Knee pain can be a result of a number of different issues, this month I have seen quite a few clients with knee pain, at Range of Motion Physical Therapy Clinic Lucan.

For the purpose of this blog I am going to talk about chondromalacia patellae, the most common cause of chronic knee pain. The condition is also called the patellofemoral syndrome (PFS).

PFS is softening of the cartilage beneath the knee cap (the patella) which results in small areas of breakdown and pain around the knee. Instead of gliding smoothly over the knee, the knee cap rubs against the thigh bone (the femur) when the knee moves.The changes can range from mild to complete erosion of the cartilage.

The symptoms of PFS are generally a vague discomfort of the inner knee or area around the patella, aggravated by activity (running, jumping, climbing or descending stairs) or by prolonged sitting with knees in a moderately bent position (driving)

The causes: the patella (kneecap) is normally pulled over the end of the femur in a straight line by the quadriceps (thigh) muscle. Patients with PFS frequently have abnormal patellar “tracking” toward the lateral (outer) side of the femur. This slightly off-kilter pathway allows the under surface of the patella to grate along the femur causing chronic inflammation and pain.

How is PFS treated? The primary goal for treatment and rehabilitation of PFS is to create a straighter pathway for the patella to follow during quadriceps contraction.

– Selective strengthening of the inner portion of the quadriceps muscle will help normalise the tracking of the patella along with stabilising additional hip muscles (Glutes) and core strengthening work.

– Reviewing any changes in training prior to PFS pain, as well as examining running shoes for proper biomechanical fit and it is critical to avoid repeating the painful cycle.

– Stretching and strengthening the quadriceps and hamstring muscle groups is critical for an effective and lasting rehabilitation of PFS.

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