Patient: Hi there I am 17 years old and have 2 horses which I attend to everyday. For about a year or so now I have had a sore right knee but the pain wasn’t there all the time, now for about the past 2 months I have been having very sore knees especially my right one, the best way to describe the pain is very sharp, and at the top of me knees. It causes me to pause what I was doing as it is really sore. It occurs when I am sitting in class for one period and I need to move which is extremly sore, also it hursts wen I stand up after sitting, kneeling or bending down. I hope you can help, I would have attended the doctors but am terrified of them but the pain is becomming worse and worse and would like to know if you have any idea what could be wrong and what treatment might me ( if i attended the doctors)
Doctor: The knee pain is the most common presentation of the Patello Femoral Syndrome or Patella Chondromalacia. It is a pain t typically located behind the kneecap and often shows during activities that require knee flexion and forceful contraction of the quadriceps (e.g., during squats, bicycle, ascending/descending stairs or pendants).The pain may be worsen by sitting with the knee flexed for a long period of time, such as while watching a movie, being in class, 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: First of all, a Physical therapy program that teach you exercises to strengthen the quadriceps muscle and pain control with TENS, ultrasound, ice packs after the exercises, secondly, Anti-inflammatory medication (i.e.: “Aleve”, “Advil”). Also it is very important educate you about which activities to avoid because those may aggravate the patellofemoral syndrome. As well, remark the need for extended adherence to the exercise regimen. The physical therapist should teach you about the home exercise program. Allow time for these conservative measures (e.g.: exercise program) to have an effect , usually 4-6 weeks is adequate for some resolution of symptoms.