What is Patellofemoral Pain Syndrome (PFPS, ) in the knee? What to do about it?
What is Patellofemoral Pain Syndrome (PFPS, ) in the knee? What to do about it?
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Anterior knee pain is one of the most common complains in an outpatient rehab clinic. It has several other names also, jumper's knee, runner's knee, patellar tendinitis or tendinopathy. Just like other conditions, it is important to knee the mechanism of irritation associated with pain.
There is a concept of primary and secondary impairments when many joints, tendons, and muscles are involved. The pain is simply a protection mechanism of our body to inform our mind that something is wrong. So the pain is not a bad thing. Don't kill the messenger, right? As I explained in the last post about the knee dislocation, the kneecap was supported by quad muscles, patellar ligament, and retinaculum on both sides. When the balance was not well maintained statistically or dynamically, the bones of the joint ---patella bone and femoral bone might rub each other with a lot of pressure. The kneecap might also tilt forward or rotate sideways. Another way to see this situation is this. Place your hands on a chair and try to put your weight over your hands. You might be able to do this quickly and safely without pain, right? OK. Now place your thumbs on the same chair and try to weight bear on the thumbs only. Pain?
Here is the basic physical formula: Pressure = weight/contact area.
That's why you heard about the recommendation of losing 5-10 lbs by surgeons before an operation of the knee joint. If you decrease 5 lbs of body weight, your knee will get almost 40 lbs less pressure inside the joint.
I know losing weight is a systematic effort and it takes time. So here is another option:
Find an experienced PT and work on the positioning and training of the knee to increase the contact area of the joint when you are doing some functional activities.
It might surprise you how much relief you might get by only 1 visit.
Sometimes, I use taping around the kneecap for better gliding of the patellofemoral joint and it takes off 80% of the irritation.
Current evidence also supports the strengthening of the hip and knee muscles to treat PFPS.
Don't head to the gym immediately yet, find a licensed outpatient PT to assess your ability of dynamic control of the distal quad muscles and hips muscles. Why? As a former physician, I knew it is almost impossible for your PCP to do a dynamic test on your knee for a better understanding of each muscle of the legs when you squatting down or landing from a jump. As a physical therapist, I found the dynamic control tests during functional activities provide critic information to lead to effective treatment quickly.
So, Talk to your PCP and find an experienced physical therapist for your knee pain. No need to suffer the pain. Don't just work on the symptoms. Understand the mechanism, you might be able to avoid severe arthritis and surgery.
www.PTcares.com
Anterior knee pain is one of the most common complains in an outpatient rehab clinic. It has several other names also, jumper's knee, runner's knee, patellar tendinitis or tendinopathy. Just like other conditions, it is important to knee the mechanism of irritation associated with pain.
There is a concept of primary and secondary impairments when many joints, tendons, and muscles are involved. The pain is simply a protection mechanism of our body to inform our mind that something is wrong. So the pain is not a bad thing. Don't kill the messenger, right? As I explained in the last post about the knee dislocation, the kneecap was supported by quad muscles, patellar ligament, and retinaculum on both sides. When the balance was not well maintained statistically or dynamically, the bones of the joint ---patella bone and femoral bone might rub each other with a lot of pressure. The kneecap might also tilt forward or rotate sideways. Another way to see this situation is this. Place your hands on a chair and try to put your weight over your hands. You might be able to do this quickly and safely without pain, right? OK. Now place your thumbs on the same chair and try to weight bear on the thumbs only. Pain?
Here is the basic physical formula: Pressure = weight/contact area.
That's why you heard about the recommendation of losing 5-10 lbs by surgeons before an operation of the knee joint. If you decrease 5 lbs of body weight, your knee will get almost 40 lbs less pressure inside the joint.
I know losing weight is a systematic effort and it takes time. So here is another option:
Find an experienced PT and work on the positioning and training of the knee to increase the contact area of the joint when you are doing some functional activities.
It might surprise you how much relief you might get by only 1 visit.
Sometimes, I use taping around the kneecap for better gliding of the patellofemoral joint and it takes off 80% of the irritation.
Current evidence also supports the strengthening of the hip and knee muscles to treat PFPS.
Don't head to the gym immediately yet, find a licensed outpatient PT to assess your ability of dynamic control of the distal quad muscles and hips muscles. Why? As a former physician, I knew it is almost impossible for your PCP to do a dynamic test on your knee for a better understanding of each muscle of the legs when you squatting down or landing from a jump. As a physical therapist, I found the dynamic control tests during functional activities provide critic information to lead to effective treatment quickly.
So, Talk to your PCP and find an experienced physical therapist for your knee pain. No need to suffer the pain. Don't just work on the symptoms. Understand the mechanism, you might be able to avoid severe arthritis and surgery.
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