Anterior Knee Pain "The Silent Danger in the Knee"
What is Patellar Chondromalacia?
We tend to resort to irregular exercise and sports activities to solve health problems caused by reduced walking and movement. As a result, sports injuries have been increasing in recent years, with the knee joint being commonly affected. Knee joint complaints also make up the majority of non-sports orthopedic service visits. Specifically, anterior knee pain is a frequently observed orthopedic complaint in these visits.
The most common cause of anterior knee pain is a condition called patellofemoral pain syndrome (PFPS). Dull and achy pain, particularly in the front part of the knee, especially around the kneecap, often worsens during activities such as running, squatting, or stair climbing. The pain we feel when we stand up after prolonged sitting is mostly due to patellofemoral pain syndrome. It can be mistaken for various knee problems and sometimes lead to incorrect treatments. Simple treatments such as cold application and rest provide temporary relief for most patients. However, if the pain persists for more than a few days, it is important to seek medical assistance.
Patellofemoral pain syndrome is the softening and deterioration of the cartilage structure on the back surface of the kneecap. While this condition can occur in young patients, it is also common among adults. Children, who are a constant source of endless energy and activity, are often the luckiest group in this regard. The pain caused by patellofemoral pain syndrome can be confused with many knee problems. Incomplete diagnosis may lead to different treatments at various centers for some patients. Among the reasons that reduce patient satisfaction after these treatments, patellofemoral pain syndrome frequently emerges.
Who is Prone to Patellofemoral Pain Syndrome?
As can be understood from here, encountering patellofemoral pain syndrome is only possible with regular movement, but it is caused by incorrect training programs and irregular sports activities in athletic individuals and athletes. Discontinuing regular sports also leads to this clinical condition over time. Patellofemoral pain syndrome coexists with many intra-articular knee problems and can exacerbate the discomfort caused by these problems. Softened and physiologically compromised joint cartilage should be treated to prevent damage during our daily activities and sports, which involve repetitive knee movements, causing wear and tear over time.
Patellofemoral pain syndrome is a common health issue, especially among athletes. Rest can temporarily alleviate the pain, but additional complaints may arise over time. These complaints include symptoms such as crepitus, catching, and buckling sounds during knee movements, which can increase the intensity of pain. The underlying cause of patellofemoral pain syndrome is the disruption of the coordinated movement between the muscles, tendons, and ligament structures that attach to the kneecap, which leads to its displacement from the joint surface of the thigh bone.
Causes of Patellofemoral Pain Syndrome
There are various causes, including congenital misalignment between the knee joint and the kneecap, weakened front and back muscle groups of the thigh (such as hamstring and quadriceps muscles), imbalance in the strength of muscles on the inner and outer sides of the thigh (abductor and adductor muscles), activities that result in repetitive stress and loads (skiing, running, jumping, etc.). Moreover, improper footwear, lack of physical activity, sedentary lifestyle, and excessive weight further elevate the risk of patellofemoral pain syndrome.
To prevent patellofemoral pain syndrome, it is necessary to engage in regular exercise and walking, maintain weight control, consume vitamins and minerals through diet, and use flexible-soled shoes. Additionally, structured and regular sports should be performed with proper equipment. Prolonged sitting should be broken up with short breaks. Additionally, choosing automatic transmission while driving, if available, is another recommended measure. These measures can prevent or reduce significant health problems like patellofemoral pain syndrome.
Diagnosis involves distinguishing patellofemoral pain syndrome from other causes of anterior knee pain through X-ray and MRI examinations. Definitive diagnosis is made through the examination of softening in the joint during MRI or arthroscopy. Physical examination and patient complaints are also as important as radiological evaluations in the diagnostic process.
Treatment of Patellofemoral Pain Syndrome
The most important aspect of treating patellofemoral pain syndrome is to reduce pressure on the kneecap and the joint. Resting the joint, stabilizing the joint, and applying cold therapy are the initial steps of treatment. During this process, the use of anti-inflammatory drugs is important for reducing pain and addressing inflammation around the joint. In addition to these measures, treatment of patellofemoral pain syndrome involves strengthening the thigh muscles (quadriceps, hamstring, abductor, and adductor muscles) and achieving balance among these muscle groups through strengthening exercises. Maintaining muscle balance will prevent the disruption of anatomical alignment in the knee. Engaging in non-weight-bearing exercises such as riding a stationary bike with the saddle set high or swimming is recommended. Additionally, performing exercises known as “isometric exercises,” which involve relaxing and contracting our muscles, is beneficial for increasing muscle strength and promoting blood supply to the cartilage-nourishing structures.
In advanced cases, arthroscopic interventions may be considered. However, surgical intervention is sometimes the initial treatment step for correcting anatomical abnormalities believed to be significant in the development of patellofemoral pain syndrome.
Preventive measures to avoid patellofemoral pain syndrome include:
– Weight control to maintain mobility
– Regular exercise or walking
– Including vitamins and minerals that support cartilage structure in our diet
– Wearing flexible-soled shoes that are suitable for our foot structure
Engaging in conscious, structured, and regular sports activities with proper equipment not only helps prevent sports injuries but also prevents the development of patellofemoral pain syndrome. Breaking up long periods of sitting in our daily and work life with short breaks and taking short breaks during long drives, avoiding frequent use of brakes and clutch pedals in heavy traffic cities by opting for automatic transmission cars, are other preventive measures. Creating opportunities for outdoor walks on soft surfaces can be beneficial. Remember that patellofemoral pain syndrome is the most common health problem causing anterior knee pain. These pains affect not only our health but also many daily activities and aspects of our life. The most significant concern with patellofemoral pain syndrome is the weakening of the joint due to softening, which increases the risk of joint problems requiring more extensive and intensive treatments in later stages.
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