*For a description of general information about the knee, see the blog titled “The Knee Explained”. The patella, or knee cap as it is more commonly known, has a layer of cartilage on the part that contacts the femur. Damage to this cartilage due to various reasons may cause pain in the knee. The cartilage acts as a natural shock absorber so any time there is damage to it, there is risk of pain.
CAUSES: Misalignment of the bones in the leg, muscular imbalance (especially of the quadriceps muscles), overuse or repetitive stress, and trauma to the knee cap are the most common causes of patellofemoral pain syndrome. Weakness in one part of the quadriceps and tightness in another part may cause the patella to track out of the normal groove causing undo stress on the under part of it contacts the femur.
SIGNS/SYMPTOMS: Usually this condition causes a dull achiness in the front of the knee. Certain movements such as walking up or down stairs, squatting, kneeling, or sitting with a bent knee for an extended period may aggravate this condition causing a more sharp pain. Usually there is little to no swelling with this and pain comes on gradually.
DIAGNOSIS: Usually diagnosis can be made with a simple physical exam, history, and possibly x-rays.
TREATMENT: Avoid activities that increase pain, have your knee and/or foot adjusted by a chiropractor to make sure there is proper alignment in the lower extremity, ice, rest, and strengthening and stretching that targets muscles such as the quadriceps, hamstrings, and gluteus medius and maximus.
COMPLICATIONS: The pain can interfere with everyday activities and may go undiagnosed or misdiagnosed for a long time.
PROGNOSIS: When patients continue to do the activities that aggravate this condition, the prognosis is fairly poor. The above treatment usually resolves up to 90% of all cases. There are occasional cases of surgery needed when the conservative forms of care are not helping.