Possible Patellofemoral syndrome in a 19 years old active woman


Q: My name is Hayley and I'm 19 years old. I played volleyball for about 4 years and never had any knee problems until recently. For about the last month or so I have been having knee pains that have been slowly getting worse. I finally made a appointment with my doctor and he told me that I have chondromalacia patella of my right knee. I hostess about 4 days a week, I observe at the hospital during the week and I work at Subway at night. So I am on my feet a lot. My question is, should I be doing physical therapy for this knee problem? It has gotten even worse since seeing my doctor and he just told me to do simple leg exercises with a five pound weight. And to add to the mix, I'm going on a four day trip with my friends to Hocking Hills in two weeks. I realize my knee won't be 100% normal, but I would like it to be as good as it can get. Thank you and hopefully you can give me some advice. -Hayley


A:   You have been already diagnose with patellofemoral syndrome or Chondromalacia Patella, in which the Knee pain is the most common presentation 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. I do not recommend at this point Hicking because that kind of activity may worsen your condition.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  so  you understands which activities avoid because those can aggravate patellofemoral syndrome. Also, and very important, remark the need for extended adherence to the exercise regimen. The  physical therapist should educate you about a home exercise program Allow time for these conservative measures (ei: exercise program) to have an effect , usually 4-6 weeks is adequate for some resolution of symptoms.

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