Treating Patellofemoral Pain Syndrome with Rehab

I was treated for patellofemoral pain syndrome with a rehab program. The before and after X-rays showed no change. How come I got better?

Many studies have been done to show before and after results with rehab for patellofemoral pain syndrome (PFPS). They look at the position of the kneecap (patella) in the groove where it tracks up and down. Some studies have found mild improvement after treatment. But other studies have shown that X-ray alignment was the same between the painful and pain-free knees.

In fact patients with severe joint changes on X-ray may get better with treatment while patients with mild changes don’t.

What researchers have found is that patients who get better have improved muscle strength and flexibility. They used a combination of rest, ice, and activity to get better. Exercises to restore normal timing of contraction seemed to help. Rehab to improve joint position sense called proprioception is also important.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com. The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of a visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

How does taping the kneecap relieve pain from PFPS?

Our 16-year old daughter has had constant knee pain from a problem called PFPS. She is seeing a physical therapist who wants to try taping the kneecap. How does this help the problem?

Patellofemoral pain syndrome (PFPS) is a fairly common condition. Girls are affected more often than boys. With the increased participation in sports, PFPS has become a bigger problem than it once was. Pain with knee motion makes it more difficult to stay active in sports.

The patella sits over the knee joint and moves up and down along a track or groove in the femur (leg bone). PFPS causes pain because of the way the patella (kneecap) tracks within the femoral groove as the knee moves.

The quadriceps muscle helps control the patella so it stays within this groove. If part of the quadriceps is weak for any reason, a muscle imbalance can occur. When this happens, the pull of the quadriceps muscle may cause the patella to move more to one side than the other. This in turn causes more pressure on the cartilage on one side than the other. In time, this pressure can damage the articular cartilage.

Taping the patella helps it stay in the groove and move up and down over the knee as it should. Many patients get immediate pain relief with this treatment technique. Taping is usually accompanied by a muscle stretching and strengthening program.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com. The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of a visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

I have Patello-Femoral Syndrome. Will I ever be able to get just my kneecaps replaced?

I have very severe patellofemoral pain syndrome. Would it ever be possible to just have my kneecaps replaced?

Patello-Femoral Syndrome (PFS) is a condition that causes pain in and around the kneecap (patella). In the normal, healthy adult, the patella moves smoothly over a groove on the femur (thigh bone). PFS can develop when the patella is not moving or tracking properly over the femur. This is a common knee problem in runners and athletes but anyone can be affected.

Where the patella and femur meet forms a joint called the patellofemoral joint. Many muscles and ligaments control this joint. Any change in alignment of the bone, ligaments, and/or muscles around the patellofemoral joint can affect how the patella tracks along the femoral groove.

Patellofemoral joint replacement is usually a treatment for patients with severe osteoarthritis. The articular cartilage covering the back of the kneecap becomes worn and torn causing painful movement. Replacing the patellofemoral joint in PFS doesn’t address the real problem of soft tissue imbalance and structure causing tracking problems.

Conservative treatment for PFS with bracing and exercise may be the best option. If the back of the patella has worn more on one side than the other from the uneven forces of PFS, then the surgeon can smooth the surface without replacing the entire bone. An orthopedic surgeon is the best person to look at your situation and advise you about treatment options including patellofemoral replacement.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com. The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of a visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

Doing many quad sets and hamstring stretches helps, but I still have knee pain. Is there anything new I can try?

I’ve had knee pain since I was 13 (I’m now 18). The doctor calls it patellofemoral pain syndrome. I’ve done a million quad sets and hamstring stretches. It helps but I still have pain when I try to increase my training schedule for track and field events. Is there anything new I can try?

Treatment for patellofemoral pain syndrome (PFPS) has traditionally relied on quadriceps strength training. Some patients also benefit from neuromuscular training, which focuses more on motor control than improving strength.

So far no one has found a “one size fits all” kind of program. Some people seem to get better with one type of exercise while others have less pain and more function with other types of training.

Some time ago researchers saw that hip strength may be an important key to PFPS. One by one studies have been done to confirm this suspicion. Most recently physical therapists at the Nicholas Institute of Sports and Medicine and Athletic Trauma in New York City studied hip strength and flexibility as it relates to PFPS.

They found that 60 percent of patients with PFPS got better after a six-week training program. Exercises to improve hip flexor strength and flexibility resulted in decreased pain and improved function.

The goal was to prevent inward rotation of the thighbone (femoral rotation). Maintaining good alignment of the patella as it moves up and down over the knee reduces the tension on the soft tissues around the knee. This new treatment approach may help you as well!

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com. The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of a visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

Why does kneecap pain come and go?

I have a painful knee problem called patellofemoral pain syndrome. Sometimes it hurts like crazy. Other times I have no pain at all. Why is that?

People with patellofemoral pain syndrome (PFPS) often have knee pain and stiffness when climbing, going down stairs, or while squatting. Popping or stiffness after sitting with the knee bent is called the movie theatre sign.

Most of the symptoms of PFPS depend on the up and down movement of the kneecap and the pressure it places on the cartilage and bone underneath. Scientists aren’t sure what causes the stiffness. Symptoms go away when the person avoids any of these activities.

Changes in the joint, ligaments, and joint capsule may occur after a long period of pain. Messages of pain and stiffness may be sent to the brain sooner or more often than in the normal knee.

A recent study at the University of Illinois found that subjects with PFPS may be misinterpreting their pain as stiffness. Future treatment of PFPS may be centered on pain relief in order to decrease the sensation of stiffness.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com. The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of a visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

Why does taping around the kneecap help reduce patellofemoral pain?

Why does taping around the kneecap help reduce patellofemoral pain? I’ve tried everything else and this is the first thing that’s worked.

Patellar (kneecap) taping has been used with good results in many patients with patellofemoral pain (PFP). Decreased pain and increased function are the two main benefits of taping.

Studies have not been able to show a difference in alignment to explain why taping works. Some doctors think taping helps with the timing of muscle contractions. Patients with PFP have been shown to have abnormal contraction of the four parts that make up the quadriceps muscle.

Other parts of rehab may be equally important in the overall results. Strengthening the quadriceps muscle will help with activities like walking down the stairs. The quadriceps power is used in this activity to keep the knee from collapsing under the load.

Flexibility is important too. Poor flexibility may add to the load on the PF joint. Flexible muscles help absorb energy during loading activities. Joint proprioception or sense of position must be retrained, too.

So if you find your results are short-lived and you have to tape for more than six weeks, reconsider some of these other elements of rehab for PFP.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

True cause of patellofemoral pain syndrome still unknown

Is anyone any closer to finding out the true cause of patellofemoral pain syndrome?

Research on PFPS is ongoing. This condition causes knee pain when the patella (kneecap) doesn’t track up and down correctly during knee movement. Foot position is a key factor in this problem. The angle of the knee changes when the arch of the foot is dropped down (flat foot). The same thing happens if the arch of the foot is too high.

Even small changes in foot position can affect the way the muscles contract. The quadriceps (thigh) muscle is a key player in PFPS. If one side of the muscle contracts more than the other, the patella is pulled in that direction. When each part of the quadriceps muscle contracts in balance, the patella stays in the middle.

A recent study at the showed that orthotics can make a difference in muscle activity. Orthotics are shoe inserts that help put the foot in a better position. Treatment to address foot position and muscle activity may help PFPS the most.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

Could my knee pain be arthritis? I’m only 33!

Lately I’ve had a lot of pain right behind my kneecap, especially when going down stairs. I am only 33 years old. Could I be developing arthritis already?

 

There are several possible causes of pain behind the knee. A recent injury can cause pain from a ligament tear. Sometimes a small structure in the knee such as a bursa or plica can become inflamed and cause pain.

You may be describing a condition called patellofemoral pain syndrome (PFPS). This occurs when the kneecap is slightly off center as it slides up and down over the joint. This kind of tracking misalignment can cause the cartilage behind the knee to become torn or frayed.

PFPS is often characterized by pain when descending stairs. There may also be pain when trying to bend at the knee in a partial squat. An orthopedic physician or physical therapist can examine you and determine the cause of your symptoms.

The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic. For more information on this subject, visit www.zehrcenter.com.