Knee Cartilage Wear: What It Means and What Helps

The ends of the bones in your knee are covered with a smooth, firm layer called articular cartilage. Together with the joint fluid, it lets the joint glide with almost no friction and helps spread the load with every step. Cartilage has no blood vessels of its own, so it renews itself only very slowly.

When a doctor says your cartilage is worn, they usually mean that this layer has become thinner, rougher or uneven in places. It is one of the main signs of knee osteoarthritis, but cartilage can also be damaged after an injury, for example after a meniscus or ligament problem.

Why does cartilage wear?

• Age. Over the years, cartilage holds less water and becomes less elastic.
• Load. Extra body weight increases the pressure on the knee with every step.
• Old injuries. A torn meniscus or ligament can change how the knee moves and how the load is spread.
• Leg alignment. Bow legs or knock knees put more load on one side of the joint.
• Weak muscles. When the thigh muscles are weak, the joint itself absorbs more of the impact.
• Genes. In some people, joint wear starts earlier, and something similar is often seen in their parents.

How it feels

Many people with worn cartilage notice pain when they start moving after rest, stiffness in the morning or after sitting, a creaking or crackling sound in the knee, swelling after more activity and pain on stairs. Interestingly, what an X-ray or MRI shows does not always match how much the knee hurts. Some people with clear wear have few complaints, while others feel more pain with smaller changes.

Crackling on its own, without pain or swelling, is common and usually harmless.

What helps day to day

• Keep moving. Cartilage is nourished by the joint fluid, and movement helps that fluid circulate. Walking, cycling and swimming are good choices. You will find more ideas in our article on morning knee stiffness.
• Strengthen your muscles. Strong thigh and hip muscles take load off the joint.
• Watch your weight. Even a few kilos less can be felt on the stairs.
• Do not stay in one position for too long. Sit a little, stand a little, walk a little.
• Be smart on stairs. Our article on knee pain on stairs has practical tips.
• Wear a soft knee sleeve if it feels good to you. Gentle compression and a sense of support give many people more confidence when they are active.

Cartilage does not grow back, but symptoms can ease

In adults, cartilage renews itself only to a very small extent. Wear usually cannot be reversed with creams, supplements or devices, whatever some advertisements promise. The good news is that symptoms are not final: with regular exercise, stronger muscles and sensible load, many people have less pain and move better. For larger cartilage damage, a doctor can explain other options.

When to see a doctor

See a doctor if the knee often swells, locks or gives way, or if pain wakes you at night or keeps you from everyday activities. We list more warning signs in our article on when to take knee pain seriously.

Worn cartilage is not a reason to stop moving. It is a reason to move wisely.

A sleeve you will actually wear

The best sleeve is the one that does not end up in a drawer. The KeenTrove Bamboo Knee Sleeve is made for exactly that:

• soft, breathable bamboo, comfortable even in summer
• fits snugly but does not dig in behind the knee
• does not lock the knee, so you move naturally
• wear it under your clothes during the day and in bed at night

With 60 days to get your money back, you have nothing to lose.

See the bamboo knee sleeve →

Note: this article is for information only and does not replace an examination by a doctor. If you have circulation problems or diabetes, or have recently had knee surgery, talk to your doctor before wearing compression.