Patella Femoral Dysfunction, or PFD, is a condition of the knee that can have many causes. The result is anterior knee pain or pain in the front part of one or both knees. The condition usually is found in young women and adolescent females, but it can affect anyone.
PFD can have many causes. It may be caused from a mechanical difficulty such as an excessive "knock-knee" situation. Sometimes the mechanical problem may not be in the knee itself but from improper formation of the bone in the hip area or foot problems such as high or flattened arches. Over time, these improper alignments of the hips, knees or feet can place excessive forces on the kneecap. As the kneecap moves across the end of the leg bone (or femur) the surfaces become irritated and painful.
Another cause may be a softening of, or defects in, the cartilage on the back side of the kneecap. Still another factor may be muscle imbalances in the muscles that control the movement of the kneecap. If the outside portions of the quadriceps muscles are stronger than the inside portions, it may, again, impose improper forces on the back side of the kneecap and femur.
Symptoms usually include pain with kneeling, walking, running, or climbing up or down stairs. The pain is usually described as aching and deep. There may also be tenderness around the kneecap and quite often swelling around the knee area. Crepitus or "creaking and crunching" may be felt when bending and straightening the knee.
Rehabilitation first begins with controlling the pain and pain-related symptoms such as swelling. Ice can help reduce swelling and pain. Myofascial release, therapeutic exercise, dry needling and even electrical stimulation treatments will help ease the pain.
Avoidance of the activities that increase the pain is typically recommended. For instance, it may be advised to take an elevator instead of stairs. These activities are usually gradually resumed during the course of treatment. Occsionally a knee brace may be issued to help control the movement of the kneecap and thus decrease the irritating forces that are contributing to the problem.
Other interventions may vary depending on what your health professionalLuke & Barker patellofemoral dysfunction sufferer has determined to be the underlying cause. In most cases, the main emphasis is on correcting the muscle imbalances through specific strengthening or stretching. Another intervention may be a thorough foot evaluation and correction of any problems found in this area. This may include fitting and issuing of orthotics. Orthotics are custom-made shoe inserts that help correct or eliminate improper forces directed to the knee from incorrect foot mechanics.
During your treatment it is important to remain optimistic and patient. PFD symptoms can flare up very easily. Too much resistance during exercises can sometimes make the problem worse. Everyone is a bit different in how their knee reacts to the exercise resistances. Therefore it is very important to relate any pain increases or problems to your health professional during the course of treatment so that modifications, if needed, can be made. Another responsibility you have is to be very consistent with your treatment visits and home program so the knee can gradually adapt and heal. The condition can be difficult to remedy, but in most cases relief and return to your activities can be achieved.
Consult your Physiotherapist to discuss the details of your particular condition.
Robinson Private Hospital
Medical Centre Block 4
Tel: 011 693 5041
Lenmed Private Hospital
Ward Street, Greenhills
Tel: 011 693 5041
1679 President Kruger Street
Tel: 011 753 2113
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