Have you had difficulty with knee pain lately? Do you feel pain underneath and around your patella/kneecap after increasing mileage during runs or after training on hills? Do you have pain and difficulty going up/down stairs and curbs? After sitting through a movie, do you have to wait a few minutes before you can get up and walk out of the theater comfortably? If so, you may be suffering from patellafemoral pain, and we, at ProActive Physical Therapy and Sports Medicine, can help you.
Patellafemoral pain is a very common disorder among young, healthy and active teens and adults. The condition usually occurs when there is a muscle imbalance and lack of flexibility in the global lower extremity of the person. The good news is that with proper physical therapy intervention this pain can be alleviated with specific strengthening and stretching of muscles and structures in the lower extremity and, in more severe cases, with the help of McConnell tape.
The patella (kneecap) functions as a “balance beam, adjusting the length, direction, and forces, at different degrees of knee flexion. This change in contact area results in a change in the lever arm and mechanical advantage provided by the patella to the quadriceps.” (Zachazewski, James E.; Magee, David J.; Quillen, William S.; Athletic Injuries and Rehabilitation. 1996. p. 698.) The undersurface of the patella has medial and lateral facets which are concave and fit well into the convex medial and lateral facets of the trochlear groove of the femur where the patella is positioned. The patella slides in a downward direction in the trochlear groove of the femur during knee flexion and up during knee extension, similar to a train riding on tracks. The patella is anchored on top by the four different regions of the quadriceps muscle (the main mover of the patella) and the non-movable stabilizers (the patella tendon below and the medial and lateral tissue structures on the sides), which help stabilize the patella in the center of the trochlear groove.
It is common to see weakness in the medial side of the quadriceps muscle, mostly in the vastus medialis obliquus (VMO) muscle, which will cause the patella to track more to the outside or lateral part of the trochlear groove of the femur. The lateral support structures of the patella can also become very tight, pulling the patella laterally “off the tracks” during activity. These are just two of the most common causes of patella tracking problems. Over time, these problems cause the cartilage to break down, both in the trochlear groove and the undersurface of the patella. This causes pain and, at times, patients may report that their knees will “buckle” during activity.
The McConnell tape method was designed to counter this lateral excursion of the patella and to keep the patella centered in the trochlear groove. At ProActive Physical Therapy and Sports Medicine, to assist our patients during their rehabilitation, we use the McConnell tape method to decrease pain during training and with other activities of daily living, such as ascending and descending stairs and curbs. We use this tape method only for the short term. Our ultimate goal is to rehabilitate the patient so that his/her medial patella structures are equal in pull to the lateral patella structures and the patella returns to its normal function of spreading compression forces over a wider surface area.
Please feel free to contact our clinic, if you have further questions regarding knee pain and rehabilitation, including McConnell taping.