Pain and swelling around the knee cap

Dear Ask The Doctor: I am trying to find out if I should get my knee checked out. It swells up and causes problems. Basically it starts up with a heating sensation (at least that is what I call it). Then it slowly swells. I can tell if it will because the area around the cap becomes tender. I haven't had any injuries to the area. Have any idea what this might be?

Dear Adam: Based on your description, the symptoms may correspond to patellofemoral syndrome or Chondromalacia Patella, in which the Knee pain is the most common presentation 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. I do not recommend at this point Hicking because that kind of activity may worsen your condition. 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”), wear a knee brace to stabilize the patella, education  so  you understands which activities avoid because those can aggravate patellofemoral syndrome. Also, and very important, remark the need for extended adherence to the exercise regimen.  The physical therapist should educate you about a home exercise program. Allow time for these conservative measures (ei: exercise program) to have an effect, usually 4-6 weeks is adequate for some resolution of symptoms.