Question :

Knee pain after hill walking

Dear Ask The Doctor:
I am training to take part in a 3 peaks challenge in 10 weeks, but towards the end of a long walk, my knee started to hurt, but only when putting pressure on it. The pain lasts the longest at the back of my knee but can get pain at the sides too. It was a little swollen and hot immediately after but I rested it with ice and it was fine after a day or two. Is this going to become a recurring problem during my training and the event, and what can I do to lessen the pain after exercise?


Answer :

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: 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 take the desire effect.


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