Patella Femoral Syndrome

Patella femoral syndrome was earlier known as chondromalacia patellae (knee cap is otherwise known as patella). Initially, this condition was defined as the damage caused to the soft cartilage under the knee cap. But with the advent of the twenty-first century, the term chondromalacia patellae was replaced by patella femoral syndrome/patellofemoral syndrome. It is a broad term, which refers to the pain in front of the knee, due to any cause. It has been observed that this condition is most commonly found in young people, especially sports persons. Any activity which involves a lot of stress on the knees can be a cause of this condition, which is prominently seen in tennis players, cyclists, rowers, runners and horse riders.

Symptoms and Causes

One of the most common symptoms of patella femoral syndrome is knee pain, more concentrated on both sides of the knee cap. The pain may be dull or like a grinding sensation in the area with or without knee stiffness. It can aggravate during movement of the legs. Sitting for prolonged hours may also worsen the pain. Some of the affected people may also experience inflammation of the area, though it is not commonly seen. In most cases, the symptoms will subside with rest, but will resurface again with movements. The causes for patella femoral syndrome may vary from one person to another. In order to understand the causes, you must have a basic idea about the anatomy of the knee cap. Knee cap or patella is a small triangular bone located at the front of the knees, just at the end of the femur (the bone that extends from the pelvis to the knee) and is the longest and thickest bone of the human skeleton. The femur possesses shallow grooves, in which the patella glides up and down during bending and straightening. The patella is attached to the quadriceps muscles in the front of the upper legs and the patellar tendon connects it to the lower leg. The movement of knees is facilitated by the joint action of the muscles and ligaments. As the quadriceps contract, the patella moves along the grooves in the femur. If the patella is not aligned properly with the grooves, lot of pressure is caused during the movement of patella, which causes irritation of the bone and other neighboring structures. This misalignment of the knee cap is one of the common causes of patella femoral syndrome. Other causes include poor flexibility of the hamstrings, calf muscles and hip rotator muscles. Muscle weakness may also cause the condition, as patella movement is mainly due to the action of quadriceps muscles. Any structural abnormality of the foot may also cause this condition. Another cause is injury to the patella.

Treatment

The treatment of patella femoral syndrome ranges from medication to surgery, as per the severity of the condition. The basic treatment includes application of ice, rest and restriction on movements. Medications include pain killers and anti-inflammatory drugs. In some cases, taping is done to correct the position of the patella and this will be continued till the patella is re-balanced with exercises. Patella femoral syndrome exercises include flexibility and mobility exercises, strengthening exercises and balancing exercises. Physical therapy is also suggested for full recovery. In some rare cases, surgery is also performed, if other measures fail to provide relief to the patient. The surgeries include arthroscopy and realignment. However, it will take around six weeks for full recovery. Post surgery, stressful activities should be avoided for some time, as it can affect the recovery process.

This condition can be prevented to some extent by losing excess pounds, wearing shoes that fit well, warming up before exercises and by following a proper exercise program.