Mild pain, popping, uncomfortable knees

Patient

Q: Hi, I have a problem with my knees. They are always making a noise every time i flex them, especially my left. it also feels uncomfortable and has a mild pain occasionally. When I was jogging this recently, I felt like its burning and really uncomfortable. What is wrong with my knees? what should I do to prevent it from worsening? thanks.

Doctor

A:    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 (e.g, 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." Also “grinding” and “clicking” may be present. 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”), educate you about 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. Please, 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.

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