Chondromalacia patellae primarily results from disturbances in patellar tracking. These movement dysfunctions can stem from congenital or developmental misalignments of the bones. Additionally, muscle imbalances, such as weakness in the quadriceps or hamstrings, or an imbalance between the inner and outer thigh muscles, can contribute to improper patellar movement. Specific contributing factors often include excessive tightness of the iliotibial band on the outer thigh and weakness of the vastus medialis obliquus (VMO), the inner portion of the quadriceps muscle. Repetitive stress on the patella from activities like running, jumping, or skiing, as well as acute trauma to the kneecap, are also common causes of chondromalacia patellae.