Knee pain can occur due to many different structures and different ways. Patello-Feroral Pain Syndrome (PFPS) is a very painful condition. This is the most common abuse syndrome affecting the sports population, and 25% of the general population is affected at one time. Despite the rather exhausting nature, PFPS can be treated conservatively with the help of appropriate physiotherapeutic (physiotherapeutic) methods and exercises.
The knee is a simple articulated joint with small accessories available for it. First of all, it stretches and bends the knee, which is the joint between the thighs (femur) above and the tibia (tibia) below.
There is a small rotational component in the knee joint, and some slide back and forth between the Femoral Condles and the platform made by Tibia.
The quadriceps muscles attach to the Patella (cap), which, in turn, is attached to the tibial tubery on Tibia (tibia) through the Patella tendon.
Although in action it produces simple movement, the knee joint is one of the most complex structures in the human body. This complexity leads to potential injury, but also makes the diagnosis problematic for the medical team.
PFPS - What is it?
Patello-Ferral Pain Syndrome (PFPS) is a painful condition in which the patella (knee cap) rubs against the femur (femur) in such a way that pain and sometimes swelling occurs. Patella is designed to glide over Femur and is equipped with a hard shiny coating over the bones in both areas to facilitate this glide. This hyaline cartilage, as the hard shiny surface is called, reduces friction at the point of contact.
However, things can go wrong.
PFPS - What causes this?
Under the surface of the Patella has the shape of "V", which corresponds to the reverse groove in Femur.
When the knee is stretched and bent, Patella slides along Femur along the line of this groove, which extends from the front of the Femur to the distal Femur. When standing, Patella sits on the upper end of the groove, but when the knee is curved, for example, when squatting, the angle of Femur changes, and Patella is larger on the bottom surface of Femur.
Everything is good if this mechanism functions correctly and there is no injury on the bone surface. However, some factors may cause changes. These include:
- biomechanical factors
- muscle factors and
- overuse factors
1. Biomechanical factors
Of the biomechanical factors, some of the most common problems in the available literature include the following:
- Modified Patella Slope
- Rotation of Patella
- Mal-tracking Patella
- Q angle changed
- Pes Planus - flat feet or more laid legs
- Pes Cavus - high arch over the legs
- Knee valgus or varus - knocking knees or onions feet
Small changes in the inclination or rotation of the Patella reduce the contact area between Patella and Femur. Over time, this causes a “hot spot” of pressure, causing abnormal wear of hyaline cartilage.
Mal-tracking Patella occurs when, for various reasons, Patella does not accurately track in the groove of Femur. Most often, Patella watches from the side (towards the outside of the knee), which causes friction between the lower surface of Patella, where she rubs against the hard ridge of the Poor Condilles.
A modified Q-angle is postulated as a biomechanical cause, especially in women.
This is the angle between the width of the hips and the alignment of the knees in relation to the vertical. An elevated angle Q is proposed to increase lateral tension on the Patella.
Pes Planus and Pes Cavus, according to some, have an impact on the knees. It is assumed that biomechanical effects alter the function of Patello-Hip, thereby causing PFPS.
The knee Valgus and Varus are probably factors affecting the function of the Patello-Hip.
2. Muscle factors
Muscles tighten bones to produce movement. If Quadriceps Muscles have an uneven effect on Patella, then it is postulated that this can change the function of the Patello-Hip.
The most common theory for PFPS is that the Vastus Medialis Obliques muscle is weak and therefore does not balance the cravings exerted by other Quad muscles, and laterally distorts Pathella.
Tightness or muscle imbalance between any leg muscle is also considered by many to be a causative factor.
3. Adverse Factors
Since the term implies excessive activity, it is proposed to trigger PFPS.
Body tissues are designed to adapt to the stresses attached to them, increasing. By lifting weights, muscles adjust over time, increasing mass and, consequently, tensile strength. Similarly, the bones, ligaments, heart, and other tissues adapt equally.
This tissue adaptation is a process that all athletes and women go through to become a mechanic for their activities, however, when these stresses are applied before the body has time to make an adaptation, the tissues can collapse. There it is postulated that an increase in activity that is too rapid can lead to injury, including PFPS.
PFPS - What else could it be?
There are several other factors that can cause knee pain. Some of them require more sophisticated equipment, such as X-rays, MRI, or bone scans, to determine the cause of the pain. Dislocation of a Patella or Patella subluxation, fractures under stress, bone ulceration, bone defects, or pathological conditions such as osteoarthritis can cause knee pain and should not be slightly dismissed.
Summary
The many potential causes of PFPS are rather confusing. There is little consensus among medical experts regarding the causes of the CFPF, and therefore the prescribed procedures are even more numerous. In a recent blog on the website of a specific medical profession, thirty-four different treatments were prescribed for PFPS. In other medical professions, it can be the same as most prescribed procedures.
Although it should be accepted that in any particular case there may be multifactor causes, and there may be different reasons between people, many of them never have many “red herrings” offered by medical specialists, although in an honest attempt to solve the PFPS. Challenge and error seems to be the norm, but it can be costly, time consuming and frustrating for the injured person.
Some questions to consider for those facing this trial and error method for their particular knee pain are:
- Was there a traumatic event that caused pain in the knee, or did it happen slowly?
- Does the intensity of pain increase from day to day or even from time to time?
- Areas of pain vary slightly or there are other symptoms in the same leg, i.e. density, severity, spasms, etc.
- Are the symptoms complicated?
If the answer to some or all of these questions is yes, then there may well be one reason and, therefore, a simple answer!
