110772 - ..
110773 - Muscles are connected to bones by tendons. The quadriceps
110774 - tendon connects the muscles in the front of the thigh to
110775 - the patella. Segments of the quadriceps tendon?called the
110776 - patellar retinacula?attach to the tibia and help to
110777 - stabilize the patella. Stretching from your patella to
110778 - your tibia is the patellar tendon.
110779 -
110781 - ..
110782 - 2. Patellofemoral Pain Syndrome
110783 -
110784 - Patellofemoral pain syndrome occurs when nerves sense pain
110785 - in the soft tissues and bone around the kneecap. These
110786 - soft tissues include the tendons, the fat pad beneath the
110787 - patella, and the synovial tissue that lines the knee joint.
110789 - ..
110790 - In some cases of patellofemoral pain, a condition called
110791 - chondromalacia patella is present. Chondromalacia patella
110792 - is the softening and breakdown of the articular cartilage
110793 - on the underside of the kneecap. There are no nerves in
110794 - articular cartilage?so damage to the cartilage itself
110795 - cannot directly cause pain. It can, however, lead to
110796 - inflammation of the synovium and pain in the underlying
110797 - bone.
110799 - ..
110800 - 3. Cause Patellofemoral Pain Syndrome
110801 -
110802 - In many cases, patellofemoral pain syndrome is caused by
110803 - vigorous physical activities that put repeated stress on
110804 - the knee ?such as jogging, squatting, and climbing stairs.
110805 - It can also be caused by a sudden change in physical
110806 - activity. This change can be in the frequency of
110807 - activity?such as increasing the number of days you exercise
110808 - each week. It can also be in the duration or intensity of
110809 - activity?such as running longer distances.
110811 - ..
110812 - Other factors that may contribute to patellofemoral pain
110813 - include:
110814 -
110815 - 1. use of improper sports training techniques or equpment
110816 -
110817 - 2. Changes in footwear or playing surface.
110819 - ..
110820 - 4. Patellar Malalignment
110821 -
110822 - Patellofemoral pain syndrome can also be caused by
110823 - abnormal tracking of the kneecap in the trochlear groove.
110824 - In this condition, the patella is pushed out to one side
110825 - of the groove when the knee is bent. This abnormality may
110826 - cause increased pressure between the back of the patella
110827 - and the trochlea, irritating soft tissues.
110829 - ..
110830 - Factors that contribute to poor tracking of the kneecap
110831 - include:
110832 -
110833 - 1. Problems with the alignment of the legs between the
110834 - hips and the ankles. Problems in alignment may result
110835 - in a kneecap that shifts too far toward the outside or
110836 - inside of the leg, or one that rides too high in the
110837 - trochlear groove?a condition called patella alta.
110839 - ..
110840 - 2. Muscular imbalances or weaknesses, especially in the
110841 - quadriceps muscles at the front of the thigh. When the
110842 - knee bends and straightens, the quadriceps muscles and
110843 - quadriceps tendon help to keep the kneecap within the
110844 - trochlear groove. Weak or imbalanced quadriceps can
110845 - cause poor tracking of the kneecap within the groove.
110847 - ..
110848 - 5. Symptoms
110849 -
110850 - The most common symptom of patellofemoral pain syndrome is
110851 - a dull, aching pain in the front of the knee. This
110852 - pain?which usually begins gradually and is frequently
110853 - activity-related?may be present in one or both knees.
110854 - Other common symptoms include:
110855 -
110856 - 1. Pain during exercise and activities that repeatedly
110857 - bend the knee, such as climbing stairs, running,
110858 - jumping, or squatting.
110860 - ..
110861 - 2. Pain related to a change in activity level or
110862 - intensity, playing surface, or equipment.
110864 - ..
110865 - 3. Popping or crackling sounds in your knee when climbing
110866 - stairs or when standing up after prolonged sitting.
110868 - ..
110869 - Right knee has been popping for several years, for example when
110870 - sitting in a car, and straightening the leg.
110871 -
110873 - ..
110874 - 6. Home Remedies
110875 -
110876 -
110877 - 1. Activity Changes
110878 -
110879 - Stop doing the activities that make your knee hurt
110880 - until your pain is resolved. This may mean changing
110881 - your training routine or switching to low-impact
110882 - activities that will place less stress on your knee
110883 - joint. Biking and swimming are good low-impact
110884 - options. If you are overweight, losing weight will
110885 - also help to reduce pressure on your knee.
110887 - ..
110888 - 2. RICE Method
110889 -
110890 - 1. Rest. Avoid putting weight on the painful knee.
110891 -
110892 - Ice - Use cold packs for 20 minutes at a time,
110893 - 2. several times a day. Do not apply ice directly on
110894 - skin.
110896 - ..
110897 - 3. Compression. To prevent additional swelling,
110898 - lightly wrap the knee in an elastic bandage,
110899 - leaving a hole in the area of the kneecap. Make
110900 - sure that the bandage fits snugly and does not
110901 - cause additional pain.
110903 - ..
110904 - 4. Elevation. As often as possible, rest with your
110905 - knee raised up higher than your heart.
110906 -
110908 - ..
110909 - 3. Medication
110910 -
110911 - Non-steroidal anti-inflammatory drugs (NSAIDs) such
110912 - as ibuprofen and naproxen can help reduce swelling
110913 - and relieve pain.
110915 - ..
110916 - If pain persists or it becomes more difficult to move
110917 - your knee, contact your doctor for a thorough
110918 - evaluation.
110919 -
110921 - ..
110922 - 7. Doctor Examination
110923 -
110924 -
110925 - 1. Physical Examination
110926 -
110927 - 1. During the physical examination, your doctor will
110928 - discuss your general health and the symptoms you
110929 - are experiencing. He or she will ask when your
110930 - knee pain started and about the severity and
110931 - nature of the pain (dull vs. sharp). Your doctor
110932 - will also ask you what activities cause the pain
110933 - to worsen.
110935 - ..
110936 - 2. To determine the exact location of the pain, your
110937 - doctor may gently press and pull on the front of
110938 - your knees and kneecaps. He or she may also ask
110939 - you to squat, jump, or lunge during the exam in
110940 - order to test your knee and core body strength.
110942 - ..
110943 - 3. To help diagnose the cause of your pain and to
110944 - rule out any other physical problems, your doctor
110945 - may also check:
110946 -
110947 - 1. Alignment of the lower leg and the position of
110948 - the kneecap
110950 - ..
110951 - 2. Knee stability, hip rotation, and range of motion
110952 - of knees and hips
110954 - ..
110955 - 3. The kneecap for signs of tenderness
110957 - ..
110958 - 4. The attachment of thigh muscles to the kneecap
110960 - ..
110961 - 5. Strength, flexibility, firmness, and tone of
110962 - the hips, front thigh muscles (quadriceps),
110963 - and back thigh muscles (hamstrings)
110965 - ..
110966 - 6. Tightness of the heel cord and flexibility of
110967 - the feet
110969 - ..
110970 - 4. Finally, your doctor may ask you to walk back and
110971 - forth in order to examine your gait (the way you
110972 - walk). He or she will look for problems with your
110973 - gait that may be contributing to your knee pain.
110974 -
110976 - ..
110977 - 2. X-Rays
110978 -
110979 - Usually, your doctor will be able to diagnose
110980 - patellofemoral pain syndrome with just a physical
110981 - examination. In most cases, however, he or she also
110982 - will order an x-ray to rule out damage to the structure
110983 - of the knee and to the tissues that connect to it.
110985 - ..
110986 - 8. Treatment
110987 -
110988 - Medical treatment for patellofemoral pain syndrome is
110989 - designed to relieve pain and restore range of motion and
110990 - strength. In most cases, patellofemoral pain can be
110991 - treated nonsurgically.
110992 -
110993 - 1. Nonsurgical Treatment
110994 -
110995 - In addition to activity changes, the RICE method, and
110996 - anti-inflammatory medication, your doctor may recommend
110997 - the following:
110998 -
110999 - 1. Physical therapy exercises.
111000 -
111001 - Specific exercises will help you improve range of
111002 - motion, strength, and endurance. It is especially
111003 - important to focus on strengthening and stretching
111004 - your quadriceps since these muscles are the main
111005 - stabilizers of your kneecap. Core exercises may
111006 - also be recommended to strengthen the muscles in
111007 - your abdomen and lower back.
111009 - ..
111010 - 2. Orthotics.
111011 -
111012 - Shoe inserts can help align and stabilize your foot
111013 - and ankle, taking stress off of your lower leg.
111014 - Orthotics can either be custom-made for your foot
111015 - or purchased "off the shelf."
111016 -
111017 -
111018 - 1. Surgical Treatment
111019 -
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