If you suffer from knee joint woes when engaging in everyday task such as walking up stairs or participating in physical activity such as cycling, you may suffer from what orthopedic specialist refer to as patellofemoral pain syndrome. While there is a lack of consensus among specialist as to initiating factors or specialized treatments, patellofemoral pain syndrome is characterized as a pain in the front of the knee that intensifies with activity.
Anatomy
The knee joint is the largest and most dynamic joint in the human body. It is composed of the thigh bone or femur, the patella, and inner and outer shin bones or tibia and fibula. The medial and collateral ligaments run along the outsides of the knee and help to stabilize the side to side movement of the joint. The anterior and posterior cruciate ligaments form an X within the knee, working to control the front to back movement of the knee joint. The patella is a sesamoid or floating bone that is held in place by the quadriceps tendon at the top and at the bottom by the patellar tendon.
Causes
As you bend and straighten your knee when walking up stairs or cycling, the knee cap glides over the smooth surfaces of the femur and tibia bone with the quadriceps and patellar tendon controlling the path of travel. The pain that you feel during these activities may be the result of a softening of the cartilage the lines the underside of the knee referred to as chondromalacia patellae or poor alignment of the kneecap along the front of the knee joint. More specifically, pain felt in the knee joint during cycling can be due to overuse of the patellar tendon or a muscular imbalance between the quadriceps or hamstrings muscles and can come as the result of excessive stress placed on the knee cap.
Treatment
Following an initial incidence of pain in the knee joint when walking up stairs or cycling, adhere to the RICE protocol: rest, ice, compression and elevation of the knee joint. Rest the knee from activities that aggravate the injury and following a 20 minutes with ice on the knee and 20 minutes without ice on the knee treatment schedule. Use a compression bandage or knee brace to help combat the symptoms of inflammation and elevate the knee above heart level when seated if possible. As symptoms dissipate physical therapist recommend a daily program consisting of 20 minutes of knee strengthening exercises that include seated knee raises and body weight squats.
Prevention
Before beginning exercise, warm up the knee joint up for five minutes with light exercise such as walking. Then perform stretches for the hamstrings and quadriceps muscles. Stretch after you are done exercising or cycling. You may also find adjustments to your bike help to alleviate knee joint pain. Adjust your seat forward or backward so that when the pedals are aligned at the 3 o'clock position your knee falls over the axle of the pedal. Raise or lower the seat so that with the lowest pedal at the 6 o'clock position, your knee is bent at a 30- to 35-degree angle.
References
- Medline Plus: Anterior Knee Pain; 6/13/10
- MayoClinic.org: Recommended Exercises for Knee Pain; Matthew Butters 3/5/10
- Brian Mac: Importance of Correct Bike Set Up; 1/18/11
- AAFP: Patellofemoral Pain Syndrome: A Review and Guidelines for Treatment; Mark S Juhn, 11/1/99
- Sports Injury Clinic: Anatomy of the Knee; 2011
