Diagnosis
In order to get to the bottom of the cause of pain in the kneecap area, a medical history (anamnesis) must first be taken. The extent, location and characteristics of the pain are of particular importance. The clinical examination focuses on the knee, but the feet, hips and spine should also be examined for abnormalities.
In some cases, abnormalities can already be palpated from the outside. Especially for the kneecap there are a number of orthopedic tests that can be performed to make a diagnosis. If, for example, the patient is lying on his back and the examiner presses the kneecap towards the pad, pain may be triggered, which can provide information about the location of the problem. An ultrasound examination (sonography) can also be useful, as it can reveal a joint effusion.With the help of an x-ray image, for example, deviation tendencies of the patella can be shown to the side. In rare cases, other imaging techniques such as magnetic resonance imaging of the knee (magnetic resonance imaging of the knee) or computer tomography are used.
Causes
To prevent knee pain, there are some tips that should be followed. First and foremost, the regulation of body weight is of utmost importance, as the knees are designed for normal weight loads. In addition, it is important to exercise regularly to promote blood circulation throughout the body and especially in the knee.
The vital cartilage in the knee joint is only connected to the bloodstream to a small extent and is dependent on physical exercise to obtain sufficient nutrients. Basically, it does not depend on what kind of exercise is done, but mainly on regular physical activity. Strong muscles in the legs relieve the knee joint.
Sports that are particularly good for the knees are swimming, cycling and walking. Wearing heavy loads as well as shoes with high heels should be avoided as it puts a lot of strain on the knee. The tendon of the large quadriceps muscles runs above the kneecap (see quadriceps thigh muscle).
If pain occurs, especially in the stretching process of the knee above the patella, this musculature can be the cause. The “quadriceps” pulls with its tendon over the kneecap and starts at the upper tibia. The tendon can be irritated or inflamed by incorrect or excessive strain, as well as by foreign interference or inflammation.
Due to the stretching, it slides towards the thigh and can cause considerable pain due to the friction. Any inflammation in the area above the patella triggers this pain in movement. Typical signs of inflammation are also at the knee a swelling, redness, limited function and pain sensitivity.
Stretching can also be very painful in the case of chronic diseases of the knee. Very often an arthrosis of the knee joint can be detected in old age. Typical is stiffness in the morning with extremely limited freedom of movement.
In addition, the movements of the worn joint are very painful and stretching is no longer completely possible. Standing up from a squatting position is a power-intensive stretching load on the knee. Here, too, the quadriceps muscle is put under great strain.
Pain when standing up is mainly caused when the muscle or its attachment tendon above the kneecap is irritated and inflamed. Such pain can also occur in young people. A permanent pain that occurs even with a few movements, such as standing up, is also called tarnishing pain.
This is not uncommon among athletes. The pain subsides slightly after prolonged movement and strain. When bending as well as stretching, there is a high load and friction of the attachment crease of the quadriceps muscle.
This glides over the patella with every movement to increase the transmission of force. In the case of an inflamed and irritated tendon, every movement becomes a torture. Pain when bending is also very typical for rheumatic diseases.
These can often be found in the knee. In osteoarthritis of the knee, which is one of the rheumatic diseases, severe wear of the cartilage causes the bones to rub against each other. This causes severe pain when bent.
The freedom of movement is also restricted overall. This can be seen particularly in the morning, when a severe stiffening of the affected joints is to be expected. Pain during movement is typical for many diseases of the knee.
However, pain at rest occurs only rarely. A pain that can occur from rest with slight movement is the typical initial pain in osteoarthritis. (see also symptoms of osteoarthritis) In adolescent patients, pain at rest, for example at night, may indicate a growth spurt.
The pronounced longitudinal growth of the bones can sometimes cause severe pain. (see also growth pain) A disease of the lumbar spine can also cause pain at rest in the knee. Irritation of nerve roots can sometimes carry pain all the way to the toes.
ISG blockage also often causes pain in the knee area. In very rare cases, malignant tumors of the bones can be behind it.
