Knee pain with bend position.

Patient

Q: No blunt trauma, just worsening pain-from a bent position no pain until trying to stand and walking is painful-from sleep position, upon wakening and stepping creates much pain-any way to diagnos without an mri? I play softball but no pain during running, seems to worsen the following day

Doctor

A:   Knee pain is the most common presentation of patellofemoral syndrome in 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 (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: 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
 

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