Patella is Latin for kneecap. Femoral means ‘relating to the thigh’.
The kneecap sits on the knee joint. When you straighten and bend your leg, the kneecap slides over the knee joint. If the kneecap does not glide properly in the groove of the thigh bone, irritation develops between the kneecap and the knee joint, causing pain on, under or around the kneecap. We call these complaints patellofemoral pain syndrome. This syndrome is more common in girls than in boys, particularly in teenagers and young adults. Squatting, climbing stairs, cycling into a headwind and kneeling can be painful.
Patellofemoral pain syndrome is essentially harmless. Scans will usually show no clear orthopaedic abnormalities. The pain often goes away by itself after 1 or 2 months, but it can also become chronic. In that case it is advisable to see an osteopath, who can look into the cause of the complaints and treat it.
– Pain, stiffness and a cracking sound in/around the kneecap.
– Pain and swelling around the kneecap. Pressing on the knee is painful.
– The pain often eases when the legs are straightened.
– Instability. You may feel as if the kneecap is moving outwards. Sometimes this can even cause your knee to lock.
The causes of PFPS are not entirely clear. Common factors include:
– abnormal alignment of the feet or legs (knock knees or bow legs)
– weak muscles around the knee joint
– a growth spurt
– reduced stability of the hip or ankle
– overuse (the syndrome is particularly common in basketball players and runners)
– previous surgery on the kneecap
– unsuitable footwear
Sometimes no cause is found.
The standard treatment for this form of knee pain is exercise therapy (such as squats and lunges). A good balance between rest and strengthening exercises often means the complaints ease within a few weeks.
– If the complaints get worse after sport, it is advisable to cut back on sport temporarily or to train less intensively.
– Strengthening exercises, especially training the quadriceps and hip abductor muscles, can help keep the knee in place. These exercises should be alternated with periods of rest. The exercises should not cause extra pain.
– Losing weight if you are overweight. This will reduce the pressure on the knees.
– If the pain is severe, paracetamol can be taken temporarily.
– No link has been shown between PFPS and the development of osteoarthritis in the knee.
Unfortunately, in some people the complaints become chronic. Sometimes the pain lasts for years. In that case a visit to the osteopath is certainly advisable. You do not need to ask your GP for a referral letter.
An osteopath always looks beyond the complaint itself. After all, the cause of the complaint often lies elsewhere in the body. That is why I always examine the whole body. I will also ask you about your work, any stress, your diet, other or previous physical complaints, medication use, etc. In this way I get a good picture of the person behind the patient.
With knee complaints, the problem is often restricted movement or misalignment in the back, hip, foot or pelvis. Of course the knee will also be treated, but the treatment will focus mainly on releasing the movement restrictions that are affecting the knee pain. This is done with gentle and slightly firmer techniques. The treatment can feel sensitive, but is not painful. An osteopath therefore does not (only) treat the symptoms, but makes sure the cause of the complaint is addressed. This gives the best chance that the complaints will not return. You will also receive tips for strengthening exercises. If I suspect there is more going on, I will refer you to a specialist (orthopaedic surgeon) or a podiatrist (for example to have insoles made).
After the treatment, the body gets to work with its own self-healing ability. It is therefore advisable to take things easy for a few days after the treatment.