The main causes of pain around the patella of the knee include.
1, abnormal patellar trajectory (especially in young women).
2. overuse leading to patellofemoral joint wear and tear, quadriceps tendonitis/patellar tendonitis.
Patients may feel significant pain around the patella at a certain angle of knee flexion, and sometimes the pain is severe enough to interfere with knee movement. For abnormal patellar trajectory, the patient may feel pain below the patella, which worsens with time or increased motion. The cause of the symptoms is usually due to abnormal patellar trajectory, imbalance of muscle strength around the knee, and overuse.
Treatment options include.
1. icing of the knee joint for the first 2 to 3 days, with icing every 3 to 4 hours for 20 to 30 minutes until symptoms are relieved.
2. elevation of the affected limb during acute episodes of knee pain.
3. non-steroidal anti-inflammatory drugs may be used as appropriate.
4, wearing appropriate braces to correct flat feet.
5. using a special below-patellar restraint belt, the “jumper’s knee brace”, placed below the patella and pressed against the patellar tendon
6. wearing a knee brace to provide support for the knee joint and patella.
Rehabilitation of patellofemoral joint pain.
The best way to prevent patellofemoral joint pain is to strengthen the thigh muscles, especially the quadriceps. Also, for flat feet, it is important to use proper arch pads or appropriate shoes.
Rehabilitation program for patellofemoral joint pain.
Hamstring pulling exercises (the first one) can be started immediately. After the pain around the patella of the knee is relieved, the second exercise can be started. After the pain is further relieved, the quadriceps pulling can be started and the exercises to enhance the muscle strength (third to sixth) can be started.
1, hamstring pull: standing position, the affected side of the heel placed on a low bench 30 ~ 40cm high, straighten the knee, slowly flex the hip so that the body leaned forward, with the body leaning forward hands gradually apply pressure to the tibia until you feel the pulling sensation at the back of the thigh. Hold this position for 30 to 60 seconds, then stand up straight. During this process, keep the shoulder joints and torso in the same line, do not tuck the shoulder joints in, and do not lower your head or bend over, as this will pull the lower back segment instead of the hamstrings. Repeat this exercise 3 times.
2, patellar activity exercise: sitting position, the affected side of the knee straight ahead, relax the quadriceps. Use both thumbs and index fingers to push the patella distally and maintain this position for 10 seconds. The patella is then relaxed to return to the starting position. The patella is then pushed proximally with the index fingers of both hands and held for 10 seconds, returning the patella to its starting position. The patella is then gently pushed medially and held for 10 seconds. Repeat the above process for about 5 minutes.
3, quadriceps pull: the lower limb on the healthy side stands on one leg, and the hand on the healthy side holds the wall to maintain balance. The other hand grasps the affected ankle joint so that the knee joint is flexed and the heel of the affected side is maintained close to the hip. Maintain for 30 seconds each time, repeat 3 times. Be careful not to bend over.
4, side lying leg lift exercise: lie on your side, the healthy side of the limb in the lower, the affected side of the lower limb quadriceps contraction, maintain the knee joint straight, lateral lift the affected limb 20 ~ 25cm, each group repeat 10 times, repeat 3 groups.
5, quadriceps isometric contraction exercise: sitting on the floor, the affected limb straight forward on the floor. Make an effort to straighten the knee joint so that the popliteal fossa is pressed on the floor. In this process, the rehabilitation exercise focuses on the effort to contract the medial femoral muscle. Maintain this position for 5 seconds, repeat each group 10 times, repeat 3 groups.
6.Straight leg raise exercise: sitting position, the affected leg straight, ankle dorsal extension, raise the affected leg 15~20cm, maintain this position for 3~5 seconds, repeat each group 10 times, repeat 3 groups.
7, weighted knee extension exercise: place the sandbag in front of the calf, knee extension exercise. Note that the exercise process again to completely straighten the knee joint, especially the last 15 degrees of knee extension is most important. Use a sandbag with enough weight to be able to feel fatigue during the knee extension exercise but not cause pain. Each group of 10 times, repeat 3 groups.
8, ball squat against the wall: stand with your back against the wall, keep your shoulders, head against the wall, feet shoulder-width apart, and about a foot away from the wall. Place a soccer between the knees and clamp. Keep your eyes level, head against the wall and clench the ball while slowly squatting down until you reach a seated position, maintain this position for 10 seconds, and then slowly stand up. During this exercise, make sure that both knees are clamped to the ball. Repeat 10 times for each set, repeat 3 sets.
9, knee stability exercise: use a rubber rope, one end around the healthy side of the ankle, the other end tied to the foot of the table or fixed object.
a) Standing facing the table, the affected side of one leg weight-bearing. The knee on the healthy side is mildly flexed, keeping the quadriceps tense. Then the lower limb on the healthy side moves backward against the pull of the rubber cord. Repeat each set 10 times for 3 sets.
b) Turn the body 90 degrees so that the affected lower extremity is close to the table and the healthy lower extremity moves outward away from the body in an abduction movement against the pull of the rubber cord. Repeat each group 10 times, repeat 3 groups.
c) again turn 90 degrees, back to the table, the lower extremity of the healthy side for the action of forward extension, against the pull of the rubber rope. Repeat each group 10 times, repeat 3 groups.
d) again turn 90 degrees, so that the healthy side of the lower limb near the table, the healthy side of the lower limb in front of the body to do cross action (inward action), against the pull of the rubber rope. Repeat 10 times for each group, repeat 3 groups. If standing unstable, you can hold a chair to maintain balance. Further balance exercises can be done by standing on the pillow on the affected side while moving the lower limb on the healthy side to increase the difficulty of the exercise.
10.Resistance knee extension exercise: Use a rubber cord loop, one end tied to the foot of a table or a fixed object, stand facing the table and place the rubber cord loop over the popliteal fossa. Lift the lower extremity on the healthy side so that the affected side stands on one leg. If needed, hold the chair to maintain balance.
a) Bend the knee 45 degrees on the affected side.
b) Slowly straighten the knee joint while keeping the quadriceps contracted against the pull of the rubber cord. Repeat each set 10 times for 3 sets. A relatively easy way to perform this exercise is to stand on your legs.