Ask The Doctor

Dear Ask The Doctor: I injured my knee at work and all tests came back clear ... just bad inflamation. Still 5 months later I can't bend to the floor without pain behind the knee and when I put the leg straight my knee is so tense i cant move my kneecap at all and it just feels tight and uncomfortable. I have had physio and now my Dr is sending me back to work were i have to stand for 8 hrs when i can't walk for more than 20mins without pain. He said i only have 30 percent incapacity so can work. Could this make it worse, I am 26 and do alot of watersports which i cant do at the minute and worryed imay never do again. do you have any ideas what may help me?

Dear Lisa: Typically the pain behind the knee with flexion (bend knee) is the most common presentation of the Patellofemoral Syndrome, which is produced by an impairment affecting the patella and femur joint, in your case the previous injury could cause an unbalanced muscle pull that produced excessive pressure or leverage forces on the patellofemoral joint surfaces.

Patellofemoral syndrome is common in US especially among young and active persons.

In the view of normal results on X rays, CT scan or MRI, the suggested strategy should be: strengthening and stretching the main muscle of the thigh: quadriceps, to restore the muscle balance around the knee joint, for this is indicated physical therapy for 6 to 8 weeks, using ice packs at the end of the exercise routine to decrease pain and swelling. The use of soft knee braces helps to control patella position and restrict full knee flexion which is good to ease the pain. Also, and very important, the activities or sports that require frequent squatting must be avoided until the pain is under control.