Retropatellar Pain Syndrome

Retropatellar Pain Syndrome (also known as RPPS, Patellofemoral Syndrome, Patellar Tendinitis, and Jumper's Knee) is an inflammation of the patellar tendon in the knee which results in pain and/or discomfort. It is often confused with (but is not the same as) a condition known as Chondromalacia Patellae.

This condition is caused by a weakening of the articular cartilage under the patella. The softened cartilage places additional stress on the patella, which results in the patella no longer gliding smoothly across the trochlear groove. The result of this is pain in the anterior knee that is worse with climbing stairs or prolonged sitting. In many cases, the patella appears to "pop" or shift suddenly when the leg is extended.

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Causes

• Stress due to improper exercise.
• Weakness of the vastus medialis.
• Poor biomechanics or existing biomechanical problems.
• Overuse, especially in situations where high stress or weight is placed on the knee.
• Sitting for excessively long periods of time.

Symptoms

There are some symptoms which may indicate the presence of this condition. It is important to note that none of these symptoms are definitive proof that the condition exists as they can be somewhat vague. It is necessary to see a doctor to determine whether the condition is actually present.

• Pain in the knee after sitting for an extended period of time.
• Clicking
• Pain when applying pressure to the knee, such as when climbing stairs or walking up/down a steep incline.
• Pain while performing exercises such as lunges or squats.
• Prolonged soreness in the patella tendon after high impact exercises.
• Inability to bend knee at joint all the way to thigh.
• Flat feet

Treatment

Due to the nature of the condition, physical therapy is the ideal solution to the issue. It is recommended that a doctor or licensed physical therapist be consulted. High-impact sports should be avoided, as well as unnecessary stair-climbing and jumping and some leg exercises. If a person has flat feet, overpronation of the foot may cause undue stress on the knee and lead to some of the aforementioned symptoms. Such individuals may want to invest in custom fit orthotics. Anti-inflammatory and pain medications are helpful in relieving discomfort. Finally, since the problem typically results from some level of weakness in the leg, the strengthening of leg muscles (quadriceps and gluteal) is helpful. Regular icing and elevation will also aid in the recovery. As a last option, surgery may be the only solution, as formation of scar tissue may prevent the knee from healing completely; and removal of this tissue through arthroscopic measures may be the last resort.

References

• American Academy of Family Physicians
• Knee Conditions