Dear Ask The Doctor: Here is my situation. When sitting in the theaters and bleachers at school my knees will start to hurt and unless i can stretch them it just keeps getting worse. When running i will get pains right below my knee cap. I play tennis and it is painful to play and do the sprints in practice along with the foot speed drills.
Dear Patient: Knee pain is the most common presentation of patellofemoral syndrome in young and active people. The pain typically is located behind the kneecap and often shows during activities that require knee flexion and forceful contraction of the quadriceps (ei, during squats, ascending/descending stairs or pendants). Pain may be worsen by sitting with the knee flexed for a long period of time, such as while watching a movie, hence leading to the terms theatre sign and movie-goers knee. The causes are diverse: Overuse (repetitive use or activity), overloading, and misuse of the patellofemoral joint.The suggested strategy for conservative treatment should be as follows: Physical therapy program (exercises and pain control with TENS, ultrasound, ice packs after exercises), anti-inflammatory drugs (i.e.: Aleve, Advil), education of the patient so he/she understands which activities avoid because those can aggravate patellofemoral syndrome.Also,and very important, remark the need for extended adherence to the exercise regimen. Your physical therapist should educate you about a home exercise program Allow time for these conservative measures (i.e.: exercise program) to have an effect, usually 4-6 weeks is adequate for some resolution of symptoms.