Anterior Knee Pain Treatment

Patellofemoral Pain Syndrome

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 non-athletes, as well. The pain and stiffness it causes can make it difficult to climb stairs, kneel down, and perform other everyday activities.

Many things 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. However, the most common cause is unknown (Idiopathic).

Symptoms are often relieved with conservative treatment, such as changes in activity levels or a therapeutic exercise program.

Anatomy

Anterior Knee Pain Treatment in HyderabadA healthy knee is made up of four main things: bones, cartilage, ligaments, and tendons.
Your knee is the largest joint in your body and one of the most complex. It is made up of the lower end of the femur (thigh bone), the upper end of the tibia (shin bone), and the patella (kneecap).

Ligaments and tendons connect the femur to the bones of the lower leg. The four main ligaments in the knee attach to the bones and act like strong ropes to hold the bones together.

Muscles are connected to bones by tendons. The quadriceps tendon connects the muscles in the front of the thigh to the patella. Segments of the quadriceps tendon—called the patellar retinacula—attach to the tibia and help to stabilise the patella. Stretching from your patella to your tibia is the patellar tendon.

knee ligament injury in hyderabadSeveral structures in the knee joint make movement easier. For example, the patella rests in a groove on the top of the femur called the trochlea. When you bend or straighten your knee, the patella moves back and forth inside this trochlear groove.

A slippery white substance called articular cartilage covers the ends of the femur, trochlear groove, and the underside of the patella. Articular cartilage helps your bones glide smoothly against each other without any friction as you move your knee.

Also aiding in movement is the synovium—a thin lining of tissue that covers the surface of the joint. The synovium produces a small amount of fluid that lubricates the cartilage. In addition, just below the kneecap is a small pad of fat that cushions the kneecap and acts as a shock absorber.

(Left) The patella normally rests in a small groove at the end of the femur called the trochlear groove. (Right) As you bend and straighten your knee, the patella slides up and down within the groove.

Description

Patellofemoral pain syndrome occurs when nerves sense pain in the soft tissues and bone around the kneecap. These soft tissues include the tendons, the fat pad beneath the patella, and the synovial tissue that lines the knee joint.
In some cases of patellofemoral pain, a condition called chondromalacia patella is present.

Chondromalacia patella is the softening and breakdown of the articular cartilage on the underside of the kneecap. There are no nerves in articular cartilage—so damage to the cartilage itself cannot directly cause pain. It can, however, lead to inflammation of the synovium and pain in the underlying bone.

Cause 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. So, If you are looking for the best anterior knee pain treatment in Hyderabad then consult the best doctor for the treatment. Many doctors says that – 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

Patellar Malalignment

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 the poor tracking of kneecap include:

• Problems with the alignment of legs between hips and ankles. Problems in alignment may result in kneecap that shifts too far toward the outside or inside of leg, or one that rides too high in the trochlear groove—a condition that is called patella alta.

• Muscular imbalances or weaknesses, especially in quadriceps muscles and at the front of the thigh. When the knee bends and then straightens, the quadriceps muscles and quadriceps tendon helps to keep the kneecap within a trochlear groove. Weak or imbalanced quadriceps can cause poor tracking of a kneecap within the groove.

Symptoms

The most common symptom of the patellofemoral pain syndrome is a vary dull, aching pain in front of the knee. This pain—which usually initiates gradually and is frequently activity-related—may be present in one or both the knees. Other common symptoms includes as follows:
• Pain during exercise and activities that repeatedly bends the knee, such as climbing stairs, jumping, running,or squatting.
• Pain after sitting for a very long period of time with your knees bent, such as one does in a movie theatre or when riding on an aeroplane.
• Pain related to change in activity level or intensity, playing surface, or by any equipment.
• Popping or crackling sounds in the knee when climbing stairs or when standing up after very prolonged sitting.

Now that you got to know all the symptoms consult the best doctor for anterior knee pain treatment in hyderabad

Home Remedies

In many cases, patellofemoral pain will improve with a very simple home treatment.

Activity Changes

Stop doing the activities that make knee hurt until your pain is resolved. This may mean changing training routine or switching to a very low-impact activities that will place less stress on your knee joint. Biking and swimming are a good low-impact options. If you are overweight, losing weight will also help to reduce pressure on the knee.

The RICE Method
To get the first hand anterior knee pain treatment one should follow these quick steps, Initial treatment of knee injuries are as follows:
RICE stands for the rest, ice, compression, and elevation.
• Rest. Avoid putting weight on painful knee.
• Ice. Use cold packs for about 20 minutes at a time, several times a day. Do not apply ice directly to the skin.
• Compression. To prevent additional swelling, lightly wrap knee in an elastic bandage, leaving a hole in the area of the kneecap. Make sure that the bandage fits snugly and does not cause an additional pain.
• Elevation. As often as possible, rest with your knee raised up higher than to your heart.

Medication

Painkillers can help reduce swelling and also helps to relieve pain. If your pain persists or it becomes more difficult to move your knee thorough clinical evaluation is required.

Clinical Examination

For the best clinical examination consult the best doctor for anterior knee pain treatment in Hyderabad
A Detailed history of pain including the activities causes the pain to worsen are also noted. Problems in patellar tracking and the exact location of pain are assessed.
To help diagnose the cause of pain and to rule out any other physical problems which are need to be checked are:
• Alignment of lower leg and position of the kneecap
• Knee stability, hip rotation, and range of other motion of knees and hips
• kneecap for tenderness
• Attachment of thigh muscles to the kneecap
• Strength, flexibility, firmness, and tone of the hips, front thigh muscles (quadriceps), and also back thigh muscles (hamstrings)
• Tightness of the heel cord and flexibility of feet
• Gait is also observed

X-Rays

Usually, we cam diagnose patellofemoral pain syndrome with history of the clinical examination. In most cases, an x-ray is performed to rule out the damage to the structure of the knee.

Treatment

There are surgical and also nonsurgical procedures for anterior knee pain treatment in Hyderabad.

Medical treatment for patellofemoral pain syndrome is also designed to relieve pain and restore the range of motion and strength. In many cases, patellofemoral pain can be treated nonsurgically.

Nonsurgical Treatment

In addition to activity changes, the RICE method, and anti-inflammatory medication, physiotherapy exercises plays an important role in the treatment. Specific exercises will help you to improve range of motion, strength, and endurance. It is especially important to focus on strengthening and stretching quadriceps since these muscles are the main stabilizers of kneecap. Core exercises may also be recommended for strengthening the muscles in your abdomen and lower back.

Surgical treatment

for patellofemoral pain is very rarely needed and is done only for severe cases that do not respond to the nonsurgical treatment. Surgical treatments may include: the following things:

Arthroscopic debridement of the cartilage:

Consult the best knee pain specialist in Hyderabad to get the best treatment.

In some cases, removing damaged articular cartilage from the surface of the patella can provided for pain relief.

• Lateral release. If the lateral retinaculum tendon is tight enough to pull the patella out of the trochlear groove, thelateral release procedure can loosen the tissue and correct the patellar mal-alignment.

Tibial Tubercle Transfer. In few cases, it may be necessary to realign the kneecap by moving the patellar tendon along with the portion of the tibial tubercle—the bony prominence on a tibia (shinbone).

Prevention

Leg extension exercises help to strengthen and stretch quadriceps, the muscles in front of the thigh.
Patellofemoral pain syndrome is usually fully relieved with a very simple measures or physical therapy. It may recur, if you do not make any adjustments to your training routine or activity level. It is essential to maintain right conditioning of the muscles around knee, particularly quadriceps and the hamstrings.

There are additional steps that you may take to prevent recurrence of patellofemoral knee pain. They include as follows:
• Wearing appropriate shoes to your activities
• Warming up before physical activity
• Incorporating stretching and flexible exercise for the quadriceps and hamstrings into your warm-up routine, and stretching after physical activities
• Increasing training very gradually
• Reducing any activity that hurts your knees in the past
• Maintaining a very healthy body weight