Is a degenerative change in the cartilage that lines the back of the patella (kneecap), causing pain in the front of the knee, especially during movements such as climbing stairs, squatting, or sitting for long periods.
It is a common condition in young athletes, particularly in sports involving running, jumping, or rapid changes of direction – such as soccer, handball, or beach soccer.

Causes and Risk Factors
• Muscle imbalances (mainly between quadriceps and glutes);

• Incorrect patellar alignment (patellofemoral syndrome);

• Patellar hyperpressure (excessive compression of the joint);

• Overload or overtraining;

• Postural or biomechanical changes (e.g., flat feet, valgus knees);

• Direct trauma to the joint.

Symptoms
• Pain in the front of the knee (when climbing stairs, running, squatting);

• Sensation of "locking" or popping in the knee;

• Discomfort when sitting for long periods (movie theater sign);

• Instability or weakness in the joint.

Diagnosis
• Clinical evaluation by an orthopedist or specialized physiotherapist;

• Functional tests (e.g., patellar compression test);

• Imaging exams, such as magnetic resonance imaging, to evaluate the cartilage.

Treatment
Conservative (in most cases):

• Physiotherapy focusing on:
o Strengthening of the core muscles, gluteus medius, and vastus medialis oblique;

o Stretching of the anterior and posterior muscle chains;

o Stabilization of the patella and correction of movement mechanics;

• Application of ice after training;

• Reduction or adaptation of the training load.

Surgical (in more severe cases):

• Indicated when there are extensive cartilage lesions or failure of conservative treatment.

Prevention and Care in Training
• Strengthening of the stabilizing muscles of the knee and hip;

• Postural correction and correction of running and jumping technique;

• Avoid unstable surfaces or excessively repetitive training;

• Perform a complete and progressive warm-up;

• Include exercises for balance, motor control, and joint mobility.

Training Adaptation (e.g., Soccer or Gym)
Avoid exercises with too much load on the knee at tighter angles in the initial phases. Suggestions:
• Step-up with light load;

• Straight leg raise in supine position;

• Plank with alternating leg raises;

• Glute bridge (hip thrust);

• Partial squat with elastic band for alignment control.

With positive progress, progressively introduce running, plyometric jumps, and technical ball movements.

Conclusion
Patellar chondromalacia is a common condition among young athletes, but with a high recovery rate when treated correctly. The focus should be on muscle strengthening, motor control, and optimization of functional movement. Early and well-guided intervention allows for a safe return to sport, with a lower risk of relapse.

Tiago Sousa