Patellofemoral syndrome

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Patellofemoral syndrome refers to pain under and around your kneecap. It includes several medical conditions such as anterior knee pain syndrome, patellofemoral malalignment and chondromalacia patella that cause pain around the front of the knee. Patellofemoral syndrome is a common complaint among runners, jumpers and other athletes such as skiers, cyclists and soccer players.

Patellofemoral syndrome can result from poor alignment of the kneecap, complete or partial dislocation, overuse, tight or weak thigh muscles, flat feet, and direct trauma to the knee. Patellofemoral pain often comes from strained tendons and irritation or softening of the cartilage that lines the underside of the kneecap. Pain in the knee may be referred from other parts of the body, such as the back or hip.

Symptoms

The most common symptom is a dull aching pain underneath the kneecap while walking up or down stairs, squatting, kneeling and sitting with your knees bent for long period of time.

Diagnosis

Your doctor will ask about your symptoms, medical history, any sports participation, and activities that aggravate your knee pain. Your doctor will perform a physical examination of your knee. Diagnostic imaging tests such as X-rays, MRIs, CT scans, and blood tests may be ordered to check if your pain is due to damage to the structure of the knee or because of the tissues that attach to it.

Treatment

The first treatment step is to avoid activities that cause pain, such as running and jumping. Treatment options include both non-surgical and surgical methods. Non-surgical treatment consists of rest, ice, compression and elevation (RICE protocol); all assist in controlling pain and swelling. Non-steroidal anti-inflammatory medications may be prescribed to reduce pain.

Exercises: Your doctor may recommend an exercise program to improve the flexibility and strength of thigh muscles. Cross-training exercises to stretch the lower extremities may also be recommended by your doctor.

Other non-surgical treatments include:

  • Knee taping: An adhesive tape is applied over the patella, to alter the kneecap alignment and movement. Taping of the patella may reduce pain.
  • Knee brace: A special brace for the knee may be used during sports participation which may help reduce pain.
  • Orthotics: Special shoe inserts may be prescribed for those with flat feet that may help relieve pain.

In some cases, you may need arthroscopic surgery or realignment surgery. During arthroscopy, damaged fragments are removed from the kneecap, while realignment moves the kneecap back to its alignment, thus reducing the abnormal pressure on cartilage and supporting structures around the front of the knee.

Prevention
  • Control weight to avoid overstressing your knees.
  • Gradually increase the intensity of your workout.
  • If you have flat feet or other foot problems use shoe inserts.
  • Avoid running on hard surfaces.
  • Wear proper-fitting, good-quality running shoes with good shock absorption.
  • Avoid running straight down hills; instead walk down it or run in a zigzag pattern.
  • Warm up for 5 minutes before starting any exercise. Also stretch after exercising.

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