Symptoms. Patients often complain of pain around and behind the knee cap (sharp or dull). Pain is common with going up or down stairs, kneeling, and squatting.
Causes. The causes of patellofemoral syndrome are often multifactorial and may be due to excess weight, roughening or softening of the cartilage, trauma, or imbalance of quadriceps muscle strength causing improper alignment.
Treatment. The treatment for this condition is most often treated conservatively. Those who are experiencing this knee pain can try modifying their activities to avoid things that aggravate their symptoms such as kneeling or squatting for long periods of time. They should avoid exercises that load the front part of the knee like squats, leg extensions, and deep knee bends. For those who enjoy biking: make sure that the seat is at an appropriate height so as to allow a slight bend in the knee at the lowest part of the pedal stroke. Too high or too low of a seat will cause poor mechanics and can cause further injury. Patients can also try ice and rest, Ibuprofen or other NSAIDs, taping or a knee brace to better stabilize the kneecap. Physical therapy is an initial form of treatment for this condition. A physical therapist will instruct in stretching and strengthening exercises that will help better condition the muscles around the knee. A few examples of these are:
- IT band stretch: Position as seen below. Twist your trunk to your left and use your right arm/elbow to push your left arm against your left leg. You should feel the stretch in your left buttock and the outer part of your left thigh. Hold the stretch for 10 to 20 seconds and then repeat 5-10 times. Do this again on the opposite side.
- Straight leg raises: Lay down with your legs straight. Bend the knee of the opposite side you want to strengthen to about 90 degrees while keeping your foot flat on the floor. While keeping your other leg straight, slowly lift it in the air starting with 8 inches and working your way up to 12 inches or higher if able. You should feel your front thigh muscles working. Hold this for 5-10 seconds and slowly lower your leg to its starting position and repeat this 10 more times.
Surgery & Next Steps. Occasionally this condition requires surgical intervention. If you are continuing to have anterior knee pain despite these conservative measures then talk with your sports medicine or orthopedic doctor and discuss your options.
For more information on knee pain or questions for Dr. Travis Hendry visit Summiut Orthopedics site or call 801-779-6200.