Patellofemoral Pain Syndrome Information

Patellofemoral Pain Syndrome Information

Patellofemoral pain syndrome (PFPS) is one of the most common sources of knee pain between the patella and femur and is seen in both sports medicine practices and family orthopedic practices. Despite its commonplace, it’s often poorly understood and labeled using an array of misnomers - runner’s knee, anterior knee pain, chondromalacia, and patellar malalignment to name a few. Chondromalacia was previously used to describe patellofemoral pain syndrome, but arthroscopic studies have shown that the chondromalacia have little to do with patellofemoral pain. The terming anterior knee pain may be confusing because anterior knee pain can refer to a broad range of conditions from patellar tendinitis to Osgood Schlatter syndrome. The same with patellar malalignment; while patellofemoral pain most often occurs secondary to patella misalignment, the patella doesn’t have to be misaligned for patellofemoral pain to exist. So, most health care professionals are leaning toward using the term patellofemoral pain syndrome to describe patellofemoral pain where the differential diagnosis has been exhausted.

 

Anatomy As It Relates To Patellofemoral Pain Syndrome

The patella (kneecap) is the small triangular bone at the front of the knee. You may feel it move as you flex your knee. It actually glides back and forth along a track located on the end of the femur (thighbone). A thin layer of cartilage lines the underside of the kneecap, which helps it glide along the track. The patella is held in place on the top and bottom by tendons and side to side by ligaments. The patella stabilizes the knee as the quadriceps (thigh muscles) pull the patellar tendon to flex and extend the leg.

What is Patellofemoral Pain Syndrome?

Patellofemoral pain syndrome is a condition characterized by pain when back of the patella comes into contact with the femur bone.

What Causes Patellofemoral Pain Syndrome?

As mentioned in the anatomy section, the patella normally glides along a track on the femur. In patellofemoral pain syndrome, the patella rubs along the outer or inner aspect of the femur bone instead of smoothly gliding along the middle of the grove.

This “malfunction” or “maltracking” can be caused by a number of occurrences:

* previous patellar dislocation or patellar subluxation (partial dislocation) from a traumatic twisting to the knee or direct blow to the knee.
* patellar tracking disorder (where the patella shifts or rotates off track from a grove that’s too shallow, cartilage that's damaged, or supporting soft tissue that's too loose or too tight)
* muscle imbalances involving the quadriceps or hamstrings
* femoral anteversion (excessive hip rotation)
* tibial torsion (excessive tibia rotation)
* genu recurvatum (hyperextended knee that bends backwards)
* genu valgum (knock knees)
* excessive foot pronation
* compression or shearing of the of the patellofemoral joint from repetitive stress or overuse

What Are The Symptoms Of Patellofemoral Pain Syndrome?

* localized anterior knee pain and stiffness
* pain and stiffness may be more intense after descending or ascending inclines or stairs, prolonged sitting with bent knees, and high impact exercises or sport-related activities
* the knee may occasionally give away, catch, grind, grate, or pop with knee movement
* mild swelling

 

Strengthening Exercises

These Patellofemoral Pain Syndrome Exercises are ideal to build strength and flexibility.

Massage Treatment

These Patellofemoral Pain Syndrome Massage Techniques are of great value in pain relief; circulation stimulation; dispersing blood and fluid accumulations; swelling reduction; and relaxing muscle spasms, especially when used alongside the Sinew Therapeutics liniments and soaks.

 

ACUTE STAGE SYMPTOMS AND TREATMENT

 

This stage is characterized by swelling, redness, pain, and possibly a local sensation of heat, indicating inflammation. If coolness makes your pain feel better, then the Acute Stage Treatment is recommended.

 

ACUTE STAGE SYMPTOMS:

 

The acute stage starts the moment an injury occurs and lasts until the swelling and inflammation are gone. The swelling is the result of the blockage of blood, tissue fluids and circulation in the knee because their normal movement has been disrupted by the force of the injury. Just like cars back up behind a traffic jam, causing congestion, exhaust and overheating; blood and fluids back up behind the injured knee, causing pain, inflammation, lumps and swelling.

The sensation of heat is due to the warming action of the blood and fluids overheating in the injured knee as they back up and accumulate. Stiffness and decreased mobility are due to spasms in tendons and ligaments that have contracted reflexively beyond their normal range from the impact of the injury.

As ligaments and tendons stretch and tear, blood from ruptured blood vessels becomes trapped in the local tissues. As the trapped blood clots up, it sticks the tissues together creating adhesions. Adhesions cause pain, inflammation and restricted movement because the layers of tissue that used to slide smoothly across one another now adhere and snap which interferes with normal functioning. It is essential to break up clotted blood as quickly as possible to prevent adhesions and scar tissue from forming.

During the acute stage it is very important to restore normal circulation to the knee, break up clotted blood and stagnant fluids, reduce swelling, and reduce the redness and heat associated with inflammation. By restoring the flow of blood, fluids, and circulation in the knee, then pain is relieved, damaged tissues can regenerate with healthy functional tissue, and the knee can strengthen and regain it's mobility.

 

ACUTE STAGE TREATMENT:

 

1. Apply the Sinew Herbal Ice on your knee to reduce redness, swelling, and inflammation while dispersing accumulated blood and fluids to help restore normal circulation to the knee. This first-aid treatment is used in place of ice to significantly speed up the healing process. It reduces the swelling and inflammation more effectively than ice, allowing you to more quickly regain range of motion. Acute Sinew Liniment can be used in-between applications.

Ice is not recommended because it does not help repair damaged tissues and keeps everything in the injured area frozen, causing the stagnation of blood and fluids and the contraction of muscles, tendons and ligaments. In Chinese sports medicine ice is not used and is considered a culprit in injuries that donít heal well.

2. Massage your knee with Acute Sinew Liniment to relieve pain, reduce swelling and inflammation, break up clotted blood and stagnant fluids, and stimulate circulation of blood and fluids to help cells quickly repair damaged tissues. Sinew Herbal Ice can be used in-between applications.

3. The Sinew Sports Massage Oil is recommended for use before and after exercise, sports and strenuous activity. It warms and stimulates your muscles, increases circulation and relieves tightness, hence improving your performance and helping to prevent injury.

 

 

CHRONIC STAGE SYMPTOMS AND TREATMENT

 

This stage begins once the swelling and inflammation are gone, but you still feel pain, stiffness, weakness, and/or sensitivity in cold and damp weather. If heat makes your pain feel better, then the Chronic Stage Treatment is recommended.


CHRONIC STAGE SYMPTOMS:

 

The chronic stage begins once the swelling and inflammation are gone, but you still feel aching pain and stiffness. This is because there are still accumulations of stagnant blood and fluids in the knee that are blocking circulation and blood supply to damaged tissues, creating residual pain, stiffness and weakness. You may actually feel hard nodules like sand in the tissue, indicating accumulation, calcification, and adhesions, which all cause pain, stiffness, and joint instability.

Your knee may feel more sensitive to the cold and ache in cold and damp weather due to impaired circulation. When you move your knee you may hear a clicking or popping sound from the tendons and ligaments slipping very slightly in and out of their natural alignment indicating weakness and joint instability, causing chronic pain and a cycle of reinjury. These symptoms are often the result of failure to treat the injury properly from the outset and overicing.

Increasing circulation and blood supply to the damaged tissues is very important in treating chronic injuries because tendons and ligaments do not have an extensive direct supply of blood. That is why chronic injuries can be slow to heal. Increasing local circulation also prevents cold and dampness from penetrating the injured area, preventing pain and stiffness.

During the chronic stage it is very important to break up remaining accumulations of blood and fluids, and increase circulation and blood supply to the damaged tissues. By increasing circulation and blood flow in the knee, then pain and stiffness is relieved, and the tendons and ligaments can strengthen to restore stability.


CHRONIC STAGE TREATMENT:

 

1. Massage your knee with Chronic Sinew Liniment to relieve pain and stiffness, strongly stimulate circulation and blood flow to damaged tissues, and promote the healing of overstretched tendons and ligaments. Sinew Injury Poultice and/or the Sinew Warming Soak can be used in-between applications.

2. Apply the Sinew Injury Poultice on your knee to relieve residual pain and stiffness, significantly stimulate circulation and blood flow to damaged tissues, and further promote the healing of overstretched tendons and ligaments. The Sinew Injury Poultice is particularly useful if your knee is more painful in cold and damp weather. Chronic Sinew Liniment and/or the Sinew Warming Soak can be used in-between applications.

3. Soak your knee with the Sinew Warming Soak to ease joint pain, increase range of motion, and strongly increase local circulation to drive coldness and dampness out of damaged tissues. The Sinew Warming Soak is particularly useful if your knee is more painful and sensitive to cold or hurts more in cold weather. The soak can be used by saturating a towel in the liquid and applying it to your knee. Chronic Sinew Liniment and/or the Sinew Injury Poultice can be used in-between applications.

4. The Sinew Sports Massage Oil is recommended for use before and after exercise, sports and strenuous activity. It warms and stimulates your muscles, increases circulation and relieves tightness, hence improving your performance and helping to prevent injury.