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Patellofemoral Pain Syndrome in Dancers
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Patellofemoral pain is used to describe pain in the patella (kneecap) and the femur (thigh bone.) The pain can occur behind or anywhere around the kneecap, and may be reported as aching or sharp. The following activities may increase pain: prolonged sitting, squatting, kneeling, and going downstairs. Swelling may be present, and patients may report that it feels as if "their knees are giving out." Patellofemoral pain may occur for a number of reasons. Commonly, the patella may not be gliding in the femoral condyles smoothly (see figure.) This is similar to a train not running smoothly on its tracks. This is often due to muscle imbalances, such as tightness of quadriceps, hamstrings, and/or iliotibial band, and weakness of the quadriceps. Another factor, especially in women is an increase |
| in the Q angle (the angle between the front of the hip and the center of the patella, and the tibial tubercle and the center of the patella,) as women have a wider pelvis. In extreme cases, if the tracking is so poor, the patella can dislocate (be pulled out of the femoral condyles,) and then become a repetitive incident. Repetitive maltracking of the patella leads to arthritic changes in the knee.
Conservative treatment for patellofemoral pain involves resting the knees for a period of time, as recommended by your doctor or physical therapist. During this period, exercises and stretches can be performed to strengthen and stretch any muscle imbalances noted from the physical therapist. Ice, ultrasound, and electrical stimulation may be used to decrease pain and swelling. Dancers should not return to dance until their doctor clears them, they have no pain, and muscle imbalances are eliminated. Taping of the patella or bracing may assist with tracking of the patella during rehab and early return to dance activities. Although the rest may be inconvenient for young dancers, it can prevent knee problems later on in life. References Jenkinson, David M., Bolin, Delmas J. “Knee Overuse Injuries in Dance,” Journal of Dance Medicine and Science, vol. 5, no.1, 2001, pp. 16-20. Potts, J. Christopher, Irrgang James J. “Principles of Rehabilitation of Lower Extremity Injuries in Dancers,” Journal of Dance Medicine and Science, vol. 5, no. 2, 2001, 51-60. Website, Johns Hopkins Department of Orthopaedic Surgery, “Patient Guide to Patellofemoral Pain Syndrome.” |
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