Cartilage Damage: What It Is, And What You Can to Protect Your Cartilage
It’s easy to take cartilage for granted, until a knee starts swelling, catching, or aching after activity. In the UK, it’s estimated that around 10,000 people each year have knee cartilage damage serious enough to need specialist treatment. If you (or someone close to you) is dealing with cartilage-related pain, here’s what to know about symptoms and treatment options as well as the practical factors that may help reduce risk.
Related: ROH leads the way with innovative knee therapy
A Quick Overview of Cartilage
Cartilage is a tough and flexible connective tissue found in different parts of our body. It covers the end surfaces of our bones where two bones meet, acting as a cushion between the bones in our joints. Any kind of movement or activities like jumping puts pressure on our bones and joints. Cartilage absorbs this pressure and reduces stress on our bones.
Cartilage is a smooth white covering, lubricated with synovial fluid , allowing the bones to glide over each other and preventing bones from rubbing against each other when we move our joints. That way, it helps reduce wear and tear on the joints.
Cartilage is also a major tissue found in our ears, nose, and windpipe.
Composition of Cartilage
The main constituents of cartilage are:
Chondrocytes
These cells form the cartilage, collagen, and ground substance called the cartilage extracellular matrix (ECM).
Extracellular Matrix (ECM)
ECM, as the name suggests, is a three dimensional network of substances that lies outside the cells (chondrocytes in this case). It provides structural and functional support to the nearby cells.
Cartilage ECM is a dynamic structure that plays a crucial role in maintaining cartilage health and function. The major components of cartilage ECM are type II collagen, aggrecan, hyaluronic acid (HA), and chondroitin sulfate (CS).
About 60% of the dry weight of the cartilage is collagen. Likewise, type II collagen makes up over 90% of the total collagen in ECM. (1)
Cartilage Damage: Causes, Symptoms, and Treatment
Cartilage damage is a common injury that often involves the knees. According to the NHS, nearly 10,000 people in the UK have serious knee cartilage damage that requires treatment. (2)
Cartilage lacks blood supply. So, once damaged, healing takes longer compared to that for other tissues with a blood supply.
Causes of Cartilage Damage
Any of the following may cause cartilage damage.
Direct impact
A heavy impact on our joints can result in cartilage damage. For example, cartilage damage is more common among people who participate in high-impact sports like football, rugby, and hockey.
Wear and tear
Cartilage damage can also occur in joints that undergo prolonged periods of physical stress. Osteoarthritis is a common joint problem that involves inflammation, breakdown, and gradual loss of cartilage.
Lack of movement
For our joints to remain healthy and functional, they need to move regularly. Prolonged periods of inactivity or immobility can increase the risk of cartilage damage.
Symptoms of cartilage damage
Individuals with damage to the cartilage in a joint (also known as articular cartilage damage) may experience:
Inflammation
The affected area swells and feels warmer than other body parts of the body. Besides, it becomes tender, stiff, and painful.
Limited range of motion
Due to progressive cartilage damage, the affected limb doesn’t move as freely and comfortably as it used to.
Our knees are more likely to sustain articular cartilage damage than other joints. However, cartilage damage can also occur in the elbow, wrist, ankle, shoulder, and hip joint.
In some cases, cartilage damage can be associated with mechanical symptoms (like catching or locking). If there is bleeding into the joint (haemarthrosis), it is usually linked to a significant injury. (3)
Treatment of Cartilage Damage
Non-surgical treatments include physiotherapy (specialized exercises), pain medications (non-steroidal anti-inflammatory drugs; NSAIDs), and sometimes steroid injections.
Surgery may be an option for those who don’t respond to non-surgical treatments. It can include procedures to:
- Remove chipped pieces of cartilage
- Trigger the production of new cartilage
- Replace damaged cartilage with a healthy one
What Does Aging Do to Cartilage?
With aging, the cartilage becomes thinner, less resilient, and less able to repair. Moreover, increased age is closely linked to increased inflammation and loss of water content. All these factors can increase the risk of osteoarthritis (OA).
How Does Cartilage Damage Cause Joint Pain?
People with significant cartilage damage often experience gradual pain that can worsen over time. As cartilage lacks a direct nerve supply, pain doesn’t usually come from the cartilage surface itself.
During movement, the joints send pain signals to sensory nerves, which the brain interprets as pain. The pain signals are often amplified, resulting in an increased pain perception. (3)
Emerging evidence suggests that synovial inflammation may contribute to pain by oversensitising local neurons or overstimulating the body’s pain processing process.
What Is the Importance of Strength in the Leg Muscles (Quadriceps) for Stability and Reducing Pressure on the Cartilage?
Having stronger legs may help protect against knee osteoarthritis. Studies show a link between stronger leg muscles and delay of disease progression in people with knee osteoarthritis.
Greater quadriceps strength can help protect against cartilage loss in certain regions of the knee joint. Likewise, people with knee osteoarthritis who have stronger legs tend to have less knee pain and better physical function. (4)
In fact, the American College of Rheumatology and Osteoarthritis Research Society International strongly recommends quadriceps strength training as the primary treatment for people with knee osteoarthritis. (5)
The Osteoarthritis Research Society International guidelines also recommend strength training as the core treatment for the nonsurgical management of knee osteoarthritis. Other treatments in the guidelines include:
- Education about osteoarthritis
- Topical pain medications (for people with digestive issues, they recommend using specific pain medications with agents that reduce stomach acid production called proton pump inhibitors)
- Water exercises
- Injection of drugs like steroids and hyaluronic acid (HA) into a joint
According to a 2025 review, exercises like straight leg raises and terminal knee extensions for 8 to 12 weeks can significantly reduce pain and improve function in knee osteoarthritis. (6)
Click here for more info about NHS-recommended knee exercises.
In a 2025 study, researchers found a positive link between decreased quadriceps strength and cartilage loss/meniscus degeneration, indicating a protective role of strong legs for knee function. (7)
That said, the exact mechanism through which quadriceps help delay disease development is largely unknown. Researchers believe that quadriceps, by acting as a shock absorber and knee stabiliser, help to distribute extra loads on the knee.
Cartilage Damage is A Feature of Osteoarthritis (OA). Does OA Involve Inflammation?
Osteoarthritis, once considered a disease of cartilage “wear and tear”, is increasingly being recognised as an inflammatory disease. (8,9). It means osteoarthritis involves both joint and systemic inflammation.
Further Reading: Chronic Inflammation Is Widespread In the UK. Here’s What You Can Do to Keep It At Bay
The shift from a “simple mechanical disease” to a ‘complex inflammatory disease” has redefined OA as a condition with several involved tissues (not just cartilage). It has also widened the scope of the risk factors.
Related: Osteoarthritis of the Ankle and Foot: Overview, Management and Treatment
These days, osteoarthritis is thought to affect several tissues, including bone, muscle, menisci, ligaments, and synovium.
Likewise, risk factors now include:
- Genetics
- Gender
- Metabolic syndrome
- Injury
- Systemic inflammation
What Happens During Joint Disease Like Osteoarthritis?
A gradual breakdown of cartilage is the primary feature of joint diseases, such as osteoarthritis. However, there’s a complex interplay between several factors that contribute to cartilage degeneration. These include: (10)
Mechanical load
Mechanical load refers to the force experienced by cartilage during movement or other activities. In an otherwise healthy joint, cartilage distributes the force, without compromising the joint function.
However, when we have joint disease, the damaged cartilage cannot function as efficiently. In such cases, even a seemingly mild force may cause microdamages, cracks, and fissures in the cartilage.
This trauma triggers the chondrocytes to release inflammatory substances and matrix-degrading enzymes, which accelerate cartilage degradation. Over time, cartilage becomes thin and fails to handle mechanical force. Consequently, we experience more intense joint pain and limited mobility.
How Can A Supplement Like Cartonica Help Support Cartilage Health and Relieve Pain?
Cartonica is a professional liquid joint supplement with evidence-backed ingredients like type II collagen, glucosamine, chondroitin, and vitamin D. This unique blend of nutrients supports cartilage formation and cartilage repair, which helps ease pain and make your daily activities more comfortable.
Click here to learn more about the science-backed benefits of each ingredient in Cartonica.
Frequently Asked Questions
- What are the best ways to reduce pain from cartilage when surgery becomes necessary?
To relieve pain while waiting for surgery, consider taking pain medications, get enough rest, eat a balanced diet, drink plenty of fluid, get enough sleep, and try a low-impact activity like swimming or chair yoga.
- Meniscus tear vs. cartilage damage: Is there a difference?
Meniscus is the cartilage lying between the thighbone and shinbone in the knee. A torn meniscus can occur when the knees are twisted. Aging, arthritis, and sports-related injuries are the most common contributors to a meniscus tear.
- Can damaged cartilage be repaired?
Surgical procedures can help repair and restore the damaged tissue. The best outcomes are often observed in individuals below 40 who have minor cartilage injuries.
- What vitamin helps regrow cartilage?
Vitamin D may help cartilage regeneration in individuals with osteoarthritis. However, the exact mechanism is largely unclear. Some studies suggest a link between vitamin D deficiency and a higher risk of osteoarthritis, but this finding is debatable.
- What are the 3 worst foods for joint pain?
The worst foods for joint pain include:
- Processed and fried foods
- Trans fats
- Refined carbs
Key Takeaways
Cartilage damage is common but not inevitable. The secret (or not so secret) to healthy cartilage comes down to simple, practical tips like keeping your muscles strong, staying mobile and drinking enough fluid.
A nutrient-packed joint supplement like Cartonica can also help to support joint health, particularly as we get older.
References:
- Akkiraju, H.; Nohe, A. Role of Chondrocytes in Cartilage Formation, Progression of Osteoarthritis and Cartilage Regeneration. J. Dev. Biol. 2015, 3, 177-192. https://doi.org/10.3390/jdb3040177
- Yootheme. “ROH Leads the Way With Innovative Knee Therapy.” Royal Orthopaedic Hospital, roh.nhs.uk/news-events/roh-leads-the-way-with-innovative-knee-therapy.
- Pettit, Taylor, et al. “Cartilage Damage: A Review of Surgical Repair Options and Outcomes.” Physical Medicine and Rehabilitation Research, vol. 2, no. 3, Jan. 2017, doi:10.15761/pmrr.1000147.
- Amin, Shreyasee et al. “Quadriceps strength and the risk of cartilage loss and symptom progression in knee osteoarthritis.” Arthritis and rheumatism vol. 60,1 (2009): 189-98. doi:10.1002/art.24182
- Gong, Ze et al. “Quadriceps strength is negatively associated with knee joint structural abnormalities-data from osteoarthritis initiative.” BMC musculoskeletal disorders vol. 23,1 784. 17 Aug. 2022, doi:10.1186/s12891-022-05635-9
- Hegde, Disha D., et al. “Effectiveness of Quadriceps Strength Training in Adults With Knee Osteoarthritis: A Systematized Review.” Musculoskeletal Care, vol. 23, no. 2, June 2025, p. e70134, doi:10.1002/msc.70134.
- Zhang, Hui MD; Shuai, Tao MD; Wang, Junqing EMD; Li, Kang PhD; Nie, Yong PhD. Relationship Between 2 Years of Muscle Strength Decrease and Volume Loss of Menisci and Cartilage According to Knee Pain in Mild and Moderate Knee Osteoarthritis. American Journal of Physical Medicine & Rehabilitation 104(1):p 1-7, January 2025. | DOI: 10.1097/PHM.0000000000002507
- de Rezende, Márcia Uchôa, and Gustavo Constantino de Campos. “Is osteoarthritis a mechanical or inflammatory disease?.” Revista brasileira de ortopedia vol. 48,6 471-474. 17 Dec. 2013, doi:10.1016/j.rboe.2013.12.002
- Van Den Bosch, Martijn H. J., et al. “Inflammation in Osteoarthritis: Our View on Its Presence and Involvement in Disease Development Over the Years.” Osteoarthritis and Cartilage, vol. 32, no. 4, Dec. 2023, pp. 355–64, doi:10.1016/j.joca.2023.12.005.
- Rehman, Saif Ur, et al. “Cartilage: Structure, Function, and the Pathogenesis of Osteoarthritis.” IntechOpen eBooks, 2024, doi:10.5772/intechopen.1003264.
