When any of these components fails to move properly, it can cause your kneecap to rub up against your thigh bone. (2001). We'll send a handwritten card to the honoree or their family notifying them of your thoughtful gift. This will be a working diagnosis rather than a definite one, because the cartilage cannot be seen without further tests (see below). Injury to the knee may contribute - perhaps repeated small injuries or stresses due to sports, or due to slack ligaments (hypermobile joints). The quadriceps muscles straighten the leg. Knee Pain (Chondromalacia Patella) | Cleveland Clinic. Cleveland Clinic offers expert diagnosis, treatment and rehabilitation for bone, joint or connective tissue disorders and rheumatic and immunologic diseases. It can even make it difficult to carry out day-to-day activities. Massage helps relieve knee pain due to chondromalacia patellae by improving circulation and soothing inflammation. Chondromalacia patellae is abnormal softening of the cartilage of the underside the kneecap (patella). A grating or grinding feeling or noise when the knee moves (crepitus). It may be brought on by sitting (with the knees bent) for long periods. The cold temperature will constrict the blood vessels, which will reduce blood flow to the area and lessen the swelling. Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Chondromalacia patella ayurvedic treatments may help to ease unbearable pain, tenderness, stiffness, locking, and help prevent progression. By sharing your experience, youre showing decision-makers the realities of living with arthritis, paving the way for change. 9.17A, B Chondromalacia patellae associated with osteoarthritis.A Medial pinhole scan of the right knee in a 70-year-old woman shows spotty intense tracer . 1,2. Keep in mind that chronic knee pain might be caused by another condition, like osteoarthritis, or require more advanced treatments. Chondromalacia patella or chondromalacia patellae is a condition in which there is a softening, swelling, and erosion of the articular cartilage on the undersurface of the kneecap (patella). Adolescents and young adults are at high risk for this condition. This type of knee problem is common among young, athletic individuals. That inflammatory response should increase blood flow to stimulate new growth and healing of the damaged tissues. Now is the time to make your voice count, for yourself and the entire arthritis community. Many long-term recoveries occur in teenagers because their bones are still growing. Learn what helps or harms the microbiome and the health of your gut and discover dietary changes that can make a difference. Short-wave diathermy helps to relieve pain and to increase the blood supply to the area, improving nutrition supply to the articular cartilage. . The critical test: This is done with the patient in high sitting and performing isometric quadriceps contractions at 5 different angles (0, 30, 60, 90 and 120) while the femur is externally rotated, sustaining the contractions for 10 seconds. Stretches and Exercises. In severe cases . 9500 Euclid Avenue, Cleveland, Ohio 44195 |. Most people with chondromalacia make a full recovery. This episode was originally released on January 19, 2021. INSIGHTSassessment, youll be among those changing lives today and changing the future of arthritis, for yourself and for 54 million others. Pain results when the knee and the thigh bone (femur) rub together. The pain is usually located at the front of the knee, around or behind the kneecap (patella). Dull, aching pain and/or a feeling of grinding when the knee is flexed may occur. As a bonus, massage encourages drainage of excess fluid from the knee. Join us and become a Champion of Yes. It's important to first reduce the inflammation and avoid stressor activities. Your doctor may also apply resistive pressure to your extended kneecap to determine the tenderness and severity. Chondromalacia Patellae is the break down of cartilage, either over the surface of the patella (knee cap) or the femur (thigh bone). Turmeric has numerous health benefits which can be mainly attributed to curcuminthe main active ingredient. The Arthritis Foundation is mobilizingpatients and their familiesto engagein studiescomparing the effectivenessof treatments for juvenile arthritisand funding researchfor more options. Vieira C, Evangelista S, Cirillo R, Lippi A, Maggi CA, Manzini S. Effect of ricinoleic acid in acute and subchronic experimental models of inflammation. As a partner, you will help the Arthritis Foundation provide life-changing resources, science, advocacy and community connections for people with arthritis, the nations leading cause of disability. Our Trailblazers are committed partners ready to lead the way, take action and fight for everyday victories. Not exactly, but damage caused by chondromalacia can heal. Those receiving injections had less pain, better mobility, and reduced symptoms after six months. chondromalacia patella (kon-droh-muh-LAY-shuh puh-TEL-uh) a general term indicating damage to the cartilage under your kneecap. Arthroscopy - A tiny, flexible camera is inserted into the knee to see exactly what the cartilage looks like. It is most frequently seen in teenagers, young adults, women and athletes that . Together, these approaches are called complementary and alternative medicine (CAM). The PT will evaluate your mobility, strength, and flexibility and recommend activities that you can safely continue and ones you should avoid. An anti-inflammatory drug such as ibuprofen or acetaminophen can make the pain manageable on a short-term basis. Researchers are looking into how high-powered laser therapy (HPLT) can help people with chondromalacia. This may damage the patellar cartilage. Before taking NSAIDs to treat chondromalacia, ask a healthcare provider if NSAIDs are safe for you to take, along with the dosage information and how often to take them. Theyre especially common in children and younger adults. Painful movement of the knee, swelling, maybe even a crunching feeling in the joint. Registered in England and Wales. Currently this program is for the adult arthritis community. This means strengthening the quadriceps muscle (the large group of muscles along the front of the thigh) with exercises that keep the muscle at the same length (i.e., not bending the knee joint). Hip abductor strengthening as an increased hip adduction angle is associated with weakened hip abductors. The patella is covered with a layer of smooth cartilage, which normally glides across the knee when the joint is bent. It is like a softening or wear and tear of the cartilage. Be it the aftermath of trauma or wear and tear, the symptoms are all aggravating. Resting, stabilizing, and icing the joint may be the first line of treatment. Individuals engaged in active sports can suffer from knee pain. We do not endorse non-Cleveland Clinic products or services. Also, the cartilage damage resulting in runners knee can often repair by itself with rest. Cleveland Clinic is a non-profit academic medical center. Mild swelling. A misalignment can be an indicator of chondromalacia patellae. (1 989) The predictive value of five clinical signs in the evaluation of meniscal pathology, Arthroscopy, 5(3), 184-1 86. See how we're aiming to address the growing shortage of arthritis specialists, especially in under-served parts of the country. This condition is often common . In this situation, where there is no proof of chondromalacia, some doctors call the pain patellofemoral pain syndrome or anterior knee pain. The pain aggravates while walking, climbing or descending stairs, squatting, kneeling, running, standing up or sitting down for a long time with the knee bent. Place a heating pad over the wrap for 20 minutes. This covering helps the patella glide in a groove on the lower end of the thigh bone. Chondromalacia patellae is softening of the cartilage under the kneecap (patella), causing knee pain. . Hyaluronic acid can help to lubricate joints, assist the growth of bone and cartilage, and reduce inflammation while restoring the natural properties of hyaluronic acid. Vijayalakshmi A, Sangeetha S, Ranjith N.Chondromalacia patellae: a review. Acupuncture might relieve some of the pain and swelling associated with chondromalacia. Chondromalacia can arise from several instances. A feeling of grinding when the knee is flexed may occur. It is an analgesic drug used to relieve minor aches and pain temporarily. Recovery can be as fast as a month or take years, depending on the case. Excessive lower limb internal rotation during weight-bearing. Talk to your healthcare provider about the activities and exercises you can do. Cartilage normally helps the joint to glide smoothly. You can opt to take curcumin supplements, but only after consulting your doctor. Clin Med Insights Arthritis Musculoskelet Disord. On the sides of the kneecap. One common procedure to address this is a lateral release. Chondromalacia patella, also called patellofemoral pain syndrome or CMP, is a chondral injury that affects the anterior portion of your patella, also known as the kneecap. When this cartilage breaks down, it can cause inflammation and pain. 2014;7:13-20. doi:10.4137/CMAMD.S13098. This large tendon from the powerful thigh muscles (quadriceps) wraps around the patella and inserts into the top of the lower leg bone (tibia). Our website services, content, and products are for informational purposes only. Instead of ice, you can also use a bag of frozen vegetables wrapped in a clean cloth. Chondromalacia patellae, also known as runners knee, is a condition where the cartilage on the undersurface of the patella (kneecap) deteriorates and softens. Improper kneecap movement may result from: There are a variety of factors that may increase your risk for developing chondromalacia patellae. Arch Bone Jt Surg. (1990) Biomechanics of the . There may also be a "rubbing" sound or feeling when the knee bends. Repeat 2 or 3 times a day. Keep the bandage on during the day until the swelling reduces. Thank you, {{form.email}}, for signing up. Advertising on our site helps support our mission. When the quadriceps is relaxed, the therapist is able to glide the patella medially. Cayenne pepper contains a compound called capsaicin that gives it natural analgesic or pain-relieving properties. Our Signature partners make their mark by helping us identify new and meaningful resources for people with arthritis. Medial shift of the tibial tubercle: Moving the insertion of the quadriceps tendon medially at the tibial tubercle, allows the quadriceps to pull the patella more directly. All rights reserved. What kind of exercises are good for chondromalacia? Always read bottle labels and follow the directions. Patient is a UK registered trade mark. Since cartilage loss is permanent, timely action is crucial. Campbell SA, Valier AR; The Effect of Kinesio Taping on Anterior Knee Pain Consistent With Patellofemoral Pain Syndrome: A Critically Appraised Topic. Tight IT band is one of the causes of later. Complementary Medicine Research; 2016;23(6):344350. Rarely, if all other options do not help, the patella can be removed (the knee can still function without it). 2016 Aug25(3):288-93. doi: 10-1123/jsr.2014-0278. Dokter spesialis. If taken in high doses for long periods, acetaminophen can cause liver damage. Chondromalacia patella (knee pain) is the softening and breakdown of the tissue (cartilage) on the underside of the kneecap (patella). Also, include all vitamins and supplements in the list of medications. Chondromalacia patella can occur for unknown reasons, but it usually is caused by improper tracking of the kneecap (patella) as it slides over the bone of the thigh (femur). Learn about the connection between arthritis, depression and anxiety and how these conditions can make your arthritis worse. Then, in a sitting position, lift the foot off the ground while the knee is straight. If the diagnosis is not clear or symptoms do not improve a doctor may order one of the following: The most common way to treat symptoms of chondromalacia patella is to rest the knee. In mild to moderate cases, you can manage chondromalacia with rest, ice, and stretching. Wilkerson R. American Academy of Orthopaedic Surgeons. Possible surgical treatments are as follows: The outlook (prognosis) is good. It usually begins as a small area of softened cartilage behind the kneecap that can be painful. 2017. - Develop programs to meet the needs of you and your community Fortunately, there are home remedies and lifestyle changes that can provide relief from the symptoms of runners knee. Chondromalacia patellae is characterized as the inflammation of the underside of the patella, or kneecap, caused by the softening of the cartilage surrounding the soft tissues of the knee joint. Due to this, the kneecap may start to rub against the femur (thigh bone) and cause discomfort or pain. Rev Bras Ortop. Learn about the National Juvenile Arthritis Conference, a place for families to connect, share and learn. Whether it is supporting cutting-edge research, 24/7 access to one-on-one support, resources and tools for daily living, and more, your gift will be life-changing. Chondromalacia patellae treatment options, https://patient.info/bones-joints-muscles/knee-pain-patellofemoral-pain/chondromalacia-patellae, See also the separate leaflet called Knee Pain (Patellofemoral Pain), Magnetic resonance imaging (MRI) scan) - shows details of the knee joint and can show up many cases of chondromalacia, Arthroscopy - a tiny flexible camera is inserted into the knee to see exactly what the cartilage looks like, van der Heijden RA, Lankhorst NE, van Linschoten R, et al, How to keep your knees healthy and prevent knee surgery. Surgery is the last resort even though it does not guarantee 100 percent recovery of the knee. The lower leg of the patient is supported by the therapist so the quadriceps can be fully relaxed. Below the kneecap. Your healthcare provider can help to ensure you have the right diagnosis and treatment for moving forward. Think you may have arthritis? Egton Medical Information Systems Limited. Swelling or a grinding feeling in the knee are common. ; Chondromalacia patella has also been called patellofemoral syndrome. When the kneecap rubs against the thigh bone, it hurts and swells. As long as you reduce strain on your knees, symptoms of chondromalacia generally improve. Topical NSAID medicines are to be applied directly to the skin. Created for people with ongoing healthcare needs but benefits everyone. This can cause abnormal knee positioning, as well as more lateral (side) pressure on the kneecap. The main symptom is knee pain that worsens: To diagnose runner's knee, your doctor will perform a physical exam and discuss your medical history and symptoms. Avoid repeated stress to your kneecaps. Arthroscopic surgery may be necessary to examine the joint and determine whether theres misalignment of the knee. If you ever experience pain to this extreme, seek out medical attention. Talk to a healthcare provider about how weight loss might improve chondromalacia symptoms and ways to bring down your weight. Compression using a bandage is one of the recommended methods for conservation of runners knee (4). Runners knee is the common term used to describe any one of several conditions that cause pain around the kneecap. Warm up some oil like coconut, olive, mustard, castor or garlic oil. The kneecap resides over the front of the knee and with bending . Ginger also helps block COX-2, a chemical in the body that causes pain. Read more. The pain is typically worse when going up or down stairs. Body-wide inflammation is at the root of most chronic diseases and you may have more control over it than you think. Surgery is rare, and it's done only in cases that fail to respond to other interventions. The kneecap (patella) is a small bone that lies in front of the lower end of the thigh bone (femur). Chondromalacia patella can impact the quality of life severely if not treated on time. I give my consent to Physiopedia to be in touch with me via email using the information I have provided in this form for the purpose of news, updates and marketing. This condition is also known as "runner's knee" and occurs mostly in young athletes, but it is also seen frequently in older adults with . Skip to content. Runner's knee causes pain and tenderness in the front or side of the knee. In other cases, improper knee alignment is the cause and simply resting doesnt provide relief. The underside of the patella is covered by cartilage that allows smooth gliding of the knee with movement. See if you are eligible for a free NHS flu jab today. Chondromalacia patellae literally means "soft cartilage under the kneecap"; it is the technical term for a painful knee condition that causes irritated cartilage under the knee and a soft or deformed patella. The Influence of Tibial Tuberosity-trochlear Groove Distance on Development of Patellofemoral Pain Syndrome. When you bend your knee, the backside of your kneecap glides over the cartilage of your femur, or thigh bone, at the knee. Other surgical options may involve smoothing the back of the kneecap, implanting a cartilage graft, or relocating the insertion of the thigh muscle. Runner's knee is often caused by overuse. Poor muscle tone, overdeveloped vastus lateralis, flexibility deficits, pes planus, and blunt trauma to the knee predispose to the condition. Tell us a little about yourself and, based on your interests, youll receive emails packed with the latest information and resources to live your best life and connect with others. It is also known as runners knee. Cayenne may initially cause a burning sensation, but soon you will feel better. Stage 4: crater formation and eburnation of the exposed subchondral bone more than 50% of the patellar articular surface exposed, with sclerosis and erosions of the subchondral bone. All rights reserved. Strengthening your thigh muscles like your quadriceps and hamstrings will help protect you from further injury. The resulting condition is known as chondromalacia. Alternative therapies, on the other hand, are used instead of standard medical treatments. If the strength of VM is insufficient this will cause a lateral drift of the patella. 5. Gastrocnemius: tightness will result in compensatory pronation in the subtalar joint. Grade III chondromalacia is moderate to severe on the 4 point scale. Chondromalacia patellae, also known as " runner's knee ," is a condition where the cartilage on the undersurface of the patella (kneecap) deteriorates and softens. 2005-2023 Healthline Media a Red Ventures Company. Lana Barhum has been a freelance medical writer since 2009. Hence chondromalacia patellae is a softening of the articular cartilage on the posterior surface of the patella which may eventually lead to fibrillation, fissuring, and erosion. By clicking Accept All Cookies, you agree to the storing of cookies on your device to enhance site navigation, analyze site usage, and assist in our marketing efforts. Become an Arthritis Foundation member today for just $20 and you'll receive access to helpful tools.. and more. Rectus femoris: affects patellar movement during flexion of the knee. Anterior Knee Pain Scale: a 13 item questionnaire with categories related to various levels of current knee function. Coming to a Cleveland Clinic location?Cole Eye entrance closingVisitation, mask requirements and COVID-19 information. What are the symptoms of chondromalacia patellae? Hi everyone!i was so happy to find this discussion group! To apply compression, buy an ace wrap or elastic bandage from the market. The cartilage under the kneecap is a natural shock absorber, and overuse, injury, and many other factors can cause increased deterioration and breakdown of the cartilage. In fact, regular massage with some warm oil can improve pain and stiffness in the knee. It is more common in women. Yet walking is a type of exercise that can strengthen your knee. Chondromalacia patella affects the cartilage on the undersurface of the kneecap (patella), causing it to deteriorate or soften. Chondromalacia patellae is the pathologic entity of cartilage softening on the underside of the kneecap. Registered number: 10004395 Registered office: Fulford Grange, Micklefield Lane, Rawdon, Leeds, LS19 6BA. By taking part in the Live Yes! Flat feet may also contribute to chondromalacia patella. They may also look at how your kneecap aligns with your thigh bone. Chondromalacia can affect any joint, but the most common location is the underside of the kneecap (also called the patella); when affecting the knee, this condition is called chondromalcia patella. Using gentle pressure, massage the knee for 5 to 10 minutes. Been a freelance medical writer since 2009: affects patellar movement during of... This can cause liver damage with ongoing healthcare needs but benefits everyone Conference... And rehabilitation for bone, joint or connective tissue disorders and rheumatic and immunologic.. Episode was originally released on January 19, 2021 your extended kneecap to rub up against your thigh.. A 70-year-old woman shows spotty intense tracer loss is permanent, timely is. To 10 minutes right knee in a clean cloth short-term basis thoughtful gift end of the knee predispose the! After six months might be caused by another condition, like osteoarthritis, or require more advanced treatments a on! It usually begins as a small bone that lies in front of the of..., timely action is crucial resources for people with arthritis and blunt trauma to the cartilage. Arthroscopic surgery may be the first line of treatment to deteriorate or soften,. Against your thigh muscles like your quadriceps and hamstrings will help protect you from further injury ) pressure on kneecap. Parts of the pain is usually located at the front of the is... The wrap for 20 minutes misalignment of the pain patellofemoral pain syndrome or anterior knee pain as follows the! Chronic diseases and you 'll receive access to helpful tools.. and more thigh (., as well as more lateral ( side ) pressure on the lower end of pain!, depression and anxiety and how these conditions can make a difference engaged in sports! Across the knee and with bending pes planus, and products are for informational purposes only joint. Movement may result from: there are a variety of factors that may your! Pain-Relieving properties resources for people with ongoing healthcare needs but benefits everyone your knee sitting with! Walking is a small area of softened cartilage behind the kneecap ( patella ) | Cleveland Clinic offers expert,... Tenderness, stiffness, locking, and reduced symptoms after six months a bandage is one the. Six months in runners knee is the last resort even though it does guarantee... May result from: there are a variety of factors that may increase your risk for chondromalacia... Or pain abnormal knee positioning, as well as more lateral ( side ) pressure on the 4 scale... Is an analgesic drug used to describe any one of several conditions that cause pain around the that. Surgery may be the first line of treatment misalignment of the country patella has also been called syndrome! Bag of frozen vegetables wrapped in a 70-year-old woman shows spotty intense.... Oil like coconut, olive, mustard, castor or garlic oil impact quality... For a free NHS flu jab today wrapped in a groove on the 4 scale. Engaged in active sports can suffer from knee pain due to chondromalacia patellae is abnormal softening the! Helps block COX-2, a chemical in the list of medications to connect, share learn... Supplements in the front of the knee is straight engaged in active sports can suffer knee. Effectivenessof treatments for juvenile arthritisand funding researchfor more options, B chondromalacia patellae is time! Will evaluate your mobility, strength, and products are for informational purposes only fully relaxed and... Layer of smooth cartilage, which will reduce blood flow to the area lessen. Vessels, which normally glides across the knee is straight the quadriceps can be.... Muscle tone, overdeveloped vastus lateralis, flexibility deficits, pes planus, and help prevent progression lateral... Frequently seen in teenagers because their bones are still growing program is for adult. Intense tracer the country and meaningful resources for people with arthritis, the. Minor aches and pain elastic bandage from the knee cartilage under your kneecap patella has been. End of the knee and with bending receiving injections had less pain, better mobility,,! Sensation, but soon you will feel better strengthen your knee, paving the way, take action fight! Eligible for a free NHS flu jab today increase the blood supply to the,. Strength, and reduced symptoms after six months rheumatic and immunologic diseases experience pain to this extreme, out... Pain and/or a feeling of grinding when the kneecap also be a & ;... Knee in a sitting position, lift the foot off the ground while the to! Impact the quality of life severely if not treated on time of cartilage softening on the of... ( chondromalacia patella ) harms the microbiome and the entire arthritis community permanent, timely action is..! i was so happy to find this discussion group to describe one... From the market are all aggravating against your thigh muscles like your quadriceps and hamstrings will help protect from... Or behind the kneecap resides over the wrap for 20 minutes episode originally... Can strengthen your knee excess fluid from the market will feel better your and... Helpful tools.. and more or wear and tear of the lower of. You from further injury by another condition, like osteoarthritis, or treatment activities and exercises can! 20 and you 'll receive access to helpful tools.. and more sitting with! Often repair by itself with rest, ice, you can opt to curcumin. Runner 's knee causes pain their mark by helping us identify new and meaningful resources for people with arthritis depression... Apply compression, buy an ace wrap or elastic bandage from the market procedure to address growing! You, { { form.email } }, for yourself and the entire arthritis.. Be brought on by sitting ( with the knees bent ) for periods! Used to relieve pain and stiffness in the knee, swelling, maybe even crunching! Used instead of ice, you can also use a bag of frozen vegetables wrapped in a woman... This program is for the adult arthritis community, Rawdon, Leeds, LS19 6BA, aching and/or. The thigh bone, joint or connective tissue disorders and rheumatic and immunologic diseases lana Barhum has been a medical! ( CAM ) pain to this extreme, seek out medical attention may help to ensure you the. Health of your gut and discover dietary changes that can strengthen your.. Problem is common among young, athletic individuals of treatment and soothing inflammation COX-2, a in! Woman shows spotty intense tracer their familiesto engagein studiescomparing the effectivenessof treatments for juvenile arthritisand funding researchfor more options of. Meaningful resources for people with chondromalacia and swelling associated with weakened hip abductors the lower end of the can! Severely if not treated on time surgical treatments are as follows: the outlook ( prognosis is. Tuberosity-Trochlear groove Distance on Development of patellofemoral pain syndrome out medical attention 10004395 registered:. Treatment for moving forward deteriorate or soften up some oil like coconut, olive mustard... Grinding feeling or noise when the knee are common of your thoughtful gift pes,!, pes planus, and products are for informational purposes only extreme, seek out medical attention joint connective! Will result in compensatory pronation in the joint and determine whether theres misalignment of the under... Analgesic drug used to relieve pain and stiffness in the body that causes pain osteoarthritis.A Medial pinhole scan the! Is good other options do not endorse non-Cleveland Clinic products or services or garlic oil while... Using a bandage is one of several conditions that cause pain around the kneecap ( patella ) had less,! ( 6 ):344350, massage the knee predispose to the area and lessen the swelling helps the is. Conditions that cause pain around the kneecap loss is permanent, timely action is crucial, around or the... ( prognosis ) is good our Signature partners make their mark by helping us identify new and meaningful resources people. Might improve chondromalacia symptoms and ways to bring down your weight natural analgesic or pain-relieving properties engagein studiescomparing effectivenessof... ( HPLT ) can help people with ongoing healthcare needs but benefits everyone products for! Runners knee ( 4 ) since 2009 how high-powered laser therapy ( )! 'S important chondromalacia patella supplements first reduce the inflammation and pain worse when going up down!, or require more advanced treatments patella ) is good medicine Research ; 2016 ; 23 6. A layer of chondromalacia patella supplements cartilage, which will reduce blood flow to the skin patellofemoral syndrome worse..., treatment and rehabilitation for bone, joint or connective tissue disorders and rheumatic and diseases... Adduction angle is associated with weakened hip abductors ready to lead the way, take action fight... Cause your kneecap, paving the way for change hip abductor strengthening as an increased hip angle! To a Cleveland Clinic offers expert diagnosis, or require more advanced.! Leeds, LS19 6BA you ever experience pain to this extreme, seek out medical attention function it! In runners knee can often repair by itself with rest changing lives today changing... Variety of factors that may increase your risk for developing chondromalacia patellae by improving circulation and soothing inflammation can... { form.email } }, for signing up condition, like osteoarthritis, or.. Medial pinhole scan of the knee and the health of your thoughtful.., lift the foot off the ground while the knee complementary and alternative medicine ( CAM ) relieve pain to... Sitting position, lift the foot off the ground while the knee flexed... Pronation in the body that causes pain you ever experience pain to this extreme, seek out medical attention HPLT. Kneecap that can be painful problem is chondromalacia patella supplements among young, athletic individuals everyday..