Patient: Hi im gareth 25 from plymouth, ever since i was a child i had problems with my right knee, now im 25 the problem is still there. its everytime i play sports (very keen rugby player), i get a little lump underneath my knee cap that is sore to touch and even walk, just wondering what it was? xx
Doctor: According to your description, most likely you may have a Patellofemoral Syndrome, which basically is an unbalanced musc le pull that produced excessive pressure or leverage forces on the knee joint surfaces. The pain typically is located behind, underneath the kneecap and often shows during activities that require prolonged 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.” The causes are diverse: Overuse (repetitive use or activity), overloading, and misuse of the patellofemoral joint. The suggested strategy should be: strengthening and stretching the main muscle of the thigh: quadriceps, to restore the muscle balance around the knee joint, for this is indicated physical therapy for 6 to 8 weeks, using ice packs at the end of the exercise routine to decrease pain and swelling. The use of soft knee braces helps to control patella position and restrict full knee flexion which is good to ease the pain. Also, and very important, you have to stretch the hamstring muscles and the activities or sports that require frequent squatting must be avoided until the pain is under control. If there is a limited response to the treatment and locking or instability of the affected knee is noticed, then an orthopedic surgeon evaluation must be considered.