WHAT IS KNEECAP PAIN?
Kneecap pain is pain that comes from the kneecap or patella. It is usually felt at the front of the knee though it sometimes seems to spread around the sides and occasionally to the back of the knee. Many different names have been given to this type of knee pain including anterior knee pain, chondromalacia patellae and patello-femoral pain. Patello-femoral pain is most in favour at present with doctors.
WHAT CAUSES THE PAIN?
The kneecap is the most heavily loaded joint in your body. The most common reason for the pain is that your child has been growing or putting on weight. This increases the load the kneecap has to bear at a time when it is still immature and not able to cope. A sudden increase in activity can also overload the joint. The pain is nature's way of protecting the kneecap from overuse damage.
For this reason it is not wise to try to exercise through the pain barrier or permanent damage may result. It is very rare that there is any abnormality of the bones or joint.
IS KNEECAP PAIN COMMON?
Yes. A survey of over 1000 schoolchildren found that 21% (1 in 5) of girls and 6% (1 in 16) boys had kneecap pain. Most children seem to grow out of the pain by the end of their teens.
CAN ANYTHING BE DONE TO HELP THE PAIN?
Nobody can cure the pain. Since the pain is protective removing it would risk doing serious damage to the knee. However there are several things that your child can do to reduce the pain to a nuisance level.
These are listed below:
- QUADRICEPS EXERCISES. The quadriceps are the thigh muscles that hold the knee straight when standing. If the knee is sore the muscles become weak very quickly. Weak muscles ache when asked to work, so they are rested more and become even weaker and more sore with use. Strong muscles help this pain. Weak muscles also cause problems because they tend to snatch, rather than working smoothly and with control. This actually increases the load on the knee and thus the pain. Finally weak muscles are sometimes not able to support your weight which may cause the knee to give way. This risks injury to the knee. The exercises are simple to do and can be done anywhere and any time without others realizing. However, they only work if done regularly. We think they should be done 6 times an hour every day!
- SIT WITH THE KNEES STRAIGHT. Another name for this condition is "TV knee". Many children sit with their legs folded under them, which puts high loads on the kneecap. Sitting with the legs straight takes this pressure off the kneecap and allows the joint fluid to circulate in the knee. This fluid is vital to nourish the shiny gristle lining the joint. It also acts as a shock absorber between the joint surfaces and to oil the surfaces. Sitting with the knee bent for a long time squeezes out this fluid and can make the knee seize up because there is nothing to oil the surfaces.
- KEEP ACTIVE WITHIN THE PAIN LIMITS. Exercise is vital to make the skeleton develop properly so we are not saying give up all sport. We do suggest reducing the level of activity when the knee is sore. This tends to be more common during a growth spurt when the bones may be slightly weaker.
- WEIGHT REDUCTION WHERE APPROPRIATE. The kneecap carries between 6 and 12 times body weight during normal use. Being overweight or carrying very heavy school bags can greatly increase the load on the knee.
- SHOCK ABSORBING FOOTWEAR. Running, jumping and even walking applies jarring forces to the knee. These cannot be avoided, but the use of shock absorbing shoes may reduce these jarring forces. Some types of trainers have been designed for this purpose and are popular with kids. Where possible it is also sensible to Walk or run on grass rather than concrete.
- SIMPLE PAINKILLERS. Even with these measures the knee will sometimes be painful. Simple painkillers, such as Paracetamol, will help the pain. It is best to only give Paracetamol at night to avoid the temptation to do too much without the protective pain.