5 Exercises to Defeat Chondromalacia Patella (and 3 to Avoid)

Chondromalacia patella knee pain is often caused by a lot of running and jumping. In fact, it’s often called “runner’s knee” because of the association. But having this mouthful of a condition does not mean you have to give up sports or exercising altogether. Quite the contrary…. You just have to be smart about what chondromalacia patella exercises you should do and which ones you avoid.

What’s Causing My Knee Pain?

Chondromalacia is where the protective cartilage covering the kneecap softens or wears down, often due to overuse and/or repetitive stress. (Find out about other causes here.) This cartilage change can make it tough for the kneecap to glide smoothly within its groove.

The resulting friction can cause inflammation and pain at the front of the knee and/or behind the kneecap. In some cases, the swelling and pain of chondromalacia patella may be so bad that it limits leg extension (your ability to straighten your knee).

Chondromalacia pain may increase during activities that stress your knee joint, such as:

• Climbing or descending stairs
• Squatting
• Kneeling
• Running
• Jumping
• Sitting for a long time with the knee bent
• Wearing high heels

Obviously, a great starting point for treatment is to avoid these irritating activities as best you can. You should also follow the steps of RICE (rest, ice, compress and elevate) and wear a chondromalacia knee brace that helps with kneecap movement. But while these steps help with the symptoms of chondromalacia patella, they do not fix the underlying problem.

The muscles of the leg and hip play an important role in making sure the kneecap moves (tracks) as it should. And tight or weak tissues and muscle imbalances can cause major movement problems. For that reason, doing exercises for chondromalacia patella can make a huge difference in terms of long-term relief.

5 Chondromalacia Patella Exercises

Generally speaking, chondromalacia treatment exercises focus on strengthening the muscles of the legs and hips without increasing the amount of pressure between the kneecap and the groove of the thigh bone. Following are a few great exercises for patellar chondromalacia, as well as exercise diagrams for additional clarification.

Straight Leg Lift

1. Lie down with one leg bent at a 90-degree angle with the foot flat on the floor and the other leg fully extended.
2. Tighten the quadriceps (thigh muscle) of the straight leg and raise it to a 45-degree angle.
3. Hold the leg in this elevated position for a second or two before slowly lowering it back to the ground.
4. Repeat for 20 repetitions then switch legs. You should do two or three sets per day.

External Hip Rotation (AKA, the Clam)

1. Lie on your side with the knees stacked and bent at 90-degree angles and the hips flexed at an angle of about 60-degrees.
2. Keeping your heels stacked together and the pelvis anchored and perpendicular to the ground, lift your top knee as high as you can, hold for a second or two then lower it.
3. Repeat this chondromalacia patella exercise 10 to 15 times per side for two or three sets.

Wall Slide

1. Begin by standing with the heels about 6 inches away from a wall and the feet about a foot apart. Your back and butt should be pressed against the wall.
2. Slowly slide the hips down the wall until the knees are bent at roughly a 45-degree angle. Hold that position for about five seconds, and then slowly slide back up to the starting position. It is important not to bend too quickly or too deeply as this can irritate the knee.
3. Repeat this motion 10 to 15 times for two to three sets.

Quadricep Contraction

1. Lay down with both legs extended in front of you. Slide a rolled up towel or blanket under one knee so that it is slightly bent.
2. Lift the foot off the ground so that the knee straightens fully.
3. Hold the knee locked in extension for five seconds, then relax the quadriceps and slowly lower the leg back to its resting position.
4. Repeat for 10 repetitions and then switch legs. This should be done three to five times a day.

Dumbbell Deadlift

A deadlift can also be an effective exercise for chondromalacia patella, but only if you exercise proper form. You will need a barbell with weights for this exercise. When starting out, you may want to use an elevated rack to limit pressure on the knee cap.

1. Pick up your dumbbells and hold them in front of you, standing with the feet shoulder-width apart.
2. Slowly lower the dumbbells by hinging forward at the hip. Be sure to keep your chest and head up, your back straight and the weights close to your body. Your knees should be bent slightly—they should not bend as much as you would during a squat.
3. When you have lowered the weights as far as you can without rounding the back, reverse the motion and slowly extend the knees, hips and waist until you are standing upright with the shoulders pulled back. Your abdominal muscles should be engaged throughout the lift.
4. Repeat three to six times for three to five sets if you are using heavy dumbbells. You can do higher repetitions if you are using lighter weights.

Best Cardio Exercises for Chondromalacia Patella

There are also some cardiovascular exercises for chondromalacia patella that are great because they put relatively low amounts of stress on the knee. For instance, swimming is a wonderful full-body exercise for chondromalacia because the water put very little stress is put on the joints.

Other “safe” exercises for chondromalacia patellae include:

• Walking (avoid hills)
• Cross-country skiing
• Kayaking or paddle boarding
• Lower-impact Pilates or yoga (you made need to modify certain poses)
• Barre workouts (with certain modifications, like shallower knee bends)
• Water aerobics
• Rowing
• Rollerblading
• Using an elliptical trainer

Some also incorporate riding a stationary bike into chondromalacia rehab, though you’ll have to take some special precautions, like placing the seat fairly high and using low resistance settings. Normal biking can be quite stressful for the knees. If strength training is more your style, you can use a hamstring curl or leg press machine. The caveat in doing so, however, is that when doing leg presses you must be careful to not let the knees bend farther than 90 degrees. Also, it’s important not to start any patella chondromalacia exercises/therapy until pain and swelling have abated. You should also stretch and warm up before doing any chondromalacia treatment exercises. Skipping those steps increase your chances of reinjuring the knee. As you do get back to normal activity, you should work back into exercising gradually. In addition, it’s important to incorporate some variety into your workouts. Doing the same thing over and over again can lead to muscle imbalances and continually stress the same areas.

Warning: Chondromalacia Knee Exercises to Avoid

While chondromalacia exercises can be great for fixing your kneecap pain, there are also some that should be avoided because they can do more harm than good. These generally include exercises that put a lot of stress on the knee. Some examples include:

• Lunges
• Deep squats
• Leg extension machine 

Generally speaking, you should avoid sports involving a lot of running, jumping,or contact when recovering from a chondromalacia knee injury since they place high amounts of stress on the knee joints.

Some “risky” sports that could make your chondromalacia pain worse:

• Volleyball
• Soccer
• Football
• Basketball
• Racquetball
• Distance running
• Stair stepper machines