PAIN ON THE FRONT OF YOUR KNEE
PATELLOFEMORAL SYNDROME
WHAT IS IT?
The patellofemoral joint in the front of the knee where the kneecap helps to extend (straighten) the knee. Patellofemoral syndrome refers to the symptoms that occur when various structural and functional problems occur in this joint.
WHY DOES IT GET INJURED?
This is an extrememly cause of sportsrelated knee pain due to the stress that builds up under the kneecap with running, combined with tricky biomechanics of the patellofemoral joint. With the repetitive high impact nature of running, there is nowhere for the kneecap to hide. The kneecap and thighbone form a delicate joint lined by a thin layer of protective cartilage. This joint is easily overloaded, especially when there is preexisting damage or common anatomical issues put the kneecap at a mechanical disadvantage.
SYMPTOMS
Patellofemoral syndrome typically causes a dull ache or sharp pain over the front of the knee, maybe with clicking or popping. Hills, steps, and prolonged sitting can make the pain worse.
TREATMENT
Your doctor can make shoe and training recommendations. Physical therapy can improve kneecap biomechanics for efficient functioning. For severe pain and structural cartilage damage (arthritis), your doctor may recommend medications, injections, and sometimes surgery. Since many biomechanical factors play a key role in kneecap pain with runners, there is a list of interventions you can try to help resolve your symptoms. This can be a frustrating problem for people when it is difficult to find the right combination of interventions, especially if the “wear and tear” process has begun. Consequently, longdistance running may not be possible in such cases.
PATELLAR TENDINITIS
WHAT IS IT?
The patellar tendon connects the kneecap, quadriceps muscles, and the shinbone to allow knee extension (straightening).
WHY DOES IT GET INJURED?
The patellar tendon tissue can get injured with repetitive overuse from long distance running.
SYMPTOMS
There will be pain very localized to the patellar tendon below the kneecap. There may be swelling over the tender areas. Hills and stairs may make the pain worse.
TREATMENT
Patellar tendinitis represents tissue failure that needs time to resolve. Rest, medical treatments, physical therapy, icing, and certain knee braces may recommended. Surgery may be recommended, usually for nonhealing tears that cause tendon failure.
OTHER CAUSES OF PAIN ON THE FRONT OF THE KNEE
- OSTEOARTHRITIS: the patellofemoral (kneecap) joint can also get worn out, causing activity-related arthritis pain and swelling. Like knee joint osteoarthritis, this is a treatable problem, but usually running is too high impact regardless of treatment.
- BURSITIS: There are several fluid-filled sacs in the knee that assist smooth movement between skin and bone. They usually become swollen and irritated with direct trauma. The prepatellar bursitis is inflammation of the bursa directly over the kneecap. It causes milddiscomfort but annoying swelling on top of the kneecap, with stiffness that can interfere with running. This is a treatable condition.
- EFFUSION: An effusion is a fluid buildup because of inflammation in the knee joint. The effusion can come from structural problems like arthritis and meniscus tears, but can also come from infections and metabolic disease. There will be pain associatedwith the swelling that can be “all over” or just in the front of the knee, with corresponding stiffness and pain with movement. Effusions must always be evaluated by a physician immediately.
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