Pain on outside of kneecap


Q: This past September I fell off my scooter while trying to go down a hill. I landed on my knee and i scraped and bruised the outside of my kneecap but i did not feel any pain. Now its May and I am feeling pain on the outside of my kneecap. The pain usually starts when my knee is bent for a long period of time and when I am sitting for a long period of time. I can walk fine on it though. Should I see an orthopedic doctor for this?


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 measures take the desire effect.

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