Knee cap pain and pain behind the knee running

Knee cap pain and pain on the inner side (medial) of the knee are common among women.  Women with patellofemoral pain syndrome often notice pain below the knee cap, on the side of the knee or in the thigh and clicking with squatting, going up and down the stairs or getting up after sitting for a while. 

 In this part of my knee pain series, I'm going to talk about patellofemoral pain syndrome.  A rose is still a rose by another name; whether it's patellar arthralgia, patellofemoral tracking disorder or patellar malalignment subluxation, they're the same.

 To fully appreciate your knees and understand the pathology of patellofemoral pain syndrome, you need to know how your knees work.  So, put the kids to bed and pop open a couple of brewskies.

 The entire quadriceps muscle and patellar tendon are anchored to the knee cap.  Your knee cap (patella), sits above a femoral sulcus.  When you bend and extend your knees such as walking or going up and down the stairs, the knee cap glides up and down along a groove.  When you sit down and enjoy that brewskies, I mean milk, the patella slowly sinks back into the sulcus.  And when you get up from sitting down for a while, the knee cap has to unlock itself to get out of the sulcus before sliding up the femoral groove. 

 Patellofemoral pain syndrome does not come over night, even though you may recently experience pain, swelling or clicking below the knee cap, on the side of the knee or in the thigh with squatting, going up and down the stairs or getting up after sitting for a while.  It takes time to develop patellofemoral pain syndrome.  And by the time it's diagnosis, there's already some wear and tear thinning of the cartilage underneath the knee cap from repetitive the grinding stress and abnormal tension on the patella.

 With the exclusion of structural hip and knee deformities such as hip coxa valga or vera or severe bow-legged and knock knees, patellofemoral pain syndrome is basically a pathomechanical problem.   You develop patellofemoral pain syndrome when the knee cap cannot properly and smoothly glide up and down the femoral groove.  This may due to improper alignment and dysfunction between the knee joints and the patella, weak and imbalanced knee muscles or a high knee Q-angle. 

  As the knee cap continues to glide improperly and out of alignment within the femoral groove, the knee becomes irritated and inflamed with pain, swelling, clicking and stiffness; various knee muscles become imbalanced and weak from uneven tension and pulling.  Earlier, I mentioned that the entire quadriceps muscle and patellar tendon are anchored to the knee cap.

The cartilage on the underside of the knee cap also begins to wear thin from the stressful grinding and tension.   Eventually your knees become degenerative and develop osteoarthritis.

 If you experience knee cap pain and pain in front and on the inner side of the knee, swelling, clicking and stiffness, please consult with a chiropractor.  It may or may not be patellofemoral pain syndrome.

 Treatment of patellofemoral pain syndrome should begin with conservative care before radical treatments such as cortisone injection and surgery.   And chiropractic treatments are tremendously effective in treating patellofemoral pain syndrome.

 Chiropractic adjustments and soft tissue treatments to the knee joints, patella and muscles relieve pain and stiffness below the knee cap, on the side of the knee or in the thigh.  The treatments also restore proper joint biomechanics and muscle functions which give you more mobility and better knee range of motion so you can rotate, bend and extend your legs with less stress to the knee joints while doing rehab exercises.

 A vital part in treating patellofemoral pain syndrome includes specific rehab exercises for the weak and imbalanced knee muscles.  Weakness to the vastus medialis oblique and adductor magus muscles or tightness vastus lateralis, iliotibial band, tensor fasciae latae and the lateral retinacula can pull the knee cap out of alignment as it glides up and down the femoral groove and place unwanted tension and grinding stress.

 It's extremely important to understand the varying amount of compression forces endure by the knee cap, knee joints and muscles at different ranges of knee motion.  General knee exercises do not take this into consideration can lead to bursitis and tendonitis.  And if the rehab exercises are not task specific and applicable to daily activities, then why are you doing them?