Patellofemoral Pain Syndrome and Patellar Chondromalacia
Patellofemoral pain syndrome (also called “Runner’s Knee”) is an overuse injury associated with chronic pain at the front of the knee during activity. It is especially common in adolescent female athletes and individuals with tibial torsion. This chronic rubbing of the patella against the femur often wears down the cartilage and roughens the under side of the patella resulting in a condition called patellar chondromalacia.
Causes & Symptoms:
Patellofemoral pain syndrome occurs when the patella rubs against the femur during movement. It is associated with malalignment (such as a kneecap that is located too high or too low) and weakness in the quadriceps muscles (the primary muscles stabilizing the knee). Also implicated are poor core and hip abductor strength, tight hamstrings or achilles tendons, and pronation of the feet (rolling onto the outer edge). Pain and swelling are usually localized under the kneecap, and mimic the same symptoms as Jumper’s Knee. However, Jumper’s knee is localized on the tendon just below the kneecap, and pain due to Patellofemoral pain syndrome will feel more “internal” as the injury is localized behind the patella at the patellofemoral joint. Symptoms are typically exacerbated by climbing stairs, running, and prolonged periods of sitting. Dancers with this condition will experience pain during jumping and pliés.
Preventative exercises include stretching the hamstrings and quadriceps, as well as strengthening the vastus medialis muscle that runs along the inner thigh and supports the knee. Weakness in the hip abductors has also been correllated with patellofemoral stress syndrome. Side extensions in parallel can strengthen these muscles, and dancers should pay particular attention to walking in parallel instead of turnout in their daily lives. The hip abductor series developed by Joseph Pilates is a great compliment to ballet training, as classical technique does not target these muscles.
Rest and refraining from activities that are painful are the best treatment. Oral anti-inflammatory drugs such as ibuprofen may be used in moderation to relieve pain.
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