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Pain around and behind the kneecap is a common
problem that may occur in all age groups especially active growing
children. It has been given
many names including patellofemoral pain syndrome, runners knee, and
chondromalacia.
What
is patellofemoral pain syndrome?
The pain usually occurs in the front of the knee,
especially around and behind the kneecap (patella).
The pain may be dull, achy, or sharp and may radiate to the back
of the knee. There is often
cracking, popping or grating sensation with knee movement.
There may even be a sensation of giving out when going down
stairs. Running, jumping,
squatting, kneeling, stair climbing, or sitting with knees bent can all
provoke the pain. The knee
may also swell at times.
How
does it occur?
Patellofemoral pain syndrome can occur from overuse
of the knees in sports and activities such as running and jumping.
Trauma, body type, malalignment, thigh muscle weakness are common
factors that predispose to patellofemoral pain syndrome.
The kneecap (patella) is attached to the thigh muscles called
quadriceps. The kneecap fits
into a groove in the end of the thigh bone called the femoral condyle.
With repeated bending and straightening of the knee, you can
irritate the undersurface of the kneecap and cause pain.
Pain also may result from the way your hips, legs, knees, and
feet are aligned. The
alignment problem can be caused by having wide hips, under developed
thigh muscles, being knock-kneed, or having feet with flat arches.
What
is the treatment?
Patellofemoral pain syndrome can be a chronic
disorder, but it rarely results in severe, permanent damage to the knee.
Learning to take care of the knee with appropriate treatment over
the long run is the key.
Activity modification, avoiding painful activities
is essential in reducing the forces on the kneecap.
Activities likely to increase pain include running, jumping,
stair climbing, deep squats, high impact aerobics.
Ice should be applied to the painful areas for
10-20 minutes 3-5 times per day during the painful episode.
Anti-inflammatory medications such as ibuprofen may
help reduce pain, swelling and inflammation.
Bracing with a patella stabilizing brace may be
helpful. Custom arch
supports for overpronation may be helpful.
Exercises designed to strengthen the quadriceps,
hamstrings, and hip muscles are essential to rehabilitation of the knee.
Bicycle riding and swimming are good exercises to
rehab the knee. You may
safely return to your sport when you can jog, sprint, jump on both legs
without pain, and have full motion and strength back in the injured
knee.
If you have any questions for future articles please
email Dr. Greg Hoffman at ghoffman@usapathway.com.
For office appointments please call Dr. Hoffman at Family
Medicine Associates in Joshua, (817) 447-1151. |
