Focus on Knee PainArticle by Bryan Huber, M.D.11/20/2008
Pain in the front of the knee is a common complain. Patients typically describe a dull aching pain under the kneecap that gets worse when walking down stairs, kneeling or sitting for long periods of time. The kneecap may be unstable with certain twisting motions. This type of knee pain is typical of patellofemoral pain syndrome and it commonly affects athletes that do a lot of jumping and running such as skiers, cyclists, runners and soccer players.
Often the pain is due to an injury such as a complete or partial dislocation of the kneecap or a direct impact injury. The pain can also be caused by imbalance, tightness or weakness in the thigh muscles. Excessive training or overuse is also a culprit.
A specific diagnosis is typically based on medical history, physical exam, and imaging studies such as x-ray, MRI and CT scan. Details about the onset of symptoms, location, and treatment history are also key to determining the proper diagnosis.
Treatment of anterior knee pain depends on the exact diagnosis. If it is the result of an acute injury, we advise rest, ice, compression and elevation along with taking anti-inflammatory medication. Often the problem is due to overuse in training. We then focus on modifying training to use cross training with a dedication to proper warm-ups and stretching before exercise, particularly the hamstrings, or thighs. We also recommend stretching after each training session along with another application of ice. Occasionally, taping and bracing the knee can be helpful for instability symptoms. If arthritis and inflammation are present, relief may be found with injection treatments of either lubricants or corticosteroids. If the pain persists, surgical treatment such as arthroscopy, mechanical realignment procedures or partial knee replacement should solve the problem.
You can lessen your risk of developing anterior knee pain by following these tips: Follow a general conditioning program that includes stretching your hamstrings before exercising. Lose weight to lessen the stress on your knees. Avoid over-training, increasing the intensity of your workout gradually. Follow proper technique for running and jumping activities. And use proper equipment such as running shoes with good shock absorption.
By practicing prevention, you can avoid the common factors that cause anterior knee pain. If you do have pain, come in for a comprehensive evaluation, treatment and rehabilitation program geared specifically for you.
About Mansfield Orthopaedics
Mansfield Orthopaedics creates a compassionate and efficient system of care in coordination with one’s primary care physician, providing comprehensive orthopedic evaluation, treatment and rehabilitation. The practice features three board certified orthopedic surgeons: S. Glen Neale, MD; Bryan Huber, MD and Eric Mullins, MD; with sports medicine specialist Richard James, MD. The practice focuses on Joint Replacement; Arthritis Care; Arthroscopic Surgery; Hand, Ankle and Foot Surgery; Sports Medicine and Fracture and Trauma Care. In addition to providing surgical consultation and post-surgical care, physical therapy, occupational therapy, aquatic therapy and athletic training care are offered in collaboration with Copley Hospital’s Rehabilitation Services. Mansfield Orthopaedics has clinics in Morrisville and Newport, with rehabilitation also offered in Stowe.
About Copley Hosptial
Copley Hospital is Lamoille County’s non-profit community hospital. The hospital is an essential health care resource in this rural region, providing emergency services, diagnostic services, general surgery, and orthopedics along with extensive Outpatient Services that includes a state-of-the-art Cancer Care program, Pain Management and access to a variety of medical specialists on its campus in Morrisville. Committed to fostering wellness, Copley sponsors extensive community education opportunities, focusing primarily on diabetes, obesity, heart health, and personal safety. Copley provides more than one million dollars annually in charity care. It was named EMS Hospital of the Year in 2008.
Contact Information
Leah Hollenberger
Senior Director Development, Marketing & Public Relations
Copley Hospital
802-888-8301
lhollenberger@chsi.org
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