Knee pain
The kneecap (or patella) is a common source of knee pain. To confirm if your pain is coming from the kneecap
Kneecap pain is usually worse with squatting, kneeling, stairs and sometimes sitting with the knee bent
While sitting up in bed grab hold of your kneecap at the front of your knee. Is this the area where your pain is located? (can be on the inside or outside of the kneecap and can radiate to other areas)
If you have had a scan or xray that shows some “degenerative changes” under your kneecap this increases the chance that this is the problem
Kneecap pain is more common in people who have dislocated their patella previously
If you do not feel that your knee pain fits these features click here for a rehabilitation approach that is likely to be most effective. Also if you have had “acute” injury due a specific incident (for example running/twisting with a sudden onset of pain) please contact us for a free telehealth consultation (by clicking the button below) or see your GP.
For detailed information on knee cap pain see here noting that the correct physiotherapy treatment is highly effective in almost all cases (surgery and injection treatment is rarely required). If your pain is relatively low (less than 4/10 on average) and not having a major impact on your life consider the following effective physiotherapy treatments you can do on your own.
Keep moving in activities that don’t aggravate the symptoms. Activity for knee pain is generally helpful provided it doesn’t significantly increase your pain by more than 2/10 during the activity or results in more than 2/10 pain for more than 30 minutes after the activity. For kneecap pain it is important to avoid prolonged sitting with the knee bent, prolonged walking/running, squatting, kneeling and stairs if it increases your pain. Vary your positions and activities as frequently as you can
Read these resources on “pacing” and “more on pacing” to ensure you have the right balance between activity and rest to optimise recovery
Walking is a simple but very effective treatment for knee pain. Generally walk a minimum of 2 times a day starting at an amount of time and speed that doesn’t significantly increase the symptoms as described in the above bullet point (for example walking 5 minutes twice a day). This can then be then slowly increased over a number of weeks (for example up to 30 minutes twice a day)
A graduated series of exercises (click on the links below to see a video description) to build up the strength of the knee is a very important strategy. Work your way through the list below step by step. The exercises should be done 2 times a day starting with 2 sets of 5 (no hold) and progressing to 2 x 12 over 3-6 days making sure there is no significant increase in pain (see bullet point above). Once mastered move to the next exercise in the list, starting again at 2 x 5 progressing to 2 x 12 over 3-6 days.
Start with a half lunge
Progress to a full lunge
Next is a step down from 10cm step
Progress to a step down from a 20cm step
Final progression is a jump lunge
While doing these exercises you should be trying to activate the inside part of your quadricep muscle (vastus medialis oblique or VMO) by feeling the muscle and focusing on “switching it on”. Don’t progress the exercises until you can feel the muscle activating.
When you are comfortably doing step downs from 20cm you should be able to also start grading up your activities by following the principles of rehabilitation described here. Running and other impact sports should not be graded up until you can comfortably do 15 jump lunges.
Negotiating the above exercise and rehabilitation program can be complex. Or you may not be noticing any improvement over a two week period. If this is the case why not try a free telehealth consultation with one of our expert practitioners by clicking the button below. Ongoing treatment by telehealth or face to face can also be provided if needed to guide your recovery.