is treat it by adjusting the joints and also doing some PT work—some light PT work depending upon what the patient can withstand—and then working the way up.

But the one way to be sure is: get in and get an exam. That's the only way we're going to know what's going on. X-rays can go ahead and confirm that, but what you will see in an X-ray—on an A to P or P to A, which is front to back or back to front—is it’ll look like a little hole in the kneecap, and that’s the different density of the cartilage in the back.

So that’s basically that condition.

Why It’s Also Called Runner’s Knee

This condition is especially common among:

• Runners

• Cyclists

• Lifters

• And anyone doing repetitive knee flexion movements

Common Causes and Risk Factors

Overuse and Repetitive Stress

Daily squats, miles of running, and sports that involve jumping put strain on the kneecap and cartilage underneath.

Poor Patellar Tracking

If the kneecap doesn’t move smoothly in the femoral groove, it causes friction—and eventually, inflammation.

Muscle Imbalances

Weak glutes, tight quads or hamstrings, or an overactive IT band can all alter how your knee tracks and functions.

Structural or Postural Issues

Postural issues like flat arches, inward knee collapse (valgus), or pelvic misalignment can all shift the way force is distributed through your knees.

That’s why our approach looks beyond the knee itself—addressing alignment throughout the entire kinetic chain with targeted manual therapy and joint correction to help restore optimal movement patterns.

Symptoms of Chondromalacia Patella

Pain Location and Type

• Dull, aching pain behind or around the kneecap

• Worse when using stairs, squatting, sitting too long, or kneeling

Other Signs

• Grinding or clicking sounds during movement

• Feeling of instability or swelling during activity

How Chiropractors Diagnose Chondromalacia Patella

Movement and Gait Analysis

We assess:

• Knee alignment during movement

• Hip and pelvic motion

• Foot strike and stance

This helps us pinpoint the cause, not just treat the pain.

Physical Examination

We’ll evaluate:

• Joint tracking

• Muscle tone

• Range of motion

• Palpation sensitivity around the patella

Imaging if Needed

If symptoms persist or we suspect cartilage degradation, we may refer for:

• X-rays – to observe cartilage density

• MRI – in more advanced or chronic cases

Chiropractic Treatment Options

Chiropractic Adjustments

We target pelvis, lumbar spine, or foot alignment to:

• Offload the knee

• Improve biomechanics

• Reduce strain during movement

Chondromalacia is often a symptom of systemic imbalance, not just a knee problem.

Myofascial Release and Soft Tissue Therapy

We release tension in:

• Quads

• Hip flexors

• IT band

• Hamstrings

This helps the kneecap glide properly and relieves irritation.

Rehab and Corrective Exercises

Our in-office and at-home protocols may include:

• Glute activation

• Hip mobility drills

• Quad strengthening and VMO targeting

• Knee tracking re-education

These are often blended with physical therapy principles tailored for active adults.

Taping and Bracing (When Needed)

We may use patellar taping techniques to guide movement during activity or temporarily stabilize the joint.

Prevention Tips for Active Adults

Warm-Up and Cool-Down

Don’t skip it. Priming your joints prevents wear and tear from repetitive motion.

Cross-Training and Load Management

Switch things up—cycling, swimming, or light hiking can give your knees a break from repetitive stress.

Strength and Stability Focus

The stronger your hips, core, and feet, the less strain your knees take on.

We also recommend dry needling for recurring IT band tension or persistent muscle knots that resist stretching.

When to See a Chiropractor

Don’t wait if:

• Knee pain worsens during activity or prolonged sitting

• You’ve tried rest, but it keeps coming back

• Your training or lifestyle is being limited by your knee

Early care prevents long-term cartilage damage. At Walsh Wellness Center, we combine movement analysis, soft tissue release, and alignment work to treat the whole system—not just the symptoms.

Frequently Asked Questions About Chondromalacia Patella

Is chondromalacia patella the same as runner’s knee?

Yes, “runner’s knee” is a common name for it—especially in athletes or gym-goers.

Can chiropractic help if I already tried PT?

Yes! We combine adjustments + rehab + soft tissue work, which can address missed issues in posture or mechanics.

Do I need surgery for this?

Rarely. Most cases respond well to conservative care like chiropractic and functional movement therapy.

Can I still be active with this condition?

Yes—but activity should be modified until pain subsides and mechanics improve.

Ready to Get Back to Movement Without Knee Pain?

Chondromalacia patella is common—but it doesn’t have to keep you on the sidelines.

With chiropractic care, you can:

• Improve alignment

• Restore knee tracking

• Eliminate pain naturally

Schedule your knee pain assessment and let’s get you back to training pain-free.