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Patellofemoral Pain Syndrome

I’ve developed this…pain under the knee cap. I know running aggrivates it, but what can I do? Anyone have experience? Will squats really hurt it?

If it’s the same thing as mine, squatting won’t bother it. Going DOWN stairs and running hurt like right under my left patellar tendon where it attaches to my kneecap. Not terrible, but enough to be bothersome. Heavy leg training and going UP stairs, even running up stairs don’t hurt at all. Maybe one of the docs here know what this is. Does it sound like the same thing?

That probably wasn’t very helpful, but there it is. Glad to see you kickin around BTW. I was going to PM you a couple times, but never did get around to it.

These articles will help:

Look at all of tip 5 in this article:
http://www.T-Nation.com/readTopic.do;jsessionid=E044DFC88740CBA9BCAA9BB29678966A.hydra?id=1127149

http://www.T-Nation.com/readTopic.do?id=462121&pageNo=0

I don’t think squats are the best thing you can do while having the pain, even if it doesn’t hurt. I’d stay away from squats until things are resolved. Good luck.

I’ve dealt with this in both my knees so I can relate.

You need to have someone (e.g. a very good physical therapist) evaluate your patellar tracking i.e. as you bend and unbend your knee your kneecap rides up and down in a groove in your thighbone. The patella should ride down the middle of the groove.

If your kneecaps gets pulled to one side of the groove, you can wear out the cushioning cartilage on the back of the kneecaps resulting in chondromalacia and causing pain.

The remedy will depend on the specifics of your problem. Strengthening the medial quad (VMO) and stretching the ITB (Iliotibial band) are commonly needed. Your adductors/abductors and issues with your ankles and leg length problems can also play a role.

My state allows people to visit physical therapists directly, though you may need an MD referral where you live.

P.S. I am not sure if the first tip in the linked article (wearing knee sleeves) is a good idea or not for people with condromalacia–I’ve been meaning to post asking MR that.

http://www.clinicalsportsmedicine.com/chapters/24a.htm

Read through this website… very handy to be informed.

With anterior knee pain, please keep in mind that there could be a number of issues - it doesn’t have to be patellar tracking, or patellar tendinopathy, etc.

I have a good example of this kind of mistaken thinking:
I was treated for patellofemoral syndrome for a long time with no results until someone thought to check out something else.

I ended up being diagnosed with infrapatellar fat pad inflammation/impingement but it was really too late… surgery made things worse and I ended up losing my job in the Army.

This whole scenario motivated me to study physiotherapy so it’s not all bad, though!

I agree with the problem possibly being patellar tracking and that you should see a physical (physio)therapist. The strengthening and stretching that was mentioned are also good, if tracking is the issue, and some taping may also be beneficial.

The problem mentioned by the second poster appears to be related more to the patellar tendon than the patella. It could be inflammation of the tendon or possible avulsion fracture at the patellar tendon’s insertion site.

Again, I would recommend seeing a physical (physio)therapist for it. Some things that may help include cross friction massage, jumper’s knee brace, anti-inflammatories, etc.

Of course to determine what will help, you need to know exactly what is wrong. That is why it is so important to have a therapist evaluate you and tailor the treatment program to your particular problem.

Let me know if you have further questions.

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[quote]sarah1 wrote:
I’ve developed this…pain under the knee cap. I know running aggrivates it, but what can I do? Anyone have experience? Will squats really hurt it?

[/quote]

First of all, if you haven’t been assessed by a competent health professional then please do so.
People who try to diagnose without assessing in person are not doing you any favours.

If you have patellar tracking issues then multijoint exercises like the squat are not likely to help resolve your condition. Targeted musculoskeletal rehabilitation is likely to help.

Squats may not, however, hurt depending on your circumstances as the forces sustained through joints while performing explosive impact exercise (i.e. running, jumping) are generally far in excess of those sustained while doing other exercises.