▲ Doctor Jay graduated from Korea University medical school and trained at the Korea University Medical School Hospital. He is currently chief executive of Everspring Hospital in Jeju. If you have any questions concerning health matters, ask Dr. Jay at email@example.com
It is sad to say, but our body peaks around the age of 30, and all functions decline from then on. So, a bump here and there, a chronic painful ankle or knee can be thought as something that starts from 60, but that is not the case. Knee pain is quite common in the elderly, and it is a result of a process most commonly caused by degeneration osteoarthritis. (But I will talk about that in another column.)
Runner’s knee is often common in runners, duh. The formal name for this kind of pain is patellofemoral pain syndrome (PFPS), and as the name implies, it involves two structures, the patella and the femur. The words together evoke pain, and there you have it. PFPS.
It starts as a pain at the back of your patella (knee cap) but can be in the front or around the patella. It most commonly induces pain while running, but as the pain progresses it might be felt while walking, going up and down the stairs, and even when you are sitting down.
The end of the femur is like two hills and a valley. As seen in the drawing, the knee cap is precisely fit to the space in between. The patella is connected to the quadriceps muscles and to a tendon below. A harmonious strength and flexibility of the muscles would assure the patella to stay in place, but for many reasons this delicate balance can be tipped.
Directly, a tight muscle, a muscle with too much laxity, or an imbalance between the muscles might cause the knee cap to shift or tilt into an unfavorable position. Indirectly, a defect or a painful state of the ankle joint might have a bad effect on the total alignment of the lower limb, leading to a strain or stress of the patella. Movement of the knee joint with this kind of malpositioned patella can induce contact between the patella and femur in a bad way, resulting in the pain explained above.
It is definitely important to rest, and I tell all my patients to do just that. Many injuries due to overuse or sprains, strains, or any of these sorts, need time to heal itself. Some argue that if they rest for a certain amount of time, their muscles will weaken. But premature exercise or improper movement could worsen the condition.
Also drugs are a help. A common urban myth, is that taking too many nonsteroidal anti-inflammatory drugs might be “addictive” and that you may come to a time when that those drugs won’t have an effect. Precise medication for a certain amount of time will do you more good than harm.
Commonly in practice, I do some taping and teach my patients some exercises. There are many exercises that can be done, and they are not specific for PFPS. Strengthening and stretching of the various lower limb muscles is definitely necessary, but as explained before, because of the mal-alignment of the patella on the femoral surface, and mostly it is to the lateral (outside) side of the femur, it is of utter importance to strengthen the adductor muscles and stretch the lateral abductor muscles.
The main aim of the taping is to place the patella to a more inner (or medial) position and fixing it in place. The method is as the picture tells you, but a more thorough explanation can be found under “McConnell taping” on YouTube.
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