Patellofemoral syndrome is associated with knee pain and swelling of the patellar tendon in the knee. It involves weakened articular cartilage beneath the patella (the kneecap), which serves to produce extra strain on the patella, resulting in an end to its normal smooth movement.
Symptoms of Patellofemoral Syndrome
Pain in the knee which may arise after a long period of sitting down or after (sometimes during) climbing something like a staircase or a hill due to pressure on the knee. The pain can also occur during exercise or physical activity, especially leg stretches such as squats. There may be a noticeable popping sound when straightening the leg, and the leg can appear to shift its position abruptly. There can also be persistent clicking in the knee and an inability to fully bend the knee so that it touches the inside of your thigh. The patella tendon can feel very sore for an extended period following high impact activities (meaning those in which pressure to the knee is great, such as those involving running and jumping).
Causes of Patellofemoral Syndrome
Many individual factors can contribute to the weakening of the articular cartilage that causes rough patella movement and patellofemoral syndrome. One cause is that the inner muscle of the quadriceps, the vastus medialis, may be far too weak for the types of activities you partake in. Another is that inappropriate exercising, such as overuse or poor warm ups, leads to stress on the patellar tendon. Overuse can be especially damaging in high impact activities like sprinting, when the knee and surrounding ligaments are repeatedly forced to bear the brunt of the body's weight. Weakness in other muscles, such as the external rotators or hip abductors, is another risk factor. Faulty biomechanics including flat feet are often observed in those with the injury. Sometimes a history of sitting for long periods is noted.
Medical Treatment for Patellofemoral Syndrome
See your doctor so that they can diagnose the injury using a physical exam and also gather the required information about strength and range of motion in important muscles surrounding the patellar tendon. This will lead them to suggest a suitable course of action. While you have the injury it is crucial to avoid high impact activities and much walking uphill or upstairs. Icing the area a few times per day and elevating the knee can help to reduce pain and swelling. Anti-inflammatory pain medication can also be beneficial. In most cases the doctor is likely to recommend a program of physical therapy that will gradually seek to strengthen any weakened muscles (e.g. gluteal, hip abductors, quadriceps) in the area in order to reduce strain on the patellar tendon and prevent further injuries. Often this is sufficient treatment, though patients with a biomechanical foot error will need to correct this by wearing appropriate shoe orthotics.
In rare instance surgical intervention may be required, but only as the last remaining option if the knee is unable to heal fully due to scar tissue.
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