How effective is physiotherapy for chondromalacia patellae?

Chondromalacia patellae refers to irritation or softening affecting cartilage on the underside of the kneecap. Pain often appears with tasks that load the bent knee, such as stairs, squatting or sitting for a long time. A physiotherapist may assess hip strength, thigh control, foot position, flexibility and how the kneecap tracks during movement. A tailored programme can gradually strengthen the quadriceps and hip muscles, improve control and reduce aggravating load. Pain can come from several structures around the knee, so the examination matters more than the label alone.

Start with a tolerable level of loading and increase it gradually as advised. Temporarily reduce deep squats, repeated stairs or jumping if they clearly flare pain, while keeping comfortable movement. Practise alignment during sit-to-stand, step-down and other exercises rather than allowing the knee to collapse inward. Ice or other comfort measures may help after activity, but they do not replace strengthening. Return to running or sport in stages once daily activities are comfortable and control has improved.

Get prompt assessment if the knee becomes very swollen, hot or red, locks, gives way repeatedly, or cannot bear weight after an injury. Seek urgent care for a deformed knee or sudden inability to straighten it. Contact your clinician when pain is worsening despite load adjustment, or when the knee is not improving with a supervised strengthening plan.

Which knee movements are currently overloading my kneecap? Should I modify stairs, cycling or running? Which strength measures will show progress? Could another knee problem be contributing to my pain?