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Knee Cap Pain
All about patellofemoral pain syndrome
If you are active, there's a good chance you have experienced knee cap pain. The medical term for pain around or behind the knee cap (patella) is patellofemoral pain syndrome (PFPS).
It mainly appears during or after exercise activities, especially jumping and running. The knee might swell, and you may feel weakness or grinding behind the knee cap.
If you sit for a long time with your legs bent, your knee may feel stiff and painful when you stand again.
You might notice PFPS after starting a new activity where you run or jump. Increasing the duration or intensity of training or changing your exercise footwear can also bring it on. Happily, several strategies can ease PFPS symptoms.
What causes the pain?
The quadriceps muscle is at the front of your thigh. PFPS usually means that your inner quadriceps is weak in comparison to the rest of the muscle. Painful symptoms occur if the pull of the muscles on the knee cap is unbalanced. PFPS appears more often in teens and young adults, and affects more women than men.
Getting PFPS under control
- Change activities. First, stop or greatly reduce the duration and intensity of exercise activities that cause knee pain. Switching to non-weight bearing activities allows you to maintain fitness and physical activity without making symptoms worse. Cycling, elliptical machine, water running and swimming are good options.
- Try physiotherapy. The main focus in treating PFPS is to strengthen the inner quadriceps muscle. This can be done with a home program under the direction of a physiotherapist. Strengthening exercises, such as squats, leg presses, and lunges, will help develop muscle control and the strength of the inner quadriceps. Stretch the quadriceps, iliotibial band, hamstring, and calf muscles to improve the muscle flexibility of the leg. Often the hip muscle is also weak and needs to be strengthened. After exercise, ice the knees to reduce inflammation. Most people with PFPS need about four to six weeks of consistent quadriceps strengthening and stretching exercises to resolve symptoms.
- Tape and brace. If exercises to strengthen the quadriceps do not adequately treat symptoms, taping or bracing the knee may improve knee cap tracking (movement) and reduce pain during activity.
- Wear appropriate footwear and possibly in-shoe orthotics. Choosing the right footwear for the activity provides proper support of the feet and legs. In some cases, in-shoe orthotics can improve the biomechanics of the leg, reducing PFPS pain. See your family physician, physiotherapist, orthotist or pedorthist to discuss whether in-shoe orthotics are a good option for you.
- Consider medication. If the pain is quite severe, pain medication (such as acetaminophen) and non-steroidal anti-inflammatory drugs (such as ibuprofen) can be taken. However, watch for possible side effects, especially if you take these medications regularly. Some prescription non-steroidal anti-inflammatory drugs have fewer side effects. Very rarely, corticosteroid or hyaluronic acid injections are used to treat PFPS.
If symptoms do not change with these non-surgical treatments, see your family doctor for further assessment.
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