The knee is one of the most important and complex joints in the body. In addition to being a major weight-bearing joint, it also plays a vital role in locomotion.

Due to this, there are many different conditions or injuries that can cause knee pain. One such cause is called patellofemoral pain syndrome.

With this syndrome, the patient experiences mild to severe knee pain located around or underneath the kneecap. It is often seen in patients that participate in sports that require running and jumping. Professional truck drivers are also at greater risk due to the repetitive nature of operating the clutch and accelerator pedals.

The most common symptom associated with patellofemoral pain syndrome is dull, aching pain in the front of the knee. The pain is usually increased by walking up or down stairs or by kneeling or squatting. Sitting with bent knees for long periods of time may also aggravate the pain.

The exact cause of patellofemoral pain syndrome is still unknown. However, it has been associated with overuse or repetitive stress on the knee joint, which in turn causes irritation under the kneecap. Activities or sports that involve a lot of running or jumping such as soccer or volleyball may increase the risk of developing this pain syndrome. Another possible cause is muscle imbalances or weakness around the knee or hip joint. These muscle deficiencies can cause improper alignment of the kneecap, thus causing irritation. Finally, trauma to the kneecap such as fractures or dislocation have been linked to patellofemoral pain syndrome.

The sedentary nature of professional truck driving often leads to muscle weakness and imbalance in the lower limbs. To add to this, drivers must repetitively depress the clutch and accelerator pedals as part of their job. Due to these two factors, truck drivers are at a greater risk of developing patellofemoral pain syndrome. 

Interestingly, patellofemoral pain syndrome usually affects adolescents and young adults. This is due to the increased activity level of this age group. Also, women are twice as likely to experience this syndrome. It is speculated this is due the wider pelvis of females, increasing the angle at which the knee joint meets.

Patellofemoral pain syndrome is usually diagnosed after taking a detailed medical history and by performing a physical examination. In order to rule out other potential causes of knee pain, your health care professional may recommend imaging tests such as X-rays, a CT scan or MRI.

Once the diagnosis of patellofemoral pain syndrome has been reached, your doctor will develop a specific treatment plan. Treatment often begins with simple home remedies such as rest and applying ice. Avoiding activities that aggravate the pain will also be recommended.

Over-the-counter medications such as acetaminophen and ibuprofen may be used to control pain as needed. If it is determined that muscle weakness and/or imbalances are the cause, physical therapy may be recommended. The goal of physical therapy is to strengthen and stabilize the muscles surrounding the knee joint. Specialized braces or tapping may be utilized to support and align the kneecap.

If conservative treatments are unsuccessful, your doctor may suggest surgery to correct the problem. Arthroscopic surgery involves inserting a thin instrument into the knee to remove fragments of damaged cartilage. In the most severe cases, surgical realignment of the kneecap may be necessary.

As I always say, prevention is the best treatment. Keeping the muscles in the legs strong and flexible is by far the most important preventive measure.

This can be accomplished by participating in a regular exercise and stretching routine. Also, as much as possible, avoid repetitive movements of the knee joint.

Keep these simple tips in mind and you will be well on your way to healthy and pain-free knees. Until next month, drive safely.

***

Dr. Christopher H. Singh runs Trans Canada Chiropractic at the 230 Truck Stop in Woodstock, Ont. He can be reached at 519-421-2024.