Patellofemoral Pain Syndrome refers to pain at the front of the knee. It is also called anterior knee pain.
Patellofemoral pain syndrome occurs when the patella does not move or 'track' in a correct fashion when the knee is being bent and straightened. This movement can lead to damage of the surrounding tissues, such as the cartilage on the underside of the patella itself, which can lead to pain in the region. This injury is quite common in people who do a lot of sport, and adolescent girls
Patellofemoral knee pain can also occur following a knee injury, if the muscles of the quadriceps (especially VMO) considerably weaknened.
other factors which contribute to the PFPS:
- Sports such as running, where repeated weight-bearing occurs, may result in PFPS.
- Pronating or 'flat' feet lead to an increased biomechanical stress on the knee joint.This may affect the alignment of the patella particularly during movement.
Symptoms of patellofemoral syndrome
· Aching pain in the knee joint, particularly at the front, around and under the patella.
· Tenderness along the inside border of the kneecap .
· Swelling sometimes occurs after activity .
· Pain is often worst when walking up or down hills or stairs.
· A clicking or cracking sound may be present on bending the knee.
· Sitting for long periods may be uncomfortable.
· Wasting (atrophy) of the quadriceps muscles in prolonged cases.
· Tight muscles including calf muscles, hamstrings, quadriceps (especially vastus lateralis
· on the outside) and iliotibial band.
Treatment
· Apply RICE (Rest, ice compression and elevation) after activity.This will help reduce and swelling
· Rest until there is no pain (this is very important).
· Use a knee support or heat retainer.
· See a sports injury Doctor at A+ Orthopedic Clinic who can advise on treatment and rehabilitation.
ACL Injury
A torn ACL is an injury or tear to the anterior cruciate ligament (ACL). The ACL is one of the four main stabilising ligaments of the knee,).
Symptoms of a torn ACL
- There may be an audible pop or crack at the time of injury
· A feeling of initial instability, may be masked later by extensive swelling
- Apply RICE (Rest, Ice, Compression, Elevation) to the knee immediately
- Seek medical attention as soon as possible.
A sports injury Doctor at A+ orthopedics and sports clinic can assess the knee joint to confirm a torn ACL
Jumpers knee / Patellar tendinopathy
The patella tendon / ligament joins the kneecap (patella) to the shin bone or tibia. This tendon is extremely strong and allows the quadriceps muscle group to straighten the leg. The quadriceps actively straighten the knee in jumping to propel the individual off the ground as well as functioning in stabilizing their landing.
As such this tendon comes under a large amount of stress especially in individuals who actively put extra strain on the knee joint such as those who regularly perform sports that involve direction changing and jumping movements. With repeated strain, micro-tears as well as collagen degeneration may occur as a result in the tendon.
This is known as patellar tendinopathy or Jumpers Knee.
Symptoms of jumpers knee
- Pain at the bottom and front of the kneecap especially when pressing in or palpating .
- Aching and stiffness after exertion.
- Pain when you contract the quadriceps muscles.
- The affected tendon may appear larger than the unaffected side.
- May be associated with poor Vastus medialis obliquus (VMO) function
- Calf weakness may be present
Two modes of treatment
· conservative treatment and
· surgical treatment:
Conservative (non-surgical) treatment
· This is normally advocated initially after diagnosis of patellar tendinopathy. Care must be taken not overload the tendon. Treatment may involve:
- Quadriceps muscle strengthening program: in particular eccentric strengthening. These exercises involve working the muscles as they are lengthening and are thought to maximise tendinopathy recovery.
- Muscle strengthening of other weight bearing muscle groups, such as the calf muscles, may decrease the loading on the patellar tendon.
- Ice packs to reduce pain and inflammation
Medial Meniscus
Each knee joint has two crescent-shaped cartilage menisci. These lie on the medial (inside) and lateral (outside) of the upper surface of the tibia (shin) bone. They are essential components of the knee, acting as shock absorbers as well as allowing for the proper interaction and weight distribution between the tibia and the femur (thigh bone). As a result, injury to either meniscus can lead to critical impairment of the knee itself.
The medial meniscus is more prone to injury than the lateral menicus. Any forces impacting from the outer surface of the knee, such as a rugby tackle, can severely damage the medial meniscus. Medial meniscal injuries are often also associated with injuries to the anterior cruciate ligament. Other mechanisms of injury may be twisting the knee or degenerative changes that are associated with age..
Symptoms
- Pain on the inner surface of the knee joint.
- Swelling of the knee within 48 hours of injury.
- Inability to bend knee fully- this may be associated with pain or a clicking noise.
- "Locking" or "giving way" of the knee.
- Inability to weight bear on the affected side.
Treatment
- Apply RICE to the injured knee.
- Wear a knee compression support.
- Try to keep the knee moving using our mobility exercises.
- Gentle exercises to maintain quadriceps strength, although care should be taken not to aggravate the symptoms.
- Consult a Sports Injury Specialist.
A sports injury specialist A+ orthopedic clinic may:
· Assess the knee to confirm the injury.
· Refer you for an MRI scan.
· Decide if conservative treatment will be effective or if surgery may be required.
Treatment
This may be indicated in the case of a small tear or a degenerative meniscus and may involve:
- Ice, compression and recommendation of NSAID's e.g aceclofenac.
- Electrotherapy i.e. ultrasound, laser therapy and TENS.
- Massage to decrease swelling and relax surrounding muscular tension.
- Manual therapy
· Once pain has subsided, exercises to restore the range of movement, improve balance and maintain quadriceps strength may be prescribed. These may include: squatting, single calf raises and wobble-board techniques.
For more details please contact:
Dr. Prateek Gupta (Senior Surgeon)
Arthroscopy Surgery Clinic
C2/5 Safdarjung Development Area (SDA),
Aurobindo Marg, New Delhi - 110016
INDIA
Telephones: +91 9810852876, +91 11 26517776
24 x 7 Helpline & Appointment: +91 9810633876
Email: sportsmedicinedelhi@yahoo.com,
sportsmedicineclinics@gmail.com
Website: http://www.sportsmedicineclinicdelhi.com/arthroscopy.htm