A very common complaint during the adolescent years is anterior knee pain. Especially common in girls, this pain is often attributed to knee cap pain. The condition is called patella femoral syndrome. This name describes the knee cap (patella) and its relationship to the leg bone (femur).
It is a disorder where the knee cap does not move, or track, correctly in its groove on the femur bone. If you feel your knee cap when you move your knee through range of motion, you will feel your knee cap move up and down as your knee moves. To make this happen, there is a joint in the front of the knee called the patellofemoral joint. When the knee cap tracks improperly it produces pain.
It has to do with the attachment of the quadriceps muscle to the knee cap. As the quad contracts, it moves the knee cap up and down within the knee joint. The problem arises when the knee cap pulls too hard toward the lateral side of the knee. In the short term this causes pain and in the long term it causes abnormal wear underneath the knee cap.
Earlier we said that females experience this problem more than males. This is because God created the female pelvis in a different shape in preparation for childbirth. Because the quad muscle is anchored from the pelvis, it creates a more lateral pull on the knee cap and thus more knee cap pain.
Treatment for Patellofemoral Syndrome is physical therapy, bracing, and avoiding deep knee bend exercises. In difficult cases, sometimes arthroscopic surgery is performed to release the lateral knee structures to assist in improved tracking. Left untreated, it will develop into arthritis often times as early as the mid-40’s. Injections can be used to treat symptoms, but they do not correct the underlying mechanics, so therefore are often not used. Bracing can be very effective when performing certain activities that are known to aggravate symptoms.
By Dr. Patrick Boyett, Orthosports
