Carpet installer with knee pain

Patient

Q: My right knee keeps clicking in and out for two weeks.i can walk but it is throbbing on the inside.it feels out of place.no falls ,but i am a carpet installer and i kick carpet with that knee.when i bend it ,it hurts.

Doctor

A:   Your occupation requires constant kneeling and knee flexions in various degrees. Knee pain is the most common presentation of patellofemoral syndrome. The pain typically is located behind the kneecap and often shows during activities that require knee flexion and forceful contraction of the quadriceps (e.i. 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. You could use during the acute pain episodes a knee sleeve with no pressure over the patella.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.

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