In principle, in addition to specific exercises, sports with low stress on the damaged knee joint, such as cycling, aqua jogging or walking, should be performed. It is better to carry out the loads for a shorter period of time and dynamically, rather than over a long period of time and statically. Endurance loads with alternating pressure loading and unloading, avoiding compression (e.g. during stop and go sports at high speed, jumping sports) on the knee joint can imitate the so-called cartilage pump that occurs during compression techniques. Coordination and strength training on the Galileo (vibration plate) is also beneficial – long-term static loads and continuous compression such as when kneeling, squatting or sitting for long periods should be avoided due to the lack of metabolic nutrition (risk of cartilage softening). Even deep knee bends, especially when performed in a supine position, trigger high retropatellar pressure and should – if unavoidable – be performed in a supine position.
Synonyms
Medical: Femoropatellar Pain Syndrome (FPSS)
Sporting overloading for anterior knee pain
If the medical diagnostics and physiotherapeutic findings described above do not indicate a clear cause, it is necessary to consider overexertion, especially in younger patients. Causes: Sports overloading often leads to inflammation of the tendon attachment points of the tendons located around the knee joint. Most frequently, the strong tendon of the thigh extensor (patella tendon) is affected, which has its attachment directly below the kneecap (volleyball, basketball, weightlifter, high and long jumper).
The problem is further aggravated by congenital malformations of the patella, the knee joint (bow legs) or foot malpositions. Runners often have an inflammation of the tractus iliotibialis (tendon plate running from the outer hip to the head of the shinbone – runner’s knee) or at the inner attachment point of the thigh flexor (Pes anserinus). Friction during bending and stretching of the knee joint in case of existing muscular imbalances of the thigh muscles causes irritation and inflammation of the tendons near the joint.
The complaints typically do not occur during but rather after loading, are unilateral or bilateral, can last for varying lengths of time or recur repeatedly (recurrent). The treatment consists primarily of load reduction and load modification. Short-term immobilization with stabilizing tape bandages or splints is rarely necessary.
Since the cause of the pain is based on overloading, the athlete should interrupt the training at least until everyday stress is pain-free again. Before resuming training, the technical execution of the respective sport, the materials required for the sport, the training content and frequency as well as the regeneration time must be checked. In order to correct the technique and the training plans, the support of an expert trainer should be sought in any case.
Wearing a functional tape during exercise can help to reduce pain and improve coordination. Sometimes a training reduction to half of the normal exercise program or a change to pain-free sports activities (swimming, cycling with the saddle up, aqua jogging) is sufficient. After loading, the affected knee joint should be cooled. Training should be increased slowly and cautiously, observing the reaction, as recurrent irritation of the tendons increases the risk of chronicity.
- Too high training frequency
- Too high training intensity
- Lack of regeneration time
- Technical error
