Chondromalacia is a term used to describe damage or softening of the articular cartilage on the underside of the kneecap. This injury can be caused by simple wear and tear and arthritis as we age. In younger exercisers, however, it is most likely due to an acute injury such as a fall, overuse, problems with knee alignment, or even muscle weakness.

The underside of the kneecap, and the top of the thigh bone (femur) are both covered with a smooth and slippery (articular) cartilage that allows these two bones to slide easily over one another when the knee flexes. If this cartilage is damaged, the surface becomes rough and gets irritated with movement. Damage can be minor or severe, and may result in varying degrees of pain.

The most common symptom of chondromalacia is a dull pain under or around the kneecap that increases while walking down stairs. There may also be pain with stair climbing or getting out of a chair, etc. This injury is common in runners, skiers, cyclists, and soccer players.

The best treatment for chondromalacia is low-impact exercise that strengthen muscles (focused the inner part of the quadriceps) and avoiding jumping or impact exercise as much as possible. Swimming, stationary bicycle, and cross-country skiing are good ways to strengthen the joint without impact. It's helpful to avoid any activity that requires the knee to flex more than 90 degrees.

Finally, arthroscopic surgery may be used to smooth the surface of the articular cartilage and clean out cartilage fragments that cause the joint to catch during bending and straightening. This determination can only be made by a proper evaluation and diagnosis, so always see your doctor for knee pain that lasts more than two weeks.

Meniscus Injuries
The meniscus is a small, horse-shoe shaped fibrous piece of cartilage that acts as a cushion in the knee joint between the thigh bone (femur) and shin bone (tibia). Theses two menisci can be injured during weight bearng exercise if the knee rotates. A partial or total tear of a meniscus commonly occurs when a person quickly twists or rotates the upper leg while the foot stays still (for example, during football or soccur 'cuts'). With a small tear, the meniscus stays connected to the front and back of the knee; if the tear is large, the meniscus may be only connected by a thread of cartilage. The seriousness of a tear depends on its location and extent.

Symptoms
The common symptoms are mild pain, particularly when the knee is straightened. A person may even be able to continue with activity. Severe pain may result if a fragment of the meniscus catches between the femur and tibia. Swelling is fairly common if after the injury or may occur several hours later. The knee may also click, lock, or feel weak. Symptoms of meniscal injury may disappear on their own with time, but generally they require treatment in order to heal fully.

Once in the physician's office, your doctor will check your range of motion and rotation to see what causes pain. An MRI (imaging test) can confirm the diagnosis.

Minor tears can be treated with conservative treatmetn including stretching and strengthening exercises to build quadriceps and hamstring strength and flexibility.

A more severe tear may require surgery and a physical therapy program for full recovery.