Dear Ask The Doctor: I am 26 years old and since I was around the age of 18 I have had knee pain. Over the years my knees started making grinding noise and now if I keep my knee bent and then straighten it causes me to have intense pain could it be Chondromalacia of the patella? I do not have health insurance so I am not able to go to the doctor. I have tried pain reliever and it doesn't help my knee pain at all and I have iced it and soaked in hot water with no results. Is there anything else I can do to help the pain?
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-goer's 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: try exercises to strenghten Quads previous adequate stretching (weights or byke) ,pain control with ice packs after exercises, anti-inflammatory meds (i.e.: “Aleve”, “Advil”), identify and avoid those activities that can aggravate the pain. Also, and very important, is the need for extended adherence to the exercise regimen, meaning keep a consistent daily routine of walking, or bicycle or gym (weights and stretching). 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.