Knee pain in Zone 2 is very common and can possibly mean
patella femoral syndrome. Now this might sound really scary but it’s a very
common and benign condition (if you are inactive). For those of you that
exercise regularly this can be a very difficult condition to deal with.
What is Patella femoral syndrome?
The patella is your “knee cap” is that bone that sort of
floats on top of your knee. This “floating bone” is connected to your body by
muscle, tendon, and fascia (or tissue). The patella is supposed to move in a
predictable and set “tract” that should not deviate. The patella sort of glides
along set grooves that dictate where it should go, this occurs when you bend and
straighten the knee. If you ever have
seen floats during the Thanksgiving Day parade you will notice that the
balloons are being controlled by several different ropes pulling in different
direction. The people pulling the ropes are controlling the tract of the
balloon.
When you have Patella femoral syndrome is it caused by an imbalance
pulling of the patella to one side or another, this causes undo pulling and
rubbing on the grooves that the knee cap glides in. So if you imagine that the parade
balloon is like the patella, it means that something is pulling on the balloon
too hard and it deviate to one side more than another. You could imagine that
during a parade this would cause a problem. I could envision a 50 foot Snoopy taking out
the north side of Macy’s. The patella is
supposed to glide up and down the knee in a way that it doesn’t rub the sides
of the grooves; much like the 50 foot Snoopy is not supposed to rub the sides
of Columbus Circle.
What does Patella femoral syndrome feel like?
- Pain with jumping, running and sometimes walking
- Pain when sitting for prolonged periods
- Pain feels like stiffness that you can’t shake off
- Pain persisted after sitting down
What causes Patella femoral syndrome?
- Tightness of ITBand (iliotibial band) which is the band of tissue on the outside of your thigh. It’s the thing that hurts when someone gives you a “dead leg”.
- Tightness of the tendons and fascia pulling on your patella
- Imbalance of muscles pulling on your knee cap
- Poor running mechanics
- Poor exercise form
What is another condition that can be confused for Patella
femoral syndrome?
- Chondromalacia patella – This is mild arthritis on the bottom surface of your knee cap which causes grinding and pain.
What are some treatments?
Of course, physical therapy is suggested. A physical
therapist would be able to best assess what limitations are causing your
condition and would address them appropriately. Patella femoral syndrome does
not often go away on its own so early treatment is important. If you suspect
that you have patella femoral syndrome please discontinue painful activities
until cleared by a physical therapist.
