Kneecap (patella femoral) pain

The knee is the largest joint in the body and the most easily injured. The kneecap (patella) fits in a groove between where the femur (thighbone) meets the tibia (shinbone). The knee is also made up of ligaments, which connect bones and help control motion. Kneecap pain or patellofemoral syndrome is pain in and around the kneecap or patella of the knee.

Irritation to the soft tissues in front of the knee, or a breakdown of the cartilage can lead to pain. Dull pain is felt under the kneecap and is usually the result of overuse. Runners who over train or train during injury are especially prone to this condition. Pain tends to worsen when ascending or descending stairs and when running downhill. The knee might stiffen after sitting for a long time. Weakness and tightness in the quadriceps, hamstrings and calf muscles, as well as flat feet and over-pronation may lead to this problem.

Other symptoms of patellofemoral pain syndrome are:

• Tenderness along the inner border of the kneecap.
• Swelling
• A cracking sound may be heard when the knee is bent.
• Temporary loss of function.

If you suffer this kind of injury you should use the RICE protocol until symptoms decrease.

• Rest the knee by staying off it or use crutches.
• Ice the knee to reduce pain and swelling.
• Compression with an elastic bandage helps to reduce swelling and pain.
• Elevate the knee to reduce swelling.

Your doctor may prescribe anti-inflammatory medications. In most cases, we may prescribe a knee brace for support. If you are flat-footed or have over-pronated feet, she may prescribe orthotic foot supports. Sometimes surgery may be required to relieve pain.

Therapy will involve the use of ultrasound, laser, or electrical stimulation, taping techniques to stabilise the knee and stretching and strengthening exercises. It is very important to strengthen the vastus medialis (oblique) muscle to provide stability to the knee. Isometric (static) contractions work best.

Some ways to prevent patellofemoral pain are:

• Stay in shape. Most pain is caused by lack of conditioning or overweight which puts stress on the knee.
• Stretch after warm-up and before and after exercise. We will show you how to do this.
• Build up gradually. Do not go full force right away; give your muscles time to warm up.
• Proper running shoes are essential. We can advise you on what is best for you.
• Modify your technique. We can show you how.