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Knee injuries: Patellofemoral syndrome or chondromalacia patella

Q: Why does my knee hurt?

A: You may be experiencing a softening and slow breakdown of the cartilage under the kneecap. This condition may be called chondromalacia or patellofemoral syndrome. Anterior knee pain can also be known as "runner's knee." For more information, refer to the Patellofemoral Pain Syndrome topic on our Dartmouth-Hitchcock Healthwise® Health Encyclopedia website.

Symptoms of chondromalacia include:

  • Soreness or pain in the front of the knee
  • Pain that gets worse after you have been sitting for a while
  • Pain when you use the stairs or get out of your chair
  • Grinding or grating pain when you straighten your leg

This injury is caused by:

  • Overuse or too much force on the knee
  • Height of the bike seat or overall bike fit
  • Overuse of knee after a previous dislocation or fracture of the knee
  • Your kneecap is out of line with your femoral (thigh) bone

Q: How can I prevent this injury or ease the pain?

A: Dr. Sparks suggests that you consider the height of your bike seat. A good bike shop can help guide you with this. Here at DHMC, physical therapy can help too. Read what DHMC physical therapist Kirsten Gleeson advises about bike fit and exercise.

Competitive and professional cyclists can look into different pedal types. A free rotating or "Speedplay" pedal may ease knee pain when you are racing.

Other important steps to ease the pain of a knee injury of this type include:

  • Resting your knee and avoiding cycling or other vigorous sports for a while
  • Anti-inflammatory drugs (NSAIDS) to reduce the swelling associated with chondromalacia. These drugs include ibuprofen, naproxen, and – for people over age 21 – aspirin.
  • When you are able to, exercises to strengthen your quadriceps (the muscles above the knee on the front and sides of your thighs).

Q: I have tried to change my activities, but the pain won't go away. What now?

A: Surgery is rarely necessary to treat this condition, Dr. Sparks says. But if changing your activities and a proper bike fitting have not helped, it is time to seek professional advice. You may need to see your primary care doctor, a specialist certified in sports medicine, or a physical therapist.

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