Pain in the knee when walking on stairs

Patient

Q: I was kicking a football one day almost 3 years ago now and I believe i hyperextended my knee due to pain in my knee. This was a long time ago and it hasn't healed on it's own at all. I have been to the doctor and they said they didn't notice any ligament damage from the outisde. They also did an X ray and there was no bone damage. From researching I myself think there is some kind of ligament damage because it is not healing on it's own, but now getting worse. There is pain when I am not moving my knee at all, and more pain when I am walking on stairs. When I am walking regularly, there is a loose feeling like it could give in at any time, but it never has. I was also given anti-inflammatory medication and that did not work either. I want to know what I could do next or what the condition that I have is called. Any help would be appreciated. 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 (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 medication (i.e.: “Aleve”, “Advil”), education to 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 measures (i.e.: exercise program) to have an effect, usually 4-6 weeks is adequate for some resolution of symptoms.

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