Massage therapy · Kitchener–WaterlooOsteochondral Lesion

Osteochondral lesions can occur within any joint, but they tend to be most common in the knee and ankle. They are areas of damage to the cartilage that covers the end of a bone and to the layer of bone just underneath it (Steele et al., 2023; Chimutengwende-Gordon, Donaldson and Bentley, 2020). The damage can include cracks, loose pieces, or fluid-filled cysts in the bone under the cartilage, known as osteochondral cysts (Steele et al., 2023). An osteochondral lesion may also be known as an osteochondral defect.

Within the knee, cartilage damage can happen on the ends of the thigh bone and the shinbone. Within the ankle, these lesions often occur on the talus, which is the bone that joins the foot and the leg together.

Most osteochondral lesions follow an injury, such as an ankle sprain or a twisting injury to the knee (Steele et al., 2023). In some cases there is no clear injury.

Osteochondral Lesion Anatomy

Where two bones meet to form a joint, the ends of the bones are covered by a smooth, slippery tissue called articular cartilage. This cartilage protects the bones and helps the joint move easily (American Academy of Orthopaedic Surgeons, n.d.). Just underneath the cartilage is a layer of bone called the subchondral bone. An osteochondral lesion affects both the cartilage and this underlying bone (Steele et al., 2023). In the knee, damage to the joint cartilage can lead to osteoarthritis earlier in life (Chimutengwende-Gordon, Donaldson and Bentley, 2020).

How to Treat an Osteochondral Lesion

Treatments you may want to discuss with your family doctor or nurse practitioner

Tips

• Take some time to rest and allow the lesion the chance to heal.
• Physical therapy is useful for improving joint movement and strength.
• If you have ongoing joint pain or swelling after an injury, see your family doctor or nurse practitioner so it can be properly assessed.

An osteochondral lesion needs time and protection to settle, and your doctor or surgeon decides how much weight the joint can take and whether you need a boot, cast or surgery. I work inside those limits. If you've had surgery, I need your surgeon's okay before any hands-on treatment.

Please bring any X-ray or scan reports and notes from your medical team to your first visit. They're an important part of planning safe treatment for you.

I assess how your joints move, your strength and balance, and what brings on pain or swelling, without forcing the joint.

While It Settles

• Massage for muscles around the joint and areas working overtime, such as your shoulders if you're on crutches
• Gentle lymphatic drainage and raising the leg to help with swelling
• Comfortable movement within your limits, and strength work for the rest of the leg

Building Back Up

1. Steele, J.R. et al. (2023) 'Republication of "Osteochondral Lesions of the Talus: Current Concepts in Diagnosis and Treatment"', Foot & Ankle Orthopaedics, 8(3), p. 24730114231192961. doi: 10.1177/24730114231192961
2. Chimutengwende-Gordon, M., Donaldson, J. and Bentley, G. (2020) 'Current solutions for the treatment of chronic articular cartilage defects in the knee', EFORT Open Reviews, 5(3), pp. 156–163. doi: 10.1302/2058-5241.5.190031
3. American Academy of Orthopaedic Surgeons (OrthoInfo) (n.d.) Osteochondritis Dissecans. Available at: https://orthoinfo.aaos.org/en/diseases--conditions/osteochondritis-dissecans/ (Accessed: 7 October 2026).