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The best approach to pain management is a long-term
commitment to behavior modification that includes
good nutrition, proper exercise and weight control.
The snapping, grinding sensation and pain many
people experience while squatting, kneeling or
walking down a flight of stairs is likely due to
patellar pain syndrome. An average of two out of
10,000 people develops this condition. It is most
common in adolescent females although older people
may develop it as well.
Women are more susceptible to patellar pain syndrome
than in men. There are several reasons for this. A
small percentage of women have poor knee alignment,
which is a major cause. The female's childbearing
pelvic structure is typically wider than the male
pelvis. This moves our hips further away from the
midline of our body, predisposing us to an increased
angle at the knee or "knocked knee" alignment.
Weight gain during pregnancy can significantly
increase the load to all joints, especially the
knees. Sitting proper and "ladylike" with crossed
legs and wearing high heels are other factors that
predispose women to this painful condition.
In active population, excessive exercise, abnormal
alignment, muscle imbalance or perhaps a direct fall
onto the knee can create swelling and "wear and
tear" of the backside of the knee cap This is called
the patellofemoral joint, where the patella (knee
cap) rubs against the end of the femur (thigh bone).
Articular or chondral cartilage is the smooth, low
¬friction surface that caps the ends of our bones
and helps joints move smoothly. It also distributes
forces evenly throughout the underlying bone. When
the chondral surface breaks down (called chondrosis),
either due to the normal aging process or through
injury, the joint loses its ability to effectively
handle the forces placed upon it. This results in
inflammation or swelling around the knee and can
lead to degenerative changes in the articular
cartilage. This then can lead to osteoarthritis.
Experts say far too many people are victimized by
surgery for this condition. Patellar pain syndromes
are the equivalent to headaches of the knee. Their
causes are vague and are better managed
conservatively or non-surgically through a holistic
or preventative approach. Research indicates that 85
percent of people do well with conservative
treatment. The remainder may still have severe pain
and require arthroscopic surgery to repair tissues
inside the knee joint. The patella is the joint that
is most susceptible to overload conditions in the
body. This is due to the large forces placed on the
bone from quadriceps muscle.
It is also the most pain-sensitive structure in the
leg due to its significant nerve and blood supply.
Main contributing factors leading to patellar pain
syndrome are following: - Excessive load on the knee
due to over-training
- Weight gain during pregnancy;
- Poor nutrition;
- Muscle weakness;
- Obesity and sentry lifestyle;
- Inactivity that can lead to cartilage softening.
The best approach to pain management is a long-term
commitment to behavior modification that includes
good nutrition, proper exercise and weight control.
Experts stress the need for nutritional
supplementation with antioxidants and bone nutrients
called glucosamine and chondroitin. Medical research
is now underway, and early indications are showing
evidence of cartilage regrowth following one year of
use of these nutrients.
Often the symptoms of patellar pain syndrome can be
relieved with rest, ice and short-term use of
over-the-counter, anti-inflammatory medicines like
ibuprofen. Initially, avoiding stairs, deep
squatting and kneeling may be necessary to help
reduce to the knee joint. If you have lessened your
intensity and still have pain, swelling or popping
consult a physical therapist or sports medicine
physician for an evaluation. Your therapist will
evaluate your injury, suggest proper stretching and
strengthening techniques, and may advise activity
modification for your specific condition. A
therapist may also evaluate your feet to rule out
excessive phonation (flat feet) or supination ( high
arch) that may lead to alignment problems at the
knee. In some cases, custom orthotics (shoe inserts)
will help correct your alignment Taping techniques
(think of it as human duct tape for the knees) or
soft neoprene braces specifically designed to
improve the patellar alignment may help. If your
symptoms aren't relived over time, your therapist
may refer you to a sports medicine physician or an
orthopedic surgeon who will perform x-rays and
determine if arthroscopic surgery may be necessary
to "clean up" articular cartilage damage. A variety
of new machines- like elliptical trainers-combine
the movements of cycling, climbing and walking
without creating join impact. The important thing is
that you find a few activities that you enjoy and
commit to doing them three to four times a week for
30 to 45 minutes. Varying activities is a great way
to avoid over use injuries.
The health of your joints will depend upon your good
decision- making skills. The best advice is to
listen to your body. With proper exercise, sound
nutrition and weight management, you and your knees
can continue to live a healthy, active lifestyle.
Three steps to knee pain prevention are:
Make it Tough: Squats above 90 degrees, heel
dip, lunges with good alignment, bench hams and toe
raises target all the major muscles of the legs,
including the quads, hams, gluts and calves.
Performing squats and lungs work the gluts, quads
and hams simultaneously.
Stretch it out: Stretching helps maintain
flexibility and full range of motion of the joints.
Target muscles that influence the knee include
quads, hip flexors, hamstrings and calves. It is
most effective to stretch after aerobics and
strengthening activities have warmed the muscles.
Hold each stretch for a 30 seconds count and do two
or three repetitions.
Lower the Impact: Aerobic exercise is the key
to fitness, weight management and cardiovascular
health. If you affected by the conditions of the
knees, hips or spine, you can still enjoy all the
benefits from aerobics exercise. Choose activities
that have a lower impact in the joints. An example
includes swimming, aqua jogging, cycling, walking,
and the elliptical trainer.
This service area is designed to help GATEGOLD
customers obtain general information and guidance
regarding health topics, and includes information
compiled from a number of resources. Nothing in this
area should be considered authoritative or complete,
or medical or health advice. You should consult your
physician or other health care professional before
making any decision based upon the general
information presented here.
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