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Living Healthfully - June 2008

On Knee Pain

June 20th 2008 14:11
E.W., from HongKong asks:
"I am a 16 year old student. And I need to go to my classroom on the second floor every weekday morning. But as I climb the stairs, I usually feel pain on my right knee- after two or three steps. What may be the possible problem on my knee? Thank you!"

MY REPLY:

Hi E.W.! Well it is very difficult to say or even assume what causes your knee pain. What I usually do is that I carefully and intensively inspect not just the knees but the whole posture of an individual from head to toe. I believe that the body parts are closely and kinematically linked to one another. And a change on a normal orientation/ configuration of any part may affect the rest of the parts of the body. And so it is best to consult an orthopedic doctor or a physical therapist to further evaluate your knee problem.


Nevertheless i know of a condition that usually affects people at your age. And I do hope that the succeeding parts may help you and our readers.

The problem I am talking about is a condition known as patellofemoral pain syndrome.

What is patellofemoral pain syndrome? It is pain associated to faulty alignment of the patellofemoral joint.

The patellofemoral joint is an articulation between the knee cap and the tip of the thigh bone. Normally the knee cap has to be placed centrally over the tip of the thigh bone.

Normal knee
NORMAL KNEE



But because of faulty body alignments and muscular imbalances the patella is deviated away from the center-usually outward.

knee pain
PATHOLOGIC KNEE


And so a patient, when he alternately bend and extend the affected knee, can experience pain because the patella (knee cap) is being dragged against the rough surface of the thigh bone.

In E.W.'s case, the above condition may be showcased when going up the stairs.

Previously I mentioned that the affectation can be caused by poor body alignment and muscular imbalance. Examples of poor body alignment are when a person is flat-footed, has wide pelvis, resulting to genu valgus. All of these result in abnormal outward translation of the knee cap. Look at the child in this illustration.

genu valgus
The knees of this child manifest with genu valgus.


Example of muscular imbalance is when the muscles pulling the knee cap sideward are stronger than the muscles pulling the knee cap medially. Normally the strength has to be equal to place the knee cap at the center.

TO BE CONTINUED...
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