1. Patellofemoral pain syndrome (Runner’s Knee)
Intro: The patellofemoral joint is where the kneecap bone meets the bottom of the thigh bone (femur). Irritation of the joint may be brought upon by either by incorrect tracking of the kneecap, muscle weakness, or damage to the cartilage within the joint.
Symptoms: Pain on getting up from a prolonged seat position, deep squatting, or going up stairs.
Treatment: Immediate relief can be achieved by rest, ice, medication, and temporary use of a patella stabilizing knee sleeve. Activity modification and physical therapy especially on the quadricep muscles, which attached to the kneecap, along with the hamstrings and core muscles. A steroid injection for pain relief or regenerative treatment such as plasma rich platelet (PRP) injection is sometimes considered to promote healing if degeneration of the cartilage is suspected. In unresolving cases, different surgical options may be considered.
2. Patella tendon pain
A. <16-year-old – Osgood-Schlatter disease/Sinding-Larsen-Johansson syndrome
Intro: Osgood-Schlatter disease/Sinding-Larsen-Johansson syndrome involves irritation to the growth plates on either the top of the shin bone (Osgood-Schlatter) or on the bottom of the kneecap (Sinding-Larsen-Johansson). These two bones are connected by the patella tendon.
Symptoms: Pain on knee extension and is a common cause of knee pain in young athletes.
Treatment: Activity modification, stretching of the quadriceps muscles, physical therapy, and medication. Temporary use of a patella tendon strap may help offset the stress from the growth plates. Symptoms typically resolve once growth plate closes.
B. >18-year-old – Patellar tendonitis (Jumper’s Knee)
Intro: Patellar tendonitis involves inflammation of the tendon connecting the kneecap to the shin bone.
Symptoms: Pain on motion of the knee and if a common cause of knee pain in athletes.
Treatment: Activity modification, stretching of the quadriceps muscles, physical therapy, and medication. Temporary use of a patella tendon strap may help. Regenerative treatment such as plasma rich platelet (PRP) injection, which promotes healing of the tendon, is another treatment modality for this condition. Surgery can be done on rare refractory cases.
3. Pes anserine bursitis
Intro: Pes anserine bursitis involves inflammation of three inner thigh muscles at its attachment site on the shin bone.
Symptoms: Tenderness on palpation and pain on certain motions of the knee.
Treatment: Rest, physical therapy to stretch and strengthen the hamstring muscles, and medication. A steroid injection for pain relief or regenerative treatment such as plasma rich platelet (PRP) injection to promote healing is considered in refractory cases.
4. Baker cyst
Intro: Baker cyst is a collection of synovial fluid in the back of knee, most commonly due to meniscal degeneration or tear. Occurrences tend to increase with age.
Symptoms: Feeling of fullness and discomfort on back of the knee.
Treatment: Rest, physical therapy, and medication. Needle aspiration along with a steroid injection may help this condition. In refractory cases, surgical cyst removal and/or meniscectomy (removal of meniscus) is considered.tment and drainage in this case.
5. Iliotibial band syndrome
Intro: The iliotibial band is a fibrous band of tissue that runs along the outer thigh and attaches just past the knee joint. Friction and thereby pain occurs where the tissue runs past a bony protuberance at the end of the thigh bone.
Treatment: Rest, physical therapy especially stretching the iliotibial band with a foam roller. A steroid injection for pain relief or regenerative treatment such as plasma rich platelet (PRP) injection to promote healing is sometimes considered. Surgery is considered in refractory cases.
6. Knee osteoarthritis/Meniscal degeneration
Intro: Osteoarthritis of the knee is a degenerative joint disorder that may manifest the elderly naturally or in individuals with prior injury. Sometimes there may also be degeneration or degenerative tear of the meniscus involved as well.
Symptoms: Pain and decreased motion of the knee.
Treatment: Weight loss, physical therapy, and medications. A steroid or hyaluronic acid injection may help provide relief as well. When nonoperative modalities fail, surgery on the meniscus or knee replacement surgery may be considered.
7. Shin splints
Intro: Shin splints are a common cause of leg pain especially in runners. This condition involves repetitive-loading stress on the shin bones resulting in pain.
Symptoms: Dull diffuse pain; it is important to differentiate from tenderness on one spot, which may be a sign of stress fracture that requires immediate medical attention.
Treatment: Rest, activity/shoe modification, physical therapy, and medication.