Patellofemoral Pain
Patellofemoral pain, commonly known as "runner's knee," refers to pain that originates at the front of the knee and may radiate around the kneecap (patella). This condition is prevalent among women and young adults, particularly those who engage in sports activities, although it can also affect non-athletes.
What are the causes of Patellofemoral Pain?
The exact cause of patellofemoral pain remains unclear, but it is believed to result from irritation between the patella (kneecap) and femur (thigh bone).
Some contributing factors include:
Overuse
Repetitive bending motions such as climbing stairs, running, jumping, kneeling, or squat exercises can lead to patellofemoral pain.
Muscle imbalances or weaknesses
When the muscles around the hip and knee fail to keep the kneecap properly aligned, it can contribute to the development of patellofemoral pain.
Injury
Trauma to the kneecap, such as dislocation or fracture, has been associated with patellofemoral pain syndrome.
Surgery
Certain knee surgeries, particularly those involving the anterior cruciate ligament (ACL) repair using the patellar tendon as a graft, can increase the risk of developing patellofemoral pain.
What you need to know:
Patellofemoral pain syndrome is more common in women, possibly due to wider pelvises that increase the angle at which the bones in the knee joint meet. Sports activities involving running and jumping place additional stress on the knees, making athletes more susceptible to this condition. The pain associated with patellofemoral pain syndrome often worsens during activities such as running, walking up or down stairs, prolonged sitting with a bent knee, kneeling, or squatting.
Symptoms
Signs and symptoms of patellofemoral pain may include:
- Localised pain behind the kneecap.
- Vague, aching pain around the kneecap.
- Tenderness when touching the kneecap.
- Cracking or popping sounds when standing or climbing stairs (without pain).
- Feelings of weakness or instability in the knee.
The presence of these symptoms does not necessarily indicate patellofemoral pain syndrome, and it is recommended to consult a healthcare provider for proper diagnosis and advice.
Diagnosis & Treatment
A prompt and accurate diagnosis is crucial for effective management of patellofemoral pain. Diagnosis typically involves a physical examination conducted by a general practitioner (GP) or specialist. X-rays may be ordered to rule out underlying bone damage or accompanying injuries, while an MRI may be used to assess the ligaments, soft tissues, and alignment of the knee.
Most cases of patellofemoral pain can be managed without surgery. Treatment aims to reduce pain and restore normal motion and strength. The following treatment options may be recommended:
- Rest and activity modification: Reducing the load on the affected knee, such as through decreased activity, can aid in healing.
- Over-the-counter pain medication: Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may help alleviate pain.
- Physical therapy: Strengthening exercises for the muscles surrounding the knee can enhance stability and prevent future occurrences.
- Orthotics: Customised shoe inserts (orthotics) can assist in improving alignment and reducing stress on the knee joint.
- Taping or bracing: Kneecap taping or bracing techniques can provide support and relieve pressure during physical activity.
- Surgical intervention: In rare cases where conservative treatments fail, surgical options such as knee arthroscopy or debridement may be considered. These surgical procedures involve the removal of damaged tissue or debris from the knee joint to alleviate symptoms and promote healing.
It’s important to note that surgical intervention is typically reserved for cases where conservative treatments have not been effective. The decision to pursue surgery will depend on the individual's specific condition and the recommendation of a healthcare professional.
Prevention
While patellofemoral pain cannot always be prevented, certain measures may help reduce the risk of developing this condition or experiencing recurring episodes:
- Strengthening exercises: Building strength in the leg and hip muscles can help maintain proper knee alignment during activities. It is advisable to avoid deep squatting during weight training.
- Safe movement techniques: Consult a physical therapist to learn correct jumping, running, and turning techniques. Focus on strengthening the outer hip muscles to prevent inward knee collapsing during activities like squatting, landing from a jump, or stepping down from a step.
- Weight management: Maintaining a healthy weight can reduce stress on the knees. If overweight, losing excess pounds can alleviate pressure on the knee joint.
- Proper warm-up: Before engaging in exercise or running, perform a five-minute warm-up routine involving light activity to prepare the muscles and joints.
- Stretching: Incorporate gentle stretching exercises to improve flexibility and reduce the risk of muscle imbalances.
- Gradual progression: Avoid sudden increases in the intensity or duration of workouts. Gradually increase the intensity and duration of activities to allow the body to adapt.
- Appropriate footwear: Wear properly fitting shoes that are designed for the specific activity being performed. This ensures adequate support and cushioning for the knees.
Remember, if you are experiencing knee pain or have concerns about patellofemoral pain, it is essential to consult with a healthcare professional for a proper diagnosis and personalised treatment plan.