Most of us don’t think much about our joints until something feels slightly off. Maybe it’s a tight feeling when you get up, a moment of catching when you walk, or discomfort after a long day. When these sensations start happening more frequently, it’s normal to wonder why the joint still works but doesn’t feel the same. In many cases, the answer is linked to how well the cartilage in joints such as the knee or ankle is coping with daily movement.
Because cartilage helps the joint move smoothly, any loss of its normal surface can make movement feel heavier or less controlled. This often leads to stiffness, sensitivity, or an unsteady feeling during everyday tasks, and these effects tend to build up gradually rather than appearing all at once. To understand why this happens, the next section describes what cartilage is made of and how its structure supports steady joint movement.
Understanding Cartilage and Its Role in Joint Movement
Smooth and controlled movement relies on how well the joint surfaces work together. These surfaces are formed by cartilage, the tissue that allows the ends of the bones to glide and manage load during daily activity. In weight bearing joints such as the knee and ankle, this smooth layer plays a major role in maintaining comfort and stability, and gradual wear can influence how natural the joint feels over time.
In light of this, the structure of cartilage becomes important because its composition varies across the body. Because each type differs slightly, the way cartilage responds to pressure and repeated use is not the same in every joint.
Types of Cartilage
Cartilage appears in three main forms, and each serves a different purpose in the body.
Elastic Cartilage
Found in the outer ear and parts of the airway. It provides flexible support and maintains shape. It does not take part in joint movement.
Fibrocartilage
Present in structures such as the meniscus of the knee and the discs of the spine. Its dense fibres help it absorb higher pressure and support stability during heavier or faster movements. Injury here usually leads to issues like meniscus tears.
Hyaline Cartilage
Covers the ends of the bones in joints such as the knee, ankle, and hip. Because it lines the joint surface, changes in this cartilage are often the ones people feel when movement becomes less smooth.
Despite their different roles, what these three types of cartilage have in common is a limited blood supply, and this directly affects how well damaged cartilage can heal.
Why Cartilage Doesn’t Heal Easily
Cartilage is avascular, meaning it has no blood vessels, nerves, or lymphatic drainage of its own. Because of this, oxygen and nutrients cannot reach damaged areas directly. Instead, the tissue depends on synovial fluid, the joint fluid that nourishes and lubricates the surface, to deliver what it needs through slow diffusion.
Since this process is gradual, worn or irritated areas often struggle to rebuild their smooth surface, especially when the joint continues to carry weight or absorb repeated stress during daily movement. This limited ability for cartilage to repair itself explains why changes tend to develop slowly and why symptoms often become noticeable only after the tissue has been strained for some time.
How Cartilage Gets Damaged
Cartilage can be stressed in many ways, especially in weight bearing joints such as the knee or ankle. For instance, activities that place repeated load on the lower limbs, such as running on hard surfaces, long periods of standing, or sports with quick direction changes, increase pressure on the joint surface. Certain habits can also shift how the joint handles load. Favouring one leg after an injury or wearing worn out footwear can increase stress on specific areas of the cartilage.
Over time, when these stresses build up, certain parts of the cartilage surface will wear down faster than others. As this happens, the tissue loses some of its smoothness, and the joint must put in more effort to maintain steady movement. People usually begin to notice this during longer periods of use, such as after a full day on their feet. Early on, the change is easy to miss because the joint still moves well enough for most tasks.
Early Signs and Symptoms
The early signs of cartilage stress are usually mild. At first, the joint might feel slightly stiff when movement begins, or you might notice that it feels less responsive during the first few steps. Since these sensations often ease as the joint warms up, they are easy to overlook and won’t seem significant.
However, as repeated load continues, the changes become clearer. A dull ache might manifest, and some people notice mild swelling or a light clicking or popping when the joint moves. As the surface loses some smoothness, bending or straightening will feel less fluid, and certain motions can produce brief catching, where the joint hesitates for a moment before continuing. Over time, this can create a sense that the joint is not as steady as before, particularly during longer periods of activity.
Treatment Options for Cartilage Damage
When cartilage stress begins to interfere with daily activities, such as walking, bending, or climbing stairs, steps can be taken to protect the joint and support recovery. Treatment typically starts with conservative approaches and, if needed, progresses to advanced repair techniques designed to restore the cartilage and preserve joint function. The goal is to reduce stress on the joint, support healing, and maintain as much of the natural tissue as possible.
Non-Surgical Approaches
Initial management usually focuses on non-invasive strategies. These aim to reduce joint load, improve muscle strength and alignment, and ease discomfort. Examples include:
- Activity Modification - Adjusting intensity, duration, or type of movement to reduce stress
- Lifestyle Adjustments: Weight management, posture optimisation, and reducing repetitive strain
- Medication or Injections - Short-term relief with non-steroidal anti-inflammatory drugs (NSAIDs) or pain relief injections as part of a broader care plan
- Physiotherapy - Exercises to strengthen surrounding muscles, improve joint mechanics, and support alignment
- Supportive Aids - Braces, custom orthotics, or footwear modifications to distribute pressure more evenly
These measures often help stabilise the joint, relieve symptoms, and maintain function without surgical intervention.
Advanced Techniques in Repair
For joints that don’t respond sufficiently to conservative care, advanced repair techniques might be considered. These focus on restoring cartilage and preserving natural joint structure rather than replacing it. Examples include:
- Arthroscopic Cartilage Repair - minimally invasive procedures to clean and repair damaged areas
- Biologic Augmentation - regenerative therapies such as platelet-rich plasma or cell-based treatments to support the body’s natural healing process
- Combination Approaches - integrating surgical repair with biologic therapies for optimal recovery
- Scaffold-based Cartilage Restoration - using bioengineered materials to support regrowth in targeted areas
The choice of technique depends on the extent of cartilage damage, the joint involved, and patient-specific factors. These approaches provide options for long-term joint preservation while allowing patients to return to daily activities safely.
Speak to Oxford Cartilage & Sports Centre
Cartilage injuries such as those to the knee or ankle are often difficult to recognise early, particularly when the joint still moves reasonably well despite stiffness, catching, or discomfort. This is why confirming the cause before deciding on treatment is sensible, especially if symptoms return with activity or the joint feels less steady over time. In a focused consultation, Dr Francis Wong will review MRI findings together with the clinical examination and explain how the depth and location of the cartilage damage, the condition of the underlying bone, and the joint’s movement patterns fit together in the overall picture. From there, treatment discussions can outline a plan that prioritises preserving natural cartilage and supports safe recovery using evidence-based repair or regeneration options suited to the specific injury. To speak with Oxford Cartilage & Sports Centre, please contact the clinic to book an appointment.
