Years ago I was told I had chondromalacia of the knee. I eventually had to give up competitive sports because of it. It went away over time, but now I notice a lot of creaking sounds from that knee. Is my chondromalacia coming back?

The patella, or kneecap, can be a source of knee pain when it fails to function properly. Alignment or overuse problems of the patella can lead to wear and tear of the cartilage behind the patella. This produces pain, weakness, and swelling of the knee joint.

Several different problems can affect the patella and the groove it slides through in the knee joint. One of those problems is a condition sometimes referred to as chondromalacia. With chondromalacia, excessive wear and tear causes the underlying cartilage to degenerate.

Chondromalacia is a condition most common in young athletes. Soccer players, snowboarders, cyclists, rowers, tennis players, ballet dancers, and runners are affected most often. But anyone whose knees are under great stress is at increased risk of developing chondromalacia.

The most common symptom is pain underneath or around the edges of the patella. The pain is made worse by any activities that load the patellofemoral joint, such as running, squatting, or going up and down stairs. Kneeling is often too painful to even try. Keeping the knee bent for long periods, as in sitting in a car or movie theater, may cause pain.

The knee may grind, or you may hear a crunching sound when you squat or go up and down stairs. If there is a considerable amount of wear and tear, you may feel popping or clicking as you bend your knee. You may be experiencing a recurrence of your chondromalacia. But what started out at chondromalacia years ago may have now developed into something called patellofemoral arthritis.

Patellofemoral arthritis occurs when there is a loss of the articular cartilage on the back of the patella and/or in the femoral groove. Even without a previous history of chondromalacia, patellofemoral arthritis is a common problem in men and women 60 years old or older.

A visit to your primary care physician, orthopedic surgeon, or physical therapist might be in order. Knee problems of this type often respond well to a conservative program of exercise, orthotics (shoe inserts to help realign the leg), and activity modification. Sometimes using taping, a knee support such as a patellar support sleeve, or a brace helps maintain proper knee alignment, thus reducing knee pain.