As the largest joint in the body, the knee is essential for competing in nearly every sport. As a result, it is also the most common site for injury in young athletes. Overall, knee injuries make up about 55% of all sports injuries. There are two main types of injuries that occur at the knee: 1) acute/traumatic and 2) overuse.
Overuse injuries are caused by a repeated action or continuous stress on the knee joint. Common overuse injuries at the knee include:
- Bursitis — inflammation of the bursa around the patella
- Patellar Tendinitis (jumper’s knee) — inflammation of the patellar tendon, the tendon that connects the patella to the quadriceps muscle
- Patellofemoral Pain Syndrome (runner’s knee) — muscle weakness, minor wear and tear to the cartilage under the kneecap, or misalignment of the patella that may cause an abnormality in the movement of the patella over the femur
- Osgood-Schlatter disease — inflammation of the patellar tendon where it attaches to the tibia that occurs in growing adolescents (most common in boys ages 13-14 and girls 11-12)
This article will focus on one of these main types of overuse injuries, patellofemoral pain syndrome.
What is it?
Patellofemoral pain syndrome (PFPS) which is often preventable in youth athletes, is one of the most common knee conditions encountered in sports medicine. It is a general term for knee pain that occurs around the kneecap (the patella.) The pain is a result of soft tissue inflammation or swelling under or around the patella. It usually comes on gradually and progresses slowly. Running, jumping, walking up or down stairs and sitting for long periods of time often make symptoms worse. Sufferers are often unable to perform sporting and work-related activities without pain.
What causes it?
The causes of PFPS are wide-ranging and can include the kneecap moving out of alignment or repetitive stress on the knee joint. Risk factors for developing PFPS include weak muscles in places like the core (abdominals), gluteal (buttock), hamstring (back of the thigh) or quadriceps (front of the thigh) muscles. Tight muscles such as the quadriceps, hamstrings or gastrocnemius (calf) muscles can cause symptoms and so can abnormal foot positioning (flat feet or high arched feet). This condition usually does not require surgery.
What are treatment options?
Often, this condition is best treated by seeing a sports medicine doctor, physical therapist or certified athletic trainer. Depending on the severity, the treatment may include:
- Rest and/or ice to reduce swelling and pain
- Special kneecap taping to improve the alignment of the patella and reduce pain
- Muscle strengthening of the core, hip, hamstring and quadriceps to improve the alignment of the kneecap
- Education about proper footwear and training techniques to prevent re-injury
- Sport specific instruction to assist with proper mechanics for jumping, cutting, pivoting
- A home exercise program to continue stretching and strengthening
If you or someone you know has persistent knee pain that isn’t improving with rest, is worsening, or for more information about physical therapy and athletic training services, please call the Institute for Athletic Medicine (IAM) at 612-672-7100 to set up a virtual video visit with one of our experts.
Visit us online at athleticmedicine.org.