Knee
> Patellofemoral
Pain Syndrome > Treatments
Non-Operative Treatment
Home Recovery
It is important to refrain from
the activities that are causing your patellofemoral
pain. In general, any activity that puts a heavy load
or strain on your knees with the knee bent beyond 90
degrees should be avoided. This includes heavy running,
bicycling with the seat too low, climbing, yoga, and
stretches, like the classic hurdler's stretch, where
the heel is brought up to the buttocks. Your general
goal for the first few months is to be gentle with your
knee. Be smart about the activities you do and be consistent
with your conditioning and physical therapy to keep
your muscles pulling evenly on your kneecap.
PAIN MEDICATION
Physicians usually prefer that you do not use painkillers,
but anti-inflammatories like aspirin or ibuprofen may
be used in some cases. A small amount of pain is normal
during physical activity, but if you feel so much pain
in your knee to warrant taking a painkiller before an
activity, you should consider cutting back or stopping.
Too much pain could be a sign that you need more aggressive
treatment of your patellofemoral pain.
KNEE SLEEVES
For simple kneecap tracking problems that cause minor
discomfort, such as might be related to patellofemoral
pain syndrome, a soft knee sleeve brace worn during
activities may provide some relief. A neoprene brace
with a hole or pad around the kneecap may help relieve
stress and ensure normal tracking. The knee sleeve should
be snug but not tight. Some sleeves may have straps
that wrap underneath the kneecap, around the patellar
tendon. At your physician's discretion, physical therapists
can also teach you to tape your knee if braces are not
effective in alleviating your pain. Even with the neoprene
sleeve, you should take it easy on your knee for about
a week. Physicians generally tell patients to avoid
strenuous or high-impact activities for up to six weeks.
In general, avoid movements that put strain on your
knees, like bending down, climbing stairs, or lifting
heavy objects.
Your physician may prescribe visits
to a physical therapist to begin supervised strengthening
exercises as soon as possible after patellofemoral pain
syndrome is diagnosed. Physical therapy can help train
the muscles around the kneecap to pull evenly in all
directions, keeping your kneecap in normal alignment.
You usually need to stay off your feet for only a short
time, but the real key is relative rest. This means
staying away from activities that put excessive pressure
on the knee while being aggressive in strengthening
the knee so the kneecap will track properly. Patients
should do stretching and strengthening exercises for
a minimum of four days a week. The workouts should focus
on the knee for at least 30 minutes and be combined
with a knee friendly cardiovascular workout. Despite
your dedicated to the rehab program and wearing a knee
sleeve, you may not feel any improvement for six weeks
or longer, and your kneecap pain may recur. Though everyone's
rehab program is slightly different, physical therapy
after kneecap pain follows a general pattern. Most people
can begin stretching the muscles and tendons around
the kneecap within a week. Although your knee may be
weak, it is generally strong enough to handle mild stretching
and slow movements. Working to restore early range of
motion may help reduce swelling and stiffness, and increase
your healing time. Rehab progresses into strengthening
exercises that focus on the quadriceps and hamstrings
– the main stabilizing muscles for your knee.
Physicians suggest you gradually increase the amount
of weight as your leg muscles get stronger. Strengthening
exercises require dedication because results often take
weeks and pain may recur. Once the muscles of your injured
leg are about as strong as the uninjured leg, the focus
of rehab turns to increasing your coordination. After
about six weeks of rehab, physical therapy can become
activity-oriented as you regain the ability to perform
complicated movements, using stationary bikes, elliptical
machines, and cross-country skiing machines. Physicians
usually suggest that you continue strength training
even after your kneecap has been rehabilitated. Have
your physician periodically check your kneecap for strength
and proper tracking.
RELATED TOPICS
Knee
strengthening exercises: Kneecap (patella) injuries
Physicians may suggest that you wear
a neoprene knee sleeve with a hole around the kneecap
during any activities that may stress your knee. The
knee sleeve by itself may improve the tracking of your
kneecap; however, to prevent patellofemoral pain, your
rehab exercises are ultimately more important than bracing.
Physicians generally recommend that you make the stretching
and strengthening exercises you learned in rehab part
of your everyday routine as soon as your doctor diagnoses
you with patellofemoral pain. Many of the exercises
and activities that are popular for fitness put stress
on your knees. To prevent further kneecap pain it is
important to learn knee-sparing exercise techniques
by dividing your activities into three components:
Daily
living – the average person takes between 12,000
and 15,000 steps a day, with each step exerting a force
between two and five times your body weight on your
knees. After a knee injury, take it easy on your knees
during the day whenever possible to save them for activities
and exercise. Avoid stairs when there is an elevator,
take the shortest path when walking, and consider wearing
athletic shoes designed to absorb shock rather than
hard-soled shoes.
Muscle
strengthening and conditioning – activities themselves
are not a substitute for conditioning. Your need for
special conditioning to prepare for activities increases
with age. The best strengthening programs are low-impact
and non-weight-bearing, like stationary bikes and certain
weightlifting programs, so that the knees do not have
to absorb shock.
Recreation
– sports that require twisting and quick direction
changes put great strain on your knee. Any climbing
or jumping activity where the knee is bent beyond 90
degrees puts undue pressure on the cartilage surfaces
under the kneecap. To prevent injury, stick to light,
non-impact activities for your recreation after suffering
patellofemoral pain. If you decide to return to sports
like football and basketball, a physician should carefully
examine your kneecap and test it for proper alignment.
If you plan on participating in sports, remember to
take it easy during daily activities and to keep your
kneecap tracking properly with stretching and strengthening
exercises.
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