The main causes of peripatellar pain in the knee include: 1. abnormal patellar trajectory (especially in young women) 2. overuse leading to patellofemoral joint wear, 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 the movement of the knee. For abnormal patellar trajectory, the patient may feel pain below the patella, which worsens with time or increased exercise. The cause of symptoms is usually due to abnormal patellar trajectory, imbalance of muscle strength around the knee, and overuse. Treatment options include: 1. Ice the knee for the first 2 to 3 days, and ice for 20 to 30 minutes every 3 to 4 hours until symptoms resolve. 2. Elevate the affected limb during acute episodes of knee pain. 3. Non-steroidal anti-inflammatory drugs may be used as appropriate. 4. Wear appropriate braces to correct flat feet. 5. Use a special below-the-patella restraint belt, ” Jumper’s Knee Brace”, placed under the patella and pressed against the patellar tendon.6. Wear a knee brace to provide support for the knee and patella. Rehabilitation of patellofemoral joint pain: The best prevention of patellofemoral joint pain is to strengthen the thigh muscles, especially the quadriceps, and it is also important to use proper arch pads or proper shoes for flat feet. Rehabilitation program for patellofemoral joint pain: You can start immediately with N-cord muscle pulling exercises (first one). After the pain around the knee patella is relieved, you can start the second exercise. After the pain is further relieved, you can start the quadriceps muscle pulling and start the exercises to enhance the muscle strength (third to sixth). 1, N rope muscle pull: standing position, the affected side of the heel on a 30 ~ 40cm high low stool, 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. In this process, keep the shoulder joints and torso in the same line, do not turn the shoulder joints inward, and do not lower your head or bend over, otherwise you will pull the lower back section instead of the N cord muscle. Repeat this exercise 3 times. 2. The images used in this article are from 2007 Relay Health2. Patellar mobility exercise: Sit with the affected knee straight ahead and relax the quadriceps. Use both thumbs and index fingers to gently 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 of the healthy side stands on one leg, and the healthy side hand holds the wall to maintain balance. The other hand grasps the affected ankle joint to flex the knee joint and maintain the heel of the affected side near the hip. Maintain for 30 seconds each time, repeat 3 times. Be careful not to bend over. 4, side lying leg lift exercise: lying on the 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 elevation of the affected limb 20 ~ 25cm, each group repeated 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 N fossa is pressed on the floor. During this process, the rehabilitation exercise focuses on the effort to contract the medial femoral muscle. Maintain this position for 5 seconds, repeat each set 10 times, repeat 3 sets. 6. Straight leg raise exercise: Sitting position, with the affected leg straight and the ankle dorsally extended, 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 set of 10 times, repeat 3 sets. 8, the ball against the wall squat: 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 each set 10 times, repeat 3 sets. 9, knee stability exercise: use a rubber cord, 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 each group 10 times, repeat 3 groups. If standing is unstable, hold a chair to maintain balance. Further balance exercises can be done by standing on the pillow on the affected side while moving the healthy side of the lower limb to increase the difficulty of the exercise. 10. Resistance knee extension exercise: Use a rubber cord loop with 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 N fossa. The lower extremity of the healthy side is lifted 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 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.