Why your knee hurts when kneeling or going downstairs?

Chondromalacia Patellae — Why Your Knee Hurts When Kneeling or Going Downstairs

Overview:Chondromalacia patellae (patellofemoral cartilage softening) is a common cause of front knee hurts during activities that load the kneecap — such as kneeling, squatting, or descending stairs.

It occurs when the cartilage beneath the kneecap becomes irritated due to poor patellar tracking, muscle imbalance, or overuse.

Typical Symptoms

• Sharp or aching pain at the front of the knee when kneeling or walking downstairs

• Grinding or clicking sensation behind the kneecap

• Stiffness after sitting for long periods (“movie-goer’s knee”)

Evidence-Based Management

1️⃣ Quadriceps & Hip Strengthening — the gold-standard approach for reducing pain and improving patellar tracking.

2️⃣ Patellar Mobilization — gentle manual gliding helps reduce compression and improve movement.

3️⃣ Activity Modification — avoid deep knee bending and high-impact stairs until symptoms ease.

4️⃣ Stretching & Towel-between-knees Exercise — restores motion without overloading the joint.

When to See a Specialist

• Persistent pain over 2–3 weeks

• Knee swelling or locking

• History of trauma or surgery

References (Recent & Reliable)

• Crossley KM et al. (2022), British Journal of Sports Medicine: “Best practice guide for patellofemoral pain.”

• Barton CJ et al. (2019), J Orthop Sports Phys Ther: Strengthening of knee and hip improves outcomes.

• StatPearls (2023): Chondromalacia Patellae overview.

• Bizzini M et al. (2018), Sports Health: Manual therapy as adjunct to exercise enhances short-term relief.