OH, My Aching Knee!

Patellofemoral Pain Syndrome (PFPS) (Also known as Chondromalacia Patella or Runner’s Knee)

A common cause of knee pain can be attributed to patellofemoral pain syndrome (PFPS). Many times what starts out as a simple knee joint sprain-strain or overuse injury can evolve into a full-blown case of PFPS.  Pain is usually in the front and what feels like the center of the knee, or “under the kneecap.”

Even though this condition may be known as “Runner’s Knee,” you don’t have to be a runner to experience this problem. Pain or swelling in the knee after injury or overuse can set off the cascade of events that cause the onset of PFPS.  The thigh muscles or quadriceps on the painful side are reflexively shut down so they can no longer adequately support the knee.  Without this support, the knee cap will begin to track out of alignment creating painful compression with movement and subsequent ongoing knee pain and inflammation.

The painful knee is typically sore over the front and inside areas of the knee. The knee cap will often crack or pop with bending, straightening or squatting movements. The pain gets worse when going up and down stairs, distance running, jumping, deep squats, lunges and any impact type of activities. You may find that if you sit with your knees bent for long periods of time, for example while watching a movie that you have sharp knee pain when you go to stand up.  You might almost feel like you have to straighten your knee to get it back into alignment. This is referred to as the “Theatre Sign” and can be consistent with diagnosis of PFPS.

This painful condition may be treated successfully with the help of the doctors at IMUA Orthopedics, Sports & Health.

Dr. Ignacio has advanced training in diagnosing and treating all types of knee problems. A comprehensive examination will be performed to determine the integrity and stability of the ligaments and cartilage of your knee to rule out damage or injury to these structures.  X-ray or imaging may also be indicated to detect structural changes or damage and to further evaluate the ligamentous and cartilage components of your knee. Once the diagnosis of PFPS is made and conservative treatment is indicated for the best outcome, Dr. Ignacio may refer you to her associate Dr. Gesik for Osteopathic Manipulative Treatment (OMT).

Dr. Gesik will identify painful pressure points on the muscles, tendons, and ligaments of the knee and treat them to relieve the painful compression of the knee cap and knee joint.  Pressure point treatment will also shut off the protective joint reflexes that maintain the weakness of the thigh muscles. Dr. Gesik will evaluate your knee movement to identify and treat any joint related restrictions or stiffness that are contributing to the problem. A simple taping technique can be applied to the knee cap to help eliminate the patellar malalignment and restore pain-free movement. The tape is waterproof, hypoallergenic and can be worn for 2-7 days for ongoing support with activity and at rest.

Physical therapy is often prescribed for additional hands on treatment, to teach specific quadriceps strengthening exercises, hamstring-calf stretches, dynamic warm-up program, self-taping and icing techniques.  Instruction in activity modification during the painful stage is a must.  Cross training, such as cycling or swimming, will be recommended in order to limit strain from impact activities.  Once the pain stabilizes, you will be instructed in a progressive program that will prepare you to safely return to your full activity levels.

PFPS is an all too common source of knee pain that often goes undiagnosed. With proper diagnosis and treatment from the doctors at IMUA, you can get better and stay better moving forward in your active life.

Mahalo to Musashi for the wonderful photos – http://www.musashi671.com/

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