Anterior knee pain characteristics.
Generally located in the lower part of the knee, it is difficult to say exactly where the pain is, the pain will increase when going up and down stairs, it will also increase when doing squatting movements or hiking in the mountains, and what is even stranger is that going downhill will hurt more than going up (going downstairs will hurt more than going up).
Causes of pain around the patella of the knee.
1, abnormal patellofemoral trajectory (especially in young women)
2, overuse leading to patellofemoral joint wear, quadriceps tendonitis/patellar tendonitis patients will feel significant pain around the patella at a certain angle of knee flexion, and sometimes the pain is severe enough to affect the movement of the knee joint. For abnormal patellar trajectory, the patient may feel pain below the patella, which worsens with time or increased exercise. 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. knee icing for the first 2-3 days, icing for 20-30 minutes every 3-4 hours until symptoms are relieved
2. Elevation of the affected limb during acute episodes of knee pain
3.Use non-steroidal anti-inflammatory drugs as appropriate
4.Wear appropriate brace to correct flat foot
5.Use a special below patella restraint belt, “jumper’s knee brace”, placed below the patella and pressed on the patellar tendon
6. Wear a knee brace to provide support for the knee joint and patella rehabilitation for patellofemoral joint pain.
The best way to prevent patellofemoral joint pain is to strengthen the thigh muscles, especially the quadriceps, and for flat feet, it is also important to use proper arch pads or appropriate shoes.
Rehabilitation of patellofemoral joint pain.
N-cord muscle pulling exercises can be started immediately (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 (the third – sixth).
1. N cord muscle pulling.
Standing position, the affected side of the heel placed on a low bench 30-1000px high, straighten the knee joint, slowly bend 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 30-60 seconds, then stand up straight. In this process, keep the shoulder joint and torso in the same line, do not tuck the shoulder joint in, and do not lower your head or bend over, otherwise you will pull the lower back segment instead of the N cord muscle. Repeat this exercise 3 times.
2, patella activity exercise.
Sit with the affected knee straight ahead and 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 pulling.
Stand on one leg of the lower limb on the healthy side, and hold the wall with the healthy hand 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 ~ 625px, each group repeated 10 times, repeat 3 groups.
5, quadriceps isometric contraction exercise.
Sit on the floor, with the affected limb straight ahead on the floor. Make an effort to straighten the knee joint, so that the N 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 set 10 times, repeat 3 sets.
6. Straight leg raise exercise.
Sitting position, straighten the affected leg, ankle dorsal extension, raise the affected leg 15-500px, 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, the ball against the wall squat.
Stand with your back against the wall, keeping your shoulders and head against the wall, feet shoulder-width apart, and about one 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 group, repeat 3 groups.
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 a fixed object.
(1) standing facing the table, the affected side of the weight on one leg. 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 10 times for each set and 3 sets.
(2) Turn the body 90 degrees, so that the affected lower limb close to the table, the healthy lower limb to the outside for the abduction away from the body, against the pull of the rubber rope. Repeat 10 times for each group, repeat 3 groups.
(3) again turn the body 90 degrees, back to the table, the lower limb of the healthy side for the action of forward extension, against the pull of the rubber rope. Repeat 10 times for each group, repeat 3 groups.
(4) 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 movement), against the pull of the rubber rope. Repeat 10 times for each group, 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 lower limb on the healthy side to increase the difficulty of the exercise.
10. Resistance knee extension exercise.
Use a rubber cord loop with one end tied to a table leg or fixture, stand facing the table, and place the rubber cord loop over the N fossa. The lower extremity on the healthy side is lifted so that the affected side stands on one leg. If needed, hold the chair to maintain balance.
(1) Bend the knee 45 degrees on the affected side
(2) 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 both legs.
If rehabilitation is not effective, it is necessary to have the joint surgeon direct the training, and if necessary, joint cavity injections (Speight), or minimally invasive surgical treatment.