1. Patellofemoral Pain Syndrome (PFS)
This is common in young adults, athletes and the elderly. The kneecap (patella) lies in a groove at the front of the lower end of the thigh bone (femur) and moves effortlessly up and down in the groove as you bend or straighten your knee. PFS is caused by ‘mis-tracking’ of the kneecap. It creates irritation on the cartilage in the grove which manifests as pain and a grinding or clicking sensation (known as crepitus) in the front of the knee, around and behind the kneecap. The pain can occur with everyday movements such as walking up and down stairs, often making kneeling or squatting difficult and is made worse by running or sports.
PFS can be caused by factors such as:
- Imbalance between the weaker inner quadriceps (thigh) than the outer quadriceps muscle.
- Poor pelvic musculature which stabilizes the pelvis
- Poor foot mechanics and over pronation
2. Osteoarthritis or ‘wear and tear arthritis’
Osteoarthritis is the most common type of knee arthritis causing the cartilage at the end of the bones to be worn away, reducing the ability of the bones to glide over each other and to absorb shocks. This causes a chronically painful knee that is often more painful with activity. It can become stiff with prolonged sitting and may become enlarged due to new bone formation at the edge of the worn cartilage.
Arthritis typically affects patients over 50 years of age, is more common in patients who are overweight and tends to run in families. Other factors that can contribute might include trauma to the knee, meniscus tears or ligament damage.
Management of osteo-arthritis can be helped by simple over the counter analgesia or anti-inflammatory medication. Injections of hyaluronic acid can be helpful in relieving pain.
Therapies – such as Osteopathy or physiotherapy may also help to alleviate pain and improve the function and mobility to the area in early to moderate stages along with an exercise programme and advice about the importance of being active to Acupuncture helps reduce muscle tension and helps to reduce pain. Severe arthritis though may need a prosthetic knee (knee replacement).
3. Iliotibial Band Syndrome (ITBS)
The Iliotibial band is a band of fibrous tissue that runs down the outside of the leg, beginning at the hip and extends to the outer side of the lower bone (tibia) just below the knee joint. It helps to provide stability to the outside of the knee joint and helps the knee to flex.
When tight the band rubs on the bottom end of the femur it causes friction and becomes inflamed causing pain, ranging from a dull ache to sharp pain. This is particularly common in runners who increase their mileage, or walkers who have poor foot mechanics.
It can be treated by stopping or reducing training load and intensity, and avoiding downhill running. Stretching exercises and anti-inflammatory medication such as Ibuprofen can be prescribed by your GP. Manual therapy such as such as physiotherapy or osteopathy is helpful. A podiatrist may need to assess your foot mechanics. Self-massage, can help but avoid direct massage onto the side of the knee where you feel the pain, as this may aggravate the friction syndrome.
For further information on any of these conditions please contact us today