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Introduction: Pain around the kneecap is often a sign of overuse. In other words, the knee might have been
exposed to too much or too frequent strain without being able to adapt to it fast enough. This is particularly
common when doing sports such as jogging, mountaineering or intensive cycling. The condition is often
referred to as â??runnerâ??s kneeâ? because of this.
There are currently no treatments that directly target the cause of pain at the front of the knee. But good-quality
studies have shown that regularly doing exercises to strengthen the thigh and hip muscles can help people who
do a lot of sports and develop acute knee pain is also advised to take a break from sports or do less for a while
so that their knee can recover.
Symptoms: Pain at the front of the knee usually occurs just behind or next to the kneecap. Doctors then call
it Patellofemral pain or Patellofemral pain syndrome (PFPS). â??Patellofemralâ? means that it affects the area
between the kneecap (patella) and the thigh bone (femur).
The pain is often mild at first and then gets worse over time. It tends to be a dull, aching pain and is particularly
noticeable when you put strain on the knee â?? especially when going up or down stairs or bending the knee a lot.
The knee may also hurt and feel stiff after sitting for a long time.
A lot of people who have knee pain can feel or hear crackling, crunching or creaking when they move the
affected knee. But this isnâ??t a reason for concern: Thereâ??s no link between knee sounds and pain or the function
of the knee. Many people have â??noisy kneesâ? without any pain or other knee problems. One reason why joints
sometimes make sounds is because small bubbles of gas form in them and you can hear the bubbles bursting.
People whose knees make sounds can â?? and should â?? still move. The knee joint can only stay healthy if it is
moved enough. If no pressure is applied to it, the cartilage in the joint isnâ??t supplied with enough nutrients. The
bones need to have strain put on them too, to stop them from becoming weaker.
Causes: Overuse of the knee can lead to small injuries around the kneecap â?? for instance, in the bands of tissue
that hold it in place, in the bones and in the small nerves. Itâ??s not clear why some people develop knee problems
and others donâ??t. One factor that plays a role is how the kneecap moves along the trochlear groove in the joint.
References:
1. Collins NJ, Barton CJ, van Middelkoop M, Callaghan MJ, Rathleff MS, Vicenzino BT et al. 2018
Consensus statement on exercise therapy and physical interventions (orthoses, taping and manual
therapy) to treat patellofemoral pain: recommendations from the 5th International Patellofemoral Pain
Research Retreat, Gold Coast, Australia, 2017. Br J Sports Med 2018; 52(18): 1170-1178.
2. Crossley KM, Stefanik JJ, Selfe J, Collins NJ, Davis IS, Powers CM et al. 2016 Patellofemoral pain
consensus statement from the 4th International Patellofemoral Pain Research Retreat, Manchester.
Part 1: Terminology, definitions, clinical examination, natural history, patellofemoral osteoarthritis
and patient-reported outcome measures. Br J Sports Med 2016; 50(14): 839-843.
Biography
Mostafa Elshikh currently working as senior physiotherapist at Salamatak Medical Complex, Saudi Arabia.
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