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Patella pain (Patellofemoral Pain Syndrome)
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Patellofemoral pain syndrome is a broad term used to describe pain in the front of the knee and around the patella, or kneecap. It is sometimes called “runner’s knee” or “jumper’s knee” because it is common in people who participate in sports—particularly females and young adults—but patellofemoral pain syndrome can occur in nonathletes, as well. The pain and stiffness it causes can make it difficult to climb stairs, kneel down, and perform other everyday activities.
Many things may contribute to the development of patellofemoral pain syndrome. Problems with the alignment of the kneecap and overuse from vigorous athletics or training are often significant factors.
Signs and Symptoms of Patella pain (Patellofemoral Pain Syndrome)
The most common symptom of patellofemoral pain syndrome is a dull, aching pain in the front of the knee. This pain—which usually begins gradually and is frequently activity-related—may be present in one or both knees. Other common symptoms include:
Pain during exercise and activities that repeatedly bend the knee, such as climbing stairs, running, jumping, or squatting.
Pain after sitting for a long period of time with your knees bent, such as one does in a movie theater or when riding on an airplane.
Pain related to a change in activity level or intensity, playing surface, or equipment.
Popping or crackling sounds in your knee when climbing stairs or when standing up after prolonged sitting
Causes of Patella pain ( Patellofemoral pain syndrome)
Overuse
In many cases, patellofemoral pain syndrome is caused by vigorous physical activities that put repeated stress on the knee —such as jogging, squatting, and climbing stairs. It can also be caused by a sudden change in physical activity.
This change can be in the frequency of activity—such as increasing the number of days you exercise each week. It can also be in the duration or intensity of activity—such as running longer distances.
Other factors that may contribute to patellofemoral pain include:
Use of improper sports training techniques or equipment
Changes in footwear or playing surface
Patellofemoral pain syndrome can also be caused by abnormal tracking of the kneecap in the trochlear groove. In this condition, the patella is pushed out to one side of the groove when the knee is bent.
This abnormality may cause increased pressure between the back of the patella and the trochlea, irritating soft tissues.
Factors that contribute to poor tracking of the kneecap
Problems with the alignment of the legs between the hips and the ankles. Problems in alignment may result in a kneecap that shifts too far toward the outside or inside of the leg, or one that rides too high in the trochlear groove—a condition called patella alta.
Muscular imbalances or weaknesses, especially in the quadriceps muscles at the front of the thigh. When the knee bends and straightens, the quadriceps muscles and quadriceps tendon help to keep the kneecap within the trochlear groove. Weak or imbalanced quadriceps can cause poor tracking of the kneecap within the groove.
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Treatment of Patella pain ( Patellofemoral pain syndrome)
In addition to activity changes, the RICE method, and anti-inflammatory medication, your doctor may recommend the following:
Physical therapy exercises. Specific exercises will help you improve your range of motion, strength, and endurance. It is especially important to focus on strengthening and stretching your quadriceps since these muscles are the main stabilizers of your kneecap. Core exercises may also be recommended to strengthen the muscles in your abdomen and lower back.
Orthotics. Shoe inserts can help align and stabilize your foot and ankle, taking stress off of your lower leg. Orthotics can either be custom-made for your foot or purchased “off the shelf.”
Surgical treatment for patellofemoral pain is very rarely needed and is done only for severe cases that do not respond to nonsurgical treatment. Surgical treatments may include:
Arthroscopy. During arthroscopy, your surgeon inserts a small camera, called an arthroscope, into your knee joint. The camera displays pictures on a television screen, and your surgeon uses these images to guide miniature surgical instruments.
- Debridement. In some cases, removing damaged articular cartilage from the surface of the patella can provide pain relief.
- Lateral release. If the lateral retinaculum tendon is tight enough to pull the patella out of the trochlear groove, a lateral release procedure can loosen the tissue and correct the patellar malalignment.
If tightness in the lateral retinaculum is pulling your kneecap to the side, your doctor may recommend lateral release surgery to cut the ligament.
