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What makes this joint snap, crackle and pop?

By Cierra Washington, ATC

What exactly is patellofemoral pain? Patellofemoral pain is a general term used to describe pain that resides in the front of the knee and around the kneecap, also known as the patella. Patellofemoral Pain Syndrome, PFPS, is also known as both runners’ and jumpers’ knee due to the type of athletes who commonly complain of the problem. Based on the nicknames of PFPS, most people tend to believe that it can only occur in athletes or those who participate in high intensity sports, however it can also occur in the older and more sedentary populations.

So what causes PFPS? Most commonly, this condition is caused by repetitive stress on the knee joint while performing high intensity exercises such as jumping, squatting and running. In addition to overuse, other common causes include:

  • Sudden change in physical activity
  • Increased frequency of physical activity whether in duration or intensity
  • Patellar malalignment
  • Improper technique
  • Muscular imbalances

During the jumping, squatting and running activities, the kneecap is repeatedly moving throughout the patellar groove. As the kneecap travels through the range of motion to complete each exercise, the backside of the kneecap starts to rub against the end of the thigh bone, also known as the femur. This causes that pain.

Let’s talk about the anatomy. The knee joint consists of three major parts: the lower end of the femur (thigh bone), the end of the tibia (shin bone), and the patella (kneecap). In addition to these three bony structures, cartilage and ligaments connect the bones together and provide additional stability inside of the knee joint. The cartilage in the knee joint provides smooth surfaces that allow for fluid movement, while the ligaments create stability through multi-directional movement. When talking about PFPS, we often are talking about a knee joint that does not have enough cartilage behind the knee cap. This causes the two bony prominences to roughly grind together. Although high levels of activity are often looked at as the primary cause, anatomical issues can be the root of the problem as well. For instance, with patellar malalignment, the kneecap simply does not sit properly in its groove. Usually, it sits towards one side of the joint. This malalignment could be from skeletal alignments, such as flat feet, which causes additional medial stress on the knees, or abnormally wide hips, which could also increase the load angle. Muscular imbalances can also contribute to knee pain. For instance, if the outer quadriceps, and/or IT band, are tighter than the inside musculature, the kneecap is going to be pulled to the outer edge of the groove, creating uneven wear in the back of the kneecap.

Some common symptoms of PFPS include but are not limited to: anterior knee pain (often dull and achy), swelling in the knee joint, stiffness, increased pain with activities that repeatedly involve knee flexion, increased pain with prolonged sitting in knee flexion, and crackling sounds when going up stairs or standing after prolonged sitting. When these symptoms arise, it becomes a hassle to climb the stairs in your home, make that 30-60 minute commute to work, exercise and even get down on the floor to play with your kids. So instead of going through the daily tasks of life while suffering in pain and sacrificing the things that you want to do or love doing, come into to Loudoun Sports Therapy Center so we can decrease the pain and swelling and increase your value of life! Not only will we spend an entire hour determining the problem and its causes, we’ll also put together a personalized rehabilitation plan to significantly decrease your pain and inflammation, increase your range of motion, strengthen your knees and the surrounding areas that attribute to your problem and get you back to living life pain free! Call our office TODAY at 703-450-4300.

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