What Is Patellofemoral Pain Syndrome?
Patellofemoral pain syndrome, also known as “Runner’s Knee,” is a condition that may be triggered by injury or inflammation of the quadriceps muscle or the attachments of the quadriceps tendon. This knee condition results from the perception of pain by the nerves in the knee within the bone and soft tissues surrounding the patella. It is important to properly diagnose and treat this condition to prevent further injury and to reduce pain and discomfort.
The knee joint is a complex and large joint in the human body, where the femur (thigh bone) and tibia (shin bone) meet the patella (kneecap). The patella is attached to the femur by the quadriceps tendon and the tibia by the patellar tendon. Articular cartilage lines the undersurface of the patella, which enables it to smoothly move up and down the trochlear groove during knee movements. Patellofemoral pain syndrome, commonly known as “Runner’s Knee,” is a condition that occurs when the nerves in the knee perceive pain in the soft tissues and bone surrounding the patella. This condition is usually caused by chronic and repetitive physical activities such as running and squatting.
What Causes Patellofemoral Pain Syndrome?
The knee joint is a complex structure comprised of bones, ligaments, tendons, and cartilage that can withstand considerable stress during daily and physical activities. However, with excessive and prolonged use of the joint, damage to these structures is likely to occur. Patellofemoral pain syndrome can be caused by several factors including:
Abrupt changes in exercise routine. This can include modifications in the frequency, duration, or intensity of physical activities as well as changes in footwear or playing surface.
Patellar malalignment. When the patella is displaced from the trochlear groove on the femur, it can cause increased pressure on the patella and trochlea, leading to irritation of the surrounding soft tissues. This abnormality can result from malalignment of the legs, between the hips and ankles, or a high-riding patella (patella alta).
Muscle weaknesses. The quadriceps muscle and quadriceps tendon are crucial to proper knee movement. Any weakness or imbalances in these muscles can lead to improper tracking of the patella within the trochlear groove.
It is essential to accurately diagnose and treat patellofemoral pain syndrome to prevent further injury and reduce pain and discomfort.
What Is The Treatment For Patellofemoral Pain Syndrome?
Patients diagnosed with patellofemoral pain syndrome can typically manage their symptoms through non-surgical treatments. Conservative therapies such as rest, ice, compression, elevation, and NSAIDs can help control pain and inflammation. Participating in a physical rehabilitation program focused on strengthening the quadriceps muscle can improve knee range of motion, while taping the patella and using custom-made shoe insoles can also provide relief.
Surgical intervention for patellofemoral pain syndrome is uncommon and is usually only considered when conservative treatments have been unsuccessful in relieving severe pain. A minimally invasive arthroscopic procedure using specialized instruments and a small camera can identify and address the underlying cause of the knee pain. Surgical procedures may include excision and removal of damaged soft tissue fragments, removal of inflamed tissues, bone spurs, or loose bodies.
Another surgical procedure, lateral retinaculum release, can be used to treat patellar instability. This involves releasing the fibrous tissue located on the outer patella to reposition the patella and alleviate tension on the outer knee.
Tibial tubercle osteotomy is an open surgical procedure used to correct patellar malalignment resulting from a shallow trochlear groove. In this procedure, the tibial tubercle, which is the bony prominence of the shin bone, is transferred to another position on the tibia with the patellar tendon still attached.