Brief Outline of Patellofemoral Pain Syndrome
Pain in the patella (knee cap), especially after sitting for a long time or running downhill, may be a result of a fairly common condition called patellofemoral pain syndrome. The pain may result from incorrect movement of the patella over the femur, or tight tendons. The articular cartilage under the knee cap may become inflamed as well, leading to another condition called chondromalacia patellae. Found more commonly in women.
Anatomy and Physiology of Patellofemoral Pain Syndrome
The patella is small triangular sesamoid bone within the tendon of the quadriceps femoris muscle and forms the front of the knee joint. It is attached above to the quadriceps tendon, and below to the patellar (tendon) ligament, and articulates with the patellofemoral joint. The angle formed between the two lines of pull of the quadroceps muscle and the patellar (tendon) ligament is known as the Q-angle. If the patella moves out of its normal path, even slightly, it can cause irritation and pain. Tight tendons also place pressure on the patella causing inflammation.
Cause of Patellofemoral Pain Syndrome
Incorrect running form or improper shoes. Weak or tight quadriceps. Chronic patella dislocations.
Signs and Symptoms of Patellofemoral Pain Syndrome
Pain on and under the knee cap, and worsens after sitting for extended periods or walking downstairs. Clicking or grinding may be felt when flexing the knee. Dull, aching pain in the center of the knee.
Complications if Left Patellofemoral Pain Syndrome Unattended
The inflammation from this condition if left unattended can worsen and cause more permanent damage to the surrounding structures. If the tendon becomes inflamed, it could eventually rupture. The cartilage under the patella may also become inflamed.
Immediate Treatment for Patellofemoral Pain Syndrome
Rest, which can be simply reducing the intensity and duration. Ice and anti-inflammatory medication. Shockwave Therapy. Anti-inflammatory injection. Physiotherapy.
Rehabilitation and Prevention for Patellofemoral Pain Syndrome
Rehabilitation starts with restoring the strength and flexibility of the quadriceps. When returning to activity after pain has subsided, gradual increases in intensity, limiting repetitive stresses on the knee and proper warm-up techniques will ensure that the pain does not return.
Strong, flexible quadriceps and hamstrings and avoiding overuse will help prevent patellofemoral pain syndrome. A good warm-up before training will also help.
Long-term Prognosis for Patellofemoral Pain Syndrome
With complete treatment there are seldom any lasting effects. If the condition does not respond to treatment, surgical intervention may be necessary.