At The North Wales Spine Clinic our Chiropractor who serves the Conwy, Gwynedd and Anglesey regions is also a registered Chiropractor with the International Federation of Sports Chiropractic.  His experience includes All Blacks, International Rugby stars, Olympic level Athletes and national teams.  He himself has represented the country as a Swimmer, played rugby for North Wales Youth and was the Royal Marine Commandos Welterweight boxing champion with over 60 undefeated fights. In a series of articles on Sports Injuries in North Wales and Chiropractic he hopes to give some understanding to the cause, effects and treatment of Sports Injuries.

T his article covers the common sports injury Patellofemoral Pain Syndrome which manifests as frontal knee pain. This article is dedicated to the many patients from Menai Bridge, Bangor, Caernarfon, Llandudno and Colwyn Bay who have attended The North Wales Spine Clinic with this type of sports injury.

Sports injury causing Patellofemoral Pain Syndrome is a common cause of pain around the knee cap, which is sometimes referred to as ‘Anterior Knee Pain’. When the knee bends or straightens, the knee cap glides in a special groove on the thigh bone called the ‘Patellofemoral groove’, controlled by the quadriceps (thigh) muscles. However, for several reasons it may stray from this path (usually towards the outside of the knee). This is called Patellofemoral Maltracking and produces abnormal stresses on the under-surface of the patella that can cause knee cap pain.

The knee joint is made up of three bones:

  • The Femur (thigh bone),
  • Tibia (shin bone)
  • Patella (kneecap).

The Patella is wrapped inside a Quadriceps tendon that connects the thigh muscles (Quadriceps) to the shin. When the knee bends, or straightens, the knee cap normally glides in a special groove on the thigh bone called the Patellofemoral groove.

In sports injuries such as Patellofemoral maltracking, abnormal stresses are put on the under-surface of the knee cap that can cause pain. This is similar to having the front tyre of a car slightly out of alignment, leading to abnormal wear. If allowed to progress, these stresses can cause damage to the articular cartilage on the knee cap (a condition called Chondromalacia Patella) and femur.

Patellofemoral maltracking is one of the most common causes of knee pain from sports injuries in North Wales and can be caused by numerous factors:

  • Tightness in certain structures. (E.g. calf and hamstring muscles).
  • Weakness or incoordination in muscles that should help maintain normal patella tracking.
  • Altered hip, knee or foot posture.
  • Anatomic variations such as a shallow Patellofemoral groove.

Sports Injury – Patellofemoral Pain Syndrome Signs & Symptoms

The most common symptom of Patellofemoral maltracking is frontal knee pain that can occur while ascending or, more often, descending stairs and whilst running. Pain can also result from prolonged sitting and some people may experience instability (this can involve a sensation of insecurity or actual giving way of the knee) or locking of the knee.

Sports Injury  – Patellofemoral Pain Syndrome Treatment

What you can do

At The North Wales Spine Clinic we are professionals at dealing with sports injuries in the Conwy, Anglesey and Gwynedd regions. We have achieved fantastic results with sports injuries suffered by patients from Menai Bridge, Beaumaris, Caernarfon, Bangor, Llanfairfechan, Penmaenmawr, Llandudno, Conwy, Colwyn Bay and Abergele. Its vital to get a diagnosis and the correct care for your sports injury.  Our North Wales Chiropractor will be able to tell you the extent of damage and a probable diagnosis.  Whilst you arrange your appointment with the Chiropractor at The North Wales Spine Clinic you can of course use ice/cold pack or even a bag of frozen peas over the affected area.  As you put the ice over your sports injury ensure you don’t put it directly onto your skin as it may cause a cold burn.  Anti-inflammatory medication is also a useful tool in the early stages of sports injury; consult your GP for this.

The causes of the sports injuryPatellofemoral maltracking will be specific for each person and so it is important that a treatment plan is formulated to meet the patient’s individual needs. Chiropractic plays a vital role in the treatment of Patellofemoral maltracking. The first priority is to attempt to settle the pain, usually through ice therapy or analgesics prescribed by a GP.

Once the initial pain has settled, treatment is likely to include stretches for the Calf muscles, Quadriceps, Hamstrings, Hip flexors, Hip rotators and Ilio Tibial band.

Of even greater importance are exercises taught by our sports performance & rehabilitation specialist to both strengthen and improve the coordination of the Vastus Medialis Oblique (VMO) muscle. The VMO forms part of the Quadriceps muscle group and is located just above the knee cap, on the inner aspect of the thigh. It is believed to help maintain the knee cap in its correct position in the Patellofemoral groove. Methods of improving VMO function with our sports performance & rehabilitation specialist involve balance, strength, coordination and functional training. We no longer use the dated braces or taping approaches, massage and stretching only has limited results.  Our cutting edge approach gives fast longer lasting results for sports injuries safely without surgery or drugs.

Strengthening of the Quadriceps muscle group as a whole is also thought to be beneficial, but it is important to note that traditional knee extension exercises may actually exacerbate the problem through over-stressing the Patellofemoral joint. Closed-chain exercises (where the sole of the foot is in contact with a flat surface) such as the squat and leg-press are more appropriate but should only be performed in a safe, pain-free range of motion and under the supervision of our North Wales Chiropractor.

During the enforced rest from sports activities many people find that they are able to do pool running and exercises in water using a buoyancy aid as a means of maintaining fitness, but it is important that these exercises are pain free.

Sports injury – Patellofemoral Pain Syndrome Prevention

What you can do to prevent this sports injury

The majority of lower limb sports injuries come from weak core muscles.  Previously in the dark ages knee braces and taping were the mainstay of treatment but we found it never really worked long term.  The reason that this type of sports injury reoccurs so often?  Many practitioners failed to find the actual cause, as they were so busy treating the symptoms.  Stability and core work is vital to avoid sports injuries and perform well at sport.

You cant fire a cannonball out of a canoe!

Take a look at our for sports category and find out more……