When you start running, climbing stairs, or getting up after a while with your knee bent, do you feel a strange pain around or under the kneecap? Do you sometimes hear a "cracking" sound? Then this is something that may be important to you. We call this kneecap pain , and doctors call it ``Patellofemoral Pain Syndrome'' or ``(PFPS)''. Some people also call it ``Runner's Knee''.
What is PFPS? Let's understand it simply!
Okay, now let's look at what this `(PFPS)` is. In front of your knee is what we call the kneecap or the kneecap. Doctors call this `(Patella)`. This is what helps the large muscle in your thigh (the `(Quadriceps)` muscle) move your leg. It also protects the knee, and it also supports the many important muscles, tendons, and ligaments around the knee.
Now, "Patellofemoral" refers to the connection between your kneecap (patella) and your thighbone (femur). Normally, the kneecap should fit snugly into a small groove in the thighbone, allowing it to slide smoothly when you bend and straighten your knee. But if you have PFPS, for some reason your kneecap can't move properly, causing pain.
Most of the time, this condition called ``(PFPS)`` develops gradually. It can occur in one knee or both knees at once. If you have knee pain that doesn't go away after a few weeks, is it a good idea to see a doctor?
How common is this condition called PFPS?
This `(PFPS)` is actually very common. According to doctors, only one-third of people who come for treatment for knee pain have this `(PFPS)` condition. Imagine how common it is.
What are the symptoms of PFPS? How does it feel?
The main symptom of PFPS is pain in the front of the knee . Sometimes you may hear a "cracking" sound in your knee or feel something twisting inside.
This pain usually increases gradually. It can be especially severe during times like these:
- When sitting with your knees bent (e.g., when squatting) or when climbing stairs.
- When you keep your knees bent for a long time (e.g., when sitting for a long time on the bus, in the office).
- When you change the playing surface (e.g. when moving from a hard surface to a soft surface).
- When you suddenly increase the amount or intensity of exercise.
- When you exercise in a new pair of shoes.
PFPS pain is usually felt as a dull, aching pain in the front of the knee or on either side of the kneecap. However, it can also be sharp, stabbing, or shooting during activities such as running, jumping, squatting, or climbing stairs.
Why do we get PFPS? What are the causes?
Doctors can't say for sure what causes PFPS, but they think it may be caused by:
- Overuse of the knees: When you do the same type of movement over and over again (e.g., a lot of jumping, working on your knees), you can develop ``PFPS''. For example, someone who climbs and descends stairs continuously, or someone who plays a sport like volleyball, is at risk.
- Weak or tight muscles around the knee: If the muscles around the knee in your legs (especially the quadriceps muscles in the front of the thigh) are weak, they may not be able to support the knee properly. Also, if these muscles are not flexible enough, i.e. if they are tight, this can also put unnecessary pressure on the knee.
- Sudden increase in exercise intensity: When you start a new sport or exercise, or when you suddenly increase the amount of exercise you do, you can develop ``PFPS''. This can happen even if you increase the intensity of your training. For example, if someone who used to run only once a week suddenly starts running every day, this problem can occur.
- The natural shape of your knee: Some people are born with a slightly abnormal kneecap. Or, their kneecap may not fit properly into the socket of the thigh bone. If this happens, they may develop PFPS even if there is no extra pressure on the knee.
Who is at higher risk of developing PFPS?
Anyone can develop `(PFPS)`, especially if you've recently changed your activity level. But certain groups are more likely to develop it. These include:
- Athletes or physically active people who do a lot of running, jumping, squatting, etc.
- People who do physically demanding work (e.g., construction workers, farmers).
- Women. (Women are thought to be at higher risk due to their body shape and hormonal changes.)
- Young children (especially those aged 12-19).
- Adults between the ages of 20 and 40.
What happens if PFPS is not treated properly? (Complications)
If you know you have PFPS but don't treat it properly, the pain will usually get worse . Not only that, but untreated PFPS can also increase your risk of other injuries. How do you know? The pain can change the way you hold your body (your posture) without you realizing it. This can put extra pressure on areas like your hip joints, ankle joints, or the muscles in your legs, abdomen, and back. Over time, this can lead to new pain.
How do you know if you have PFPS? (Diagnosis)
A doctor will confirm whether you have PFPS through a physical exam . He or she will examine your knees and ask about your symptoms. You will need to tell them exactly when you first felt the pain, what activities make it worse, and more.
Your doctor will ask you to do things like bend your knee, extend your leg straight out in front of you, and squat. If you feel pain when doing these, let them know. Sometimes, you may also be asked to take an X -ray or MRI scan (Magnetic Resonance Imaging - MRI) to look at your knee joint and surrounding tissues.
What are the treatments for PFPS?
Your doctor will suggest treatments that will help you reduce pain and move around more easily.
Things you can do at home (RICE method)
In most cases, PFPS can be treated at home using the RICE method (Rest, Ice, Compression, Elevation).
- Rest: Stop the physical activity that caused the pain. Give your knee a rest.
- Ice: Place an ice pack or a cloth soaked in cold water on the knee for about 20 minutes every three to four hours. Do not let the ice touch the skin directly ; wrap it in a towel or cloth.
- Compression: Applying compression to your knee (e.g., with a compression bandage) can help reduce blood flow to your knee and reduce swelling. Your doctor will show you how to do this properly.
- Elevation: Keep your knees higher than your heart as much as possible. You can use things like pillows, blankets, or pieces of bedding to keep your knees elevated.
Physical Therapy
A physical therapist will teach you exercises and stretches to strengthen the muscles around your knee. Strengthening and increasing the flexibility of your quadriceps muscles in particular will help your knee support itself and help your kneecap move properly.
Painkillers
Your doctor may prescribe medications to help relieve your PFPS pain. Many people can use over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) (e.g., ibuprofen, aspirin, naproxen) or paracetamol (e.g., Tylenol®, Panadol). However, it is best not to take these medications for more than 10 days at a time without medical advice .
Knee Braces and Orthotics
You may need to use a knee brace or special orthotics to stabilize your knee, ankle, or lower leg.
- Knee Braces: These stabilize and support the knee joint. They can help reduce pain, especially during the initial stages when there is a lot of pain and when you are physically active. Ask your doctor what type of brace is right for you.
- Orthotics: These are insoles that are placed inside your shoes. You can buy them at a pharmacy, or you can have them custom-made for you. Your doctor will tell you what kind you need and how long you should wear them.
Surgery for PFPS
Surgery is rarely necessary for PFPS. A doctor will only suggest surgery if you have unbearable pain and other treatments have not helped.
If such a surgery is required, it is most likely to be a knee arthroscopy . This involves making several small incisions in the skin around the knee and inserting a special instrument called an arthroscope into the knee joint. This instrument has a camera and a light, so the surgeon can see and correct problems inside the knee.
Can PFPS be prevented?
Depending on what your doctor thinks is causing your `(PFPS)`, it may be possible to prevent it. For example, if you are starting a new sport or exercise program, you may want to increase your level of physical activity gradually rather than trying too hard all at once . However, if your kneecap does not naturally fit into the socket of your thigh bone properly, it may be difficult to prevent `(PFPS)` from occurring at that time.
The best way to prevent knee pain, not just PFPS, is to be safe when you are physically active . Keep these things in mind when playing sports or doing other physical activities:
- Wear appropriate safety equipment (e.g., appropriate sports shoes).
- If your knees hurt, either during or after physical activity, " don't play through the pain ."
- Give your body time to rest and recover after strenuous exercise.
- Before playing sports or exercising , warm up and stretch your muscles (especially the quadriceps).
- After physical activity, cool down and stretch your muscles again.
How long does it take for PFPS to heal?
Most people recover from Patellofemoral Pain Syndrome within a month or two . Your doctor or physical therapist will give you a timeframe that works best for you based on your condition, strength, and activity level.
Expect to make some changes to your usual activities or stop them for a while during `(PFPS)`. Most people can resume their usual sports and work activities after the pain and other symptoms have subsided.
When should I see a doctor?
If you have knee pain, and it doesn't go away after a few weeks of home treatment and rest, be sure to see a doctor. Also, if the pain returns or gets worse after you start treatment for `(PFPS)` (especially if it hurts when doing certain exercises or positions), tell your doctor or physical therapist.
What questions should you ask the doctor?
It's a good idea to ask these questions when you see your doctor:
- Do I have `(PFPS)` or another type of knee pain?
- Will I need to have any tests? (like `(X-ray)`, `(MRI)`)
- What kind of treatment do I need?
- How long will I have to do physical therapy?
- When will I be able to play sports or do strenuous exercise again?
Take-Home Message
Patellofemoral Pain Syndrome (PFPS) is a long-winded term, but in simple terms, it is a type of knee pain that occurs when you exercise or climb stairs. But don't worry, most of the time it can be managed with simple treatments and physical therapy . The key is to listen to your body. Don't ignore pain. Once you get medical advice, strengthen your muscles, and increase your flexibility, you can resume your normal activities and sports.
` Patellofemoral Pain Syndrome, PFPS, Knee Pain, Runner's Knee, Kneecap, Exercise, Physical Therapy
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