Patello-Femoral Knee Pain
What is it?
Patello-femoral knee pain refers to pain behind the kneecap. The knee joint is composed of three bones- the patella (kneecap), the femur (thigh bone) and the tibia (shin bone). The patella is attached to a large group of muscles in the thigh called the quadriceps. It attaches to the tibia by the patellar tendon. The patella fits into a groove in the end of the femur called the femoral sulcus. When there is a muscle imbalance or when the kneecap doesn’t track properly in the groove, the cartilage under the kneecap can break down and causes pain. Patello-femoral knee pain is commonly referred to as Runner’s Knee or Chondromalacia.
What are the causes?
Patello-femoral knee pain is very common and can affect all ages. Patello-femoral knee pain commonly occurs as a result of overuse of the knee in sports and activities that involve running, cycling, walking, jumping and weight training. It can also be the result of a muscle imbalance as occurs when the muscles are stronger on the outside of your leg than those on the inside of your leg. Women can have a tendency towards this imbalance because they have wider hips. Wider hips in women cause the knees to be more knock-kneed, pulling the kneecap towards the outside. This can lead to wear of the cartilage on the undersurface of the kneecap. Patello-femoral knee pain can also be the result of overpronation of the feet, a form of flat feet.
Symptoms:
- Pain behind the kneecap
- Pain when you walk, run or sit for long periods of time
- Increased pain when you walk or run downhill or down stairs, or kneel
- Grinding and popping noises beneath or on the sides of the kneecap
- Pain with squats
- Possible swelling
Diagnosis:
Your physician will do a thorough examination, including a detailed history, a review of your symptoms and discuss your current activities. If indicated, s/he will order x-rays or other radiographic studies.
Treatment:
Your physician will develop a treatment plan based on your symptoms, radiographic studies, activities and age. Treatment options may include:
- If the knee is swollen and painful, stopping activity and rest
- Icing for 15-20 minutes before and after activity to reduce pain and swelling
- Begin a therapeutic exercise program, which includes stretching and strengthening for the quadriceps, hamstrings and calves.
- Specific exercises as instructed by your physician or formal physical therapy
- Non-steroidal anti-inflammatory medications
- Neoprene braces during sports or activities
- Orthotics to correct abnormal foot mechanics
- Altering of running surface and varying of routes
- Surgery; dependent on underlying cause of symptoms
Summary:
The good news is that the symptoms of patello-femoral knee pain should be managed with an individualized treatment plan. Should surgery be indicated, your physician and his/her staff will full discuss the benefits and procedure with you. Our goal is to have you remain active and fully participate in the activities that bring you enjoyment.
