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quality, satisfaction and care
| Knee
Pain (Patello-Femoral
syndrome) |
Medical Etiology: (information for health
professionals)
Definition:
Displacement of the knee cap as it
tracks over the femur. This causes inflammation and pain at the
underside of the patella.
Symptoms:
The patient
complains of a nagging pain beneath or on the sides of the kneecap
during activities like walking up-stairs or getting out of the car.
In addition, a dull ache may occur after sporting activities or
getting out of a chair. Also, the patient experiences a
crunching/clicking (crepitus) sensation around the knee cap.
Sometimes swelling is present.
Biomechanical
etiology:
Excess internal tibial rotation, is directly
associated with excessive pronation. Therefore, medial displacement
of the patello-femoral path encourages lateral displacement of the
patella. The cartilage under the patella will eventually soften,
resulting in pain and inflammation under and about the patella,
especially with excess loading activities such as running. The
cartilage becomes damaged because the patella is not sliding
smoothly over the patello-femoral path. Subsequent wasting of the
Vastus Medialis Obliquis (VMO) commonly occurs. In addition, the
quadriceps, which are important in proper tracking of the knee cap -
may be weakened (or fatigued in athletes), thereby displacing the
patella further.
Treatment:
Common treatments
involve the reduction of pain and balancing of soft tissue
structures. However, knee pain commonly associated with excess
pronation responds well to foot orthotics. Orthotics effectively
replace the natural footprint and provide a stabilising angle for
the calcaneus. This calcaneal angle reduces calcaneal eversion
associated with excess subtalar joint pronation and limits secondary
internal tibial rotation. Pre-molded ORTHAHEEL orthotics or custom
VASYLI Moldables (full-length model for
athletes).
Additional treatment: Ice therapy (15 min.
3-4 times per day), muscle balancing.
Exercises:
�
Strengthening of the quadriceps, especially the VMO
� Stretching
of quadriceps and
hamstrings.
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