Patellofemoral Pain Syndrome is also known as Chondromalacia Patella. It is pain in the front of knee & around the patella (kneecap). Quite often it is also known as the “runner’s knee”. It is more common among people participating in sports which involve jumping & running. This knee pain quite often increases when people run, squat, walk up or down stairs or sit for long periods of time, although simple treatments like resting & application of ice most often help, physical therapy is also sometimes needed to ease chondromalacia patella.
Signs & Symptoms of Chondromalacia Patella
Usual signs & symptoms of chondromalacia patella (patellofemoral pain syndrome) include a dull & aching pain which is located in front of the knee. This pain is generally aggravated when performing the following tasks.
- Kneeling or squatting
- Sitting with bent knee for long periods of time
- Walking up or down stairs
Time to Seek Professional Help for Chondromalacia Patella
When knee pain does not improve within a few days of time, it is time to consult a doctor.
Causes of Chondromalacia Patella
Although doctors are still not certain as to what causes chondromalacia patella, it is generally associated with the following factors.
- Overuse – Sports which involve jumping or running & which puts repetitive stress on knee joints can sometimes cause irritation under the patella (kneecap).
- Muscle Weaknesses or Imbalances – Chondromalacia patella usually occurs when muscles around hip & knee are unable to keep the kneecap properly aligned. Inward movement of knee during squatting is also found to be associated with chondromalacia patella.
- Injury – Trauma to kneecap, like in fracture or dislocation of knee is also linked with chondromalacia patella.
- Surgery – Knee surgery, particularly involving repair to anterior cruciate ligament using the patient’s own patellar tendon as graft is also found to increase risk of developing chondromalacia patella.
Risk Factors Associated with Chondromalacia Patella
Factors which commonly increase risk of chondromalacia patella include the following.
- Age – Chondromalacia patella or patellofemoral pain syndrome is typically found to affect adolescents & young adults. Knee problems among older populations are generally caused by arthritis.
- Sex – Women are found to be twice as likely as men are to develop chondromalacia patella. Reason behind this could be the woman’s wider pelvis which increases the angle at which bones in knee joint typically meet.
- Certain Sports – Participating in jumping & running sports activities can put extra stress on knees, especially when sports persons generally increase training levels.
Preparing for Initial Appointment Concerning Chondromalacia Patella
Most people would usually begin by seeing the primary healthcare provider. Subsequently they may be referred to a physiatrist (physical medicine & rehabilitation specialist), physical therapist, sports medicine specialist or an orthopedic surgeon. It would be sensible of the patient to take along a friend or family member to the initial appointment. This will help patients in remembering any information given during the appointment & which they may forget. Patients must also remember to take along copies of any x-rays or imaging tests they have had of the knees, while consulting the doctor during initial appointment. The following information will help the patient get ready for the initial appointment.
- What Patients Can Do Prior to the Initial Appointment
Patients can prepare a list of answers to the following questions which specialist doctors would usually ask during the initial appointment.
- Regarding Symptoms – Make note of signs & symptoms & when they began.
- Key Personal information – This should include having ever injured the knee or if the patient has undergone knee surgery in the past. Types of exercises & sporting activities which the patient participates in should also be mentioned.
- List of Medications – This would normally include all types of medications which the patient is taking with doses, including vitamins & supplements.
- List of Questions which Patients Can Ask Doctors – For chondromalacia patella or patellofemoral pain syndrome, some questions which patients can ask specialist doctors include the following.
- What is it that is most likely causing my knee pain?
- Which other possible causes are there for my knee pain?
- What type of tests will I need for diagnosis?
- Is my knee pain condition likely to be temporary or chronic?
- Which is the best course of action you suggest?
- Can you suggest any other alternatives to the primary approach?
- How can I best manage knee pain with other health conditions?
- Will I need to restrict any of my activities?
- Will I need to see another specialist for my condition?
- Can you provide me with brochures or other printed material on the subject?
- Which websites would you recommend I visit for more information?
Apart from these questions, patients should not hesitate to ask what they have in mind.
- What Doctors Usually Ask Patients During Initial Appointment
Doctors are most likely to ask the following questions during initial appointment.
- How would you like to describe the experience of knee pain?
- Where exactly in the knee does it hurt?
- What type of activity improves or worsens you symptoms?
- Did you recently increase your athletic activities?
- Which home treatments did you try & have they proved to be helpful?
Tests & Diagnosis for Chondromalacia Patella
Doctors will commonly ask patients about history of knee problems & will press upon areas of knee & will also move the patient’s leg into a variety of positions in order to help rule out other conditions which feature similar signs & symptoms. In order to help determine the exact cause of knee pain, doctors may recommend imaging tests like the ones mentioned below.
- X-Rays – Small amounts of radiation is passed through the patient’s body in the process of creating images using x-rays. This technique is ideal for visualizing bone, but is less effective for viewing soft tissue.
- CT Scans – These normally combine x-ray images from various angles in order to create cross-sectional images of internal structures of the body. CT scans usually visualize both bones & soft tissue, but this procedure delivers a much higher dose of radiation when compared to plain x-rays.
- MRI – This procedure uses radio waves alongside a strong magnetic field to produce detailed images of both bones & soft tissue, including the cartilage & ligaments in knee. But MRI procedure is far more expensive than CT scans or x-rays.
Treatment Options for Chondromalacia Patella
Treatment options for chondromalacia patella usually begin with simple measures. Along with resting the knee as much as possible, patients must modify or avoid activities which increase pain, like squatting, kneeling or climbing stairs.
- Medications – Chondromalacia patella patients can take over-the-counter pain relievers like naproxen sodium (Aleve), ibuprofen (Motrin IB, Advil) or acetaminophen (Tylenol) whenever required.
- Physical Therapy – Physical therapists usually suggest the following.
- Rehabilitation Exercises – These include specific exercises which can strengthen muscles supporting knees & controlling limb alignment including hamstrings, quadriceps & muscles around hips, especially the hip abductors. Correcting inward movement of knees while squatting is the primary goal of these exercises.
- Taping – Physical therapists will usually show patients as to how to tape the knee in order to reduce pain & enhance ability to exercise.
- Supportive Braces – Arch supports or knee braces are generally found to improve knee pain.
- Application of Ice – Icing the knee following exercise can often be very helpful.
- Knee-Friendly Sports – Chondromalacia patella patients might like to restrict themselves to low-impact activities during the recovery procedure. These sporting activities generally include bicycling, swimming or water running, are also easy on the knees.
- Surgery & Other Options – Doctors usually suggest surgery when nonsurgical treatments have failed to be effective.
- Arthroscopy – Doctors insert a pencil-thin device which is equipped with camera lens & light (arthroscope) into the patient’s knee through a tiny incision during this procedure. Surgical instruments are subsequently passed through the arthroscope in order to remove fragments of the damaged cartilage.
- Realignment – Orthopedic surgeons may at times need to operate upon the kneecap in more severe cases in order to relieve pressure on the cartilage or for realigning the angle of kneecap.
Prevention & Self-Management of Chondromalacia Patella
Quite often knee pain just happens. However, certain steps like the following can help prevent knee pain.
- Maintaining Strength – Strong hip abductor muscles & quadriceps help keep knees balanced during activity. However, deep squatting should be avoided during weight training.
- Think Technique & Alignment – Seek advice from doctors & physical therapists regarding strength & flexibility exercises in order to optimize technique for pivoting, jumping & running & to help patella properly track within its groove. This is especially important when patients are exercising for outer hip muscles in order to prevent knees from caving inwards while squatting, landing from a jump or stepping down stairs.
- Loose Excessive Weight – Losing weight will relieve stress on knees. This is very important for people who are overweight.
- Warm Up – It would be sensible to warm up for 5 minutes or so of light activity before running or exercising.
- Stretching Exercises – Gentle stretching exercises will promote flexibility so as to prevent knee pain.
- Gradually Increase Intensity – People must avoid sudden changes in intensity of workouts.
- Practice Shoe Smarts – It is sensible to ensure that shoes fit well & are able to provide good shock absorption. People having flat feet must consider shoe inserts.
Affordable Orthopedic Treatments & Surgeries in India
Costs of healthcare across the world have dramatically risen over the past few decades. However, apart from maintaining high quality of medical procedures, India is among the few countries which have withstood escalating the prices of healthcare services. Maintaining excellence in medical treatments goes to the fact that India is having a large pool of specialist doctors & surgeons who have constantly delivered outcomes at par with the best in the world. Many of these doctors have for decades initially trained & experienced in advanced western countries & gained global recognition. They are well versed with the latest technologies & are aware of the emerging trends in medicine as well. Alongside these medical professionals, India is home to a large network of nationally & internationally accredited multispecialty hospitals which include quite a few famous international groups like Apollo, Fortis Hospitals, Wockhardt & Max Healthcare. Other Indian counterparts are equally good & committed to high standards of excellence. They are also equipped with the latest technologies which enable them deliver top-of-the-line diagnosis & treatment procedures. Lastly, but not the least, skilled nurses & professional staff managing these healthcare institutions are English speaking. This is a comforting factor, especially for the international patient, who can look forward to undergo speedy recovery within a soothing & familiar environment following surgery.
Patellofemoral Pain Syndrome Treatments with Orthopaedic Surgery India
Orthopaedic Surgery India is a reputed one-stop specialist healthcare tourism platform which has developed under the Travcure Medical Tourism banner. Engaged in providing seamless healthcare services to international patients, Orthopaedic Surgery India is offering a wide spectrum of affordable medical solutions for a variety of bone & joint ailments. In fact our services begin with the first telephonic conversation with the patient & then move on to identifying the best doctor & the most ideal treatment facility for the ailment. Wide range of other essential services which we provide to foreign patients include assistance in obtaining medical visas for the patient & his/her accomplice, receiving them at the airport, arranging for convenient local travel, comfortable accommodation options which include budget or luxury hotels or serviced apartments near treatment facilities, scheduling appointments with doctors & surgeons for tests & medical procedures without any waiting period, follow-up evaluation checks for speedy recovery & an affectionate farewell when patients fly back home.