When a patient presents to our office complaining of pain behind the kneecap or patella it is most often due to a chronic overuse type of injury. Repetitive kneeling, running, and stair climbing are huge contributors to this type of condition. The 3 most common diagnoses are:
PTD (Patellar Tracking Disorder)
PTD is caused by the kneecap or patella being pulled outside of its natural position within the groove in the femur. This is most often caused by a muscular imbalance where the lateral quadriceps muscles overpower the medial quadriceps and pull the kneecap laterally. This causes an abnormal wear and tear of the backside of the patella as well as the femur and the patient experiences pain and grinding when straightening the leg.
Runner’s Knee (Chondromalacia Patella)
Runner’s Knee is simply that, a progressive weakening or irritation of the cartilage behind the patella due to overuse, which in the case of a runner is a straightening, and flexing of the knee under axial pressures.
Housemaid’s Knee (PrePatellar Bursitis)
Housemaid’s Knee is a condition where the bursa sac in the knee becomes inflamed and swollen due to repetitive kneeling. Today it is most common with laborers who kneel constantly such as carpet or tile installers.
The conditions above, which cause pain behind the kneecap, can usually be managed conservatively and don’t require an invasive solution. Typically a course of NSAIDs, ice and physical therapy will resolve the symptoms and of course eliminating or altering the performance of the aggravating activity is a must.