Patellofemoral syndrom: a frequent running injury

Articles

The same structure can be referred to as the “kneecap,” the “patella,” or the “knee joint.” This bone has a reverse triangular shape, and slides over the front of the knee when it bends or straightens.

Here is a little anatomy to put it into context…

A tendon is the fibrous and rigid connector to a muscle. A muscular contraction causes tugging on the tendon, which “pulls” it over the bone to allow the joint to move.

Here, the joint in question is the knee, the muscle is the quadriceps (the front of the thigh) and the tendon is the patellar. The bones involved are the femur, the tibia, the fibula, and the kneecap. The patella (kneecap) is in fact nested in the quadriceps. This muscle’s contraction causes the patella to slide upwards over the “rough cavity” of the femur, and downwards when the muscle is relaxed.

The problem arises when…

Given that the cavity is rough and narrow and that the kneecap is perfectly adapted to this surface, inflammation can occur if there is a misalignment.  This irritation can be caused by poor alignment in a crouched position, while kneeling, or during repetitive high-impact sports such as running. Otherwise, excess weight or repetitive movements can also cause this inflammation.  This irritation can often occur under the kneecap and where it attaches to the quadriceps, at the patellar tendon.  Noise and crackling are often heard. Pain is often localized under the kneecap or at the insertion of the patellar tendon.

What can be done?

Firstly, it is important to apply the principles of rest, meaning ice and rest from the irritating activity. Sometimes, anti-inflammatory medication or Voltaren can be helpful.

Secondly, attempt to identify the cause in order to apply the appropriate changes to reduce the return of inflammation.

Finally, if pain persists, a physical therapy consultation will provide a more specific evaluation within the context of the injury in order to correct the causes. Afterwards, the treatments of choice are ultrasound, mobilization of the kneecap and knee, taping, and muscular strengthening. A decrease in training and activity is often necessary. It is important to make a slow and progressive return to activity when the injury is on the path to recovery. This reduces the risk of relapse and encourages a complete return without after effects.

Have a good running season!