Patellofemoral Syndrome (PFS), pain in the front of the knee, is one of the most common complaints of athletes and active people.
PFS is typically caused by a repetitive strain injury or a single traumatic event. PFS is usually characterized by a dull aching pain on the front, bottom or top of the knee, sometimes accompanied by swelling of the knee joint.
This syndrome commonly occurs in athletes participating in sports such as basketball, football, soccer, triathlons or track. These sports involve repetitive running, jumping and sometimes kicking, placing a lot of tension on the structures supporting the knee joint.
Pain is usually also felt after sitting for a long period of time with the knees bent. Running downhill and sometimes even walking down stairs can be followed by pain.
An understanding of the anatomy and the biomechanics of the knee joint during flexion (bending) and extension (straightening) of the leg will make it easier to comprehend how to effectively treat and prevent Patellofemoral Syndrome.
The underside of the kneecap (patella) of the patella glides over a groove located at the bottom and front of the femur (thigh) bone. The quadriceps muscle (which is really four muscles) shares a common tendon which connects these muscles to the top of the patella. The patella is anchored on the bottom by a ligament that attaches to the top of the shin bone (tibia). The patella ‘floats’ in place, held in place above and below by tendons, and glides either up or down.
The patella acts as a pulley system by supporting the pull of the quadriceps muscle during straightening of the knee. Proper function of this pulley system depends on the ability of the patella to slide properly through its track during movement. Muscle tightness in the outer knee area and muscle weakness in the inner knee area may compromise this tracking, and is often a root cause of knee injury. A problem with the feet such as fallen arches or forefoot pronation (flat feet) can also cause PFS.
Your training program will need to change to address the causative factors of this condition:
• Conduct a lower body strength training program as prescribed by your chiropractor. In addition to these movements, the program should include strengthening of the calf musculature, tibialis anterior, and core abdominal musculature.
• After exercise ice both knees for 20 minutes.
• Cross train, rather than repeating one activity over and over. For example substitute biking, cycling, and swimming for running.
• Slowly increase the duration or intensity of the training program; use the 10 per cent increase in mileage per week rule.
• Change sneakers every 250-400 miles, and run on softer surfaces.
Chiropractic treatment of Patellofemoral Syndrome may consist of:
• Adjustments of the ankle and foot to restore joint mobility.
• Possible recommendation of a semi-rigid orthotic or taping of the foot.
• Acupuncture to the quadriceps musculature and surrounding knee structures to enhance proper muscle tone, reduce inflammation and enhance healing.
Jenny P:Editorial_DeptEdited – unusedHealthAlign columnsunners knee.doc [ 503 words] 2:15 PM 13 July 2006 [Page 1]