WHAT CAUSES PAIN IN THE KNEE CAP?

There are multiple causes for pain in the knee cap, one of the most common biopmechcnical causes would be Patellofemoral Pain Syndrome (PFPS). PFPS is pain behind or in front of the patella (knee cap). It is one of the most frequent musculoskeletal conditions of the knee, and can affect all ages, most commonly adolescents and young adults. Prognosis of PFPS is very good, with conservative care often resulting in complete recovery, particularly in young patients.

Common PFPS symptoms can include:

• Pain behind or in front of the patella on movement.
• Swelling around the front of the knee.
• A “cracking” or “popping” sound in the knee during movement.

WHAT CAUSES PATELLOFEMORAL PAIN SYNDROME?

PFPS can be caused by a number of factors, including flexibility issues, biomechanical changes, muscle imbalances or weaknesses, training errors or increased training loads. PFPS can be aggravated by activities such as:

• Walking
• Running
• Squatting
• Jumping
• Kneeling
• Going up and down stairs
• Sitting for long periods of time.

Two things that may help decrease the symptoms of PFPS are strengthening the quadriceps muscles, and stretching the hip and knee muscles, particularly the quadriceps, hamstrings, and ITB.

WHAT CAN WE DO TO HELP WITH PATELLOFEMORAL PAIN SYNDROME?

Our Morley Chiropractors use a combination of different treatments and rehab exercises to help with knee pain. These treatments are only done once we have completed a thorough history and examination to find out why there is pain in the knee.

• Adjustments and mobilisations of the spine, pelvis, hips, knees and ankles.
• Functional taping (kinesiotaping) of the knee.
• Soft tissue techniques, including massage, dry needling and stretching of the muscles surrounding the hip and knee.
• Remedial Massage Therapy.
• Rehab exercises to strengthen the hip and quadriceps muscles.
• Functional exercises to get you back to your chosen activity or sport as soon as possible.
• Advice on activities to change or avoid to help resolve your pain quickly.

COULD THE PAIN IN THE FRONT OF MY KNEE BE CAUSED BY SOMETHING ELSE?

Non-biomechanical factors, including inflammatory conditions, infections, tumors, or systemic diseases, can also present as front-of-the-knee pain, making it crucial to maintain a broad diagnostic perspective. Understanding key red flags helps in differentiating serious conditions from common PFPS.

The top five red flags to watch out for include sudden swelling and warmth, which might indicate infection or inflammatory arthritis; significant trauma followed by severe, immediate pain suggesting fractures or ligamentous injuries; unexplained weight loss or persistent night pain raising concern for tumors; systemic symptoms such as fever or fatigue pointing toward infections or autoimmune diseases; and knee locking or instability that could suggest meniscal tears or loose bodies within the joint. Being vigilant about these warning signs ensures that appropriate medical evaluation and intervention are sought promptly.

References

1. Alba-Martin, P. et al. (2015). Effectiveness of therapeutic physical exercise in the treatment of patellofemoral pain syndrome: a systematic review. Journal of Physical Therapy Science. 27(7): 2387-2390.

2. Papadopolous, K. et al. (2015). A Systematic Review of Reviews in Patellofemoral Pain Syndrome. Exploring the Risk Factors, Diagnostic Tests, Outcome Measurements and Exercise Treatment. The Open Sports Medicine Journal. 9(1): 7-16

3. Logan, C.A. et al. (2017). Systematic Review of the Effect of Taping Techniques on Patellofemoral Pain Syndrome. Sports Health. 9(5): 456-461.