Patellofemoral Disorders commonly referred to as Patellofemoral Pain Syndrome, Patellar Malalignment, Runner’s Knee or Chondromalacia, is widely accepted as the single most common cause of knee pain.
A Patellofemoral Disorder, which causes pain behind and around the kneecap, is common in the athletic and sedentary alike. Discomfort is felt when engaging in activities such as walking up and down stairs, running, kneeling, squatting, or sitting for extended period of time with a bent knee.
The knee connects the Femur, or thighbone, to the Tibia and Fibula. The patella or kneecap is a mobile, smooth, round bone on top of the knee joint functioning to protect the joint as well as help the knee bend, lift and move. Meniscus cartilage in between serves as a cushion and allows the smooth fluid movement between the two. The Patella lies in a groove on the front of the femur, just above the knee joint called the Trochlear Groove. The normal movement of the patella when walking is up and down. When the patella is not correctly tracking vertically, or well-aligned, it is pulled sideways and grinds on the knee – causing pain and discomfort. The discomfort originates from the joint located between the patella and the femur, as a result of cartilage wearing away, allowing the patella to rub directly against the femur.
Patellofemoral Disorders are typically caused by overload and overuse of the patellofemoral joint, biomechanical problems and muscular dysfunction.
Overloading and overuse are caused from excessive bending of the knee and repeated weight bearing impact (further exaggerated with obesity), which increases pressure between the patella and various points of contact with the femur. Biomechanical problems add stress to the patellofemoral mechanism. These problems include: Pes Planus, or flat foot; Pes Cavus, or high-arched foot; Q angle variation and muscular dysfunction. Flat feet and foot pronation refers to the absence of a supportive mechanical arch.
Foot pronation causes an internal rotation of the tibia or femur. A high-arched foot provides inadequate cushioning when the leg hits the ground. A normal Q Angles varies anywhere from 10 and 22 degrees. It is believed that those with a Q Angle degree of 22 degrees are predisposed to patellofemoral pain. Muscular dysfunction occurs when the muscles in the area of the Patellofemoral joint become either weakened or inflexible due to any of the previously mentioned conditions, as well as accidents, sports injuries and aging.
Patellofemoral Disorders are a mechanical issue resultant of a malalignment and imbalance of the muscles and bones. The best treatment is non-surgical if addressed early – addressed with such things as proper strengthening, stretching and footwear. Quadriceps strengthening is most commonly recommended, because the quadriceps muscles play a significant role in patellar movement. And in keeping with balanced training of opposing muscle groups supporting joints, the hamstrings should be equally trained – as well as calf muscles.
Along with specific physician-directed stretching exercises, the Cyro/Cuff® is used to deliver cold therapy. It combines focal compression with cold to provide optimal control of swelling and pain. Anti-inflammatory medication such as ibuprofen and nutritional supplements are also helpful in recovery.
Dr. Mark Sanders is an orthopedic surgeon and sports medicine physician certified by the American Board of Orthopaedic Surgery. He specializes in Patellofemoral Disorders, ACL injuries and Accelerated Rehabilitation. If you are experiencing knee pain, log onto www.sandersclinic.net to read patient testimonials or call 1.888.8 DR MARK (24/7) and let him help you start living a stronger life today.