Pain in the knee when sitting for a long time


Q: I am 21 and have been experiencing knee pain since 7th grade more so recently. My knee cracks or pops probably 2 dozen times or more a day. I can't kneel, stand, crouch or be in long car rides for long periods of time (10 mins and the pain is there). If I sit or keep it moving (walking or jogging, no running) it is fine. By the time I go to sleep I put on a brace so I can sleep. Any information? My Great-Grandma had Rheumatoid arthritis and my Grandpa has had both knees replaced. My mother experiences the same problems as me. Could it be hereditary?


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 (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

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