Early killers of knee pain
A syndrome is a general term for a bunch of symptoms: anterior knee pain, pain around or under the patella, patellar exostosis, patellar tenderness… etc. These are all included in patellofemoral syndrome (for convenience, we will refer to it as PFPS).
In simple terms, the causes of PFPS are.
The contact surfaces of the “patella” and “femur” rub against each other, causing cartilage wear and tear, resulting in inflammation and pain.
PFPS is more likely to occur in younger age groups or in people who play sports. Studies show that about 20% of young people and sports groups in the United States have PFPS, and 25% of patients who go to sports injury clinics for knee treatment have PFPS. Twenty-five percent of patients treated at sports injury clinics have PFPS, which shows that the disease is quite common, and PFPS is more likely to occur in women due to the difference in the natural skeletal alignment of men and women.
Causes of Pencil-icon PFPS
The most common cause is the imbalance of muscle and soft tissue tension around the patella, resulting in a shift in the patella’s gliding path, which in turn causes wear and tear between the patella and the femur, and because of the body’s alignment and structure, coupled with the modern lifestyle of sitting, the muscles around our hips and pelvis become increasingly weak.
From the picture above, we can find the gluteus medius on the outside of the pelvis, which is a very important muscle to stabilize the pelvis, and of course, the gluteus maximus on the back side is also very important, just like building a house to build a stable foundation. When the pelvis is stable enough, the muscles of the legs will not need to bear too much burden. Therefore, it is conceivable that when the gluteus medius and gluteus maximus are weak. The pelvis is not stable enough, and the leg is overburdened. The broad fascia tensor and the iliotibial bundle under it are the first to suffer.
When they are overburdened beyond their limits. The muscles then become tight and even painful. The tight iliotibial bundle pulls on the lateral support band of the patella. This causes the patella to glide outward, and even the medial patella to buckle slightly. This is commonly heard as patellar valgus. The patella is thus constantly rubbing against the lateral track. At the same time, the medial support band is also stretched due to the outward shift of the patella. In addition, the muscles around the patella are unbalanced. The muscles on the anterior and posterior sides of the knee joint are also affected. When the paraspinatus muscle on the back of the thigh or the pectoralis muscle on the back of the calf is too tight. This causes friction between the patella and the femur to be tighter and more frequent.
Symptoms of Pencil-icon PFPS
1.Pain when walking up and down stairs or going up and down hills
2. Discomfort and pain when squatting or sitting (theatersign)
3.Knee joint makes a sound when moving
Treatment and prevention of Pencil-icon PFPS
Physical therapy is divided into 3 M’s, Modality, Manual and Movement. After an injury occurs, the soft tissues underneath and around the patella may become sticky or tight.
For Modality.
The therapist can use ultrasonic heating to soften the tissue and promote K-healing.
Manual.
Deep transverse massage (DFM) is used to break the adhesion and promote repair, while targeting the imbalance of the surrounding muscles. Manual massage can be used to release the tightened vastus lateralis and iliotibial bundle.
Movement.
Release the tight muscles, including the vastus lateralis, iliotibial bundle, paraspinatus and pneumoneuroticus.
Stretching the vastus fasciae tensor and iliotibial bundle.
Stretching the paraspinalis muscle.
Stretching of the pulmonary gastrocnemius.
In addition, patients can foam roller massage these muscles, especially the outer thighs, the effect is much more significant than just stretching.
And for the pelvic stabilizing gluteus medius, we can train in the following way.
Lie on your side and lift your leg, remember to keep your toes facing forward and your leg behind your body.
In addition to the gluteus medius, don’t forget that the gluteus maximus is also an important foundation for the legs.
Bridge hip lift, remember to put the neck and do not arch the chest.
In addition to a good foundation, do not forget to also train the inner femoral oblique muscles of the knee joint, the inner femoral oblique muscles are strong in order to counterbalance the outer iliotibial bundle, so that the patella glides less easily to the outside.
The ball squat with both legs, training the internal femoral oblique.