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Non-surgical treatment recommended for patients with common knee pain

Reason for pain is still unclear and may be a result of many factors

Anterior knee pain, which occurs at the front and center of the knee, is one of the most common knee complaints in physically active people. Its cause is still unclear, but is believed to be the result of numerous factors. Non-surgical treatment is typically recommended for anterior knee pain and should be given for at least three months before other considerations are made. In attempts to guide physical therapists treating this condition, a comprehensive guide was created.

Thorough examination essential before beginning treatment

Since patients with anterior knee pain may have a wide range of symptoms and complaints, a thorough clinical examination is necessary before creating a treatment program. This should focus mainly on the legs and feet, and should check the patient's foot position while walking and running, and their shoes. In addition, patients should be tested for muscle strength, flexibility, and stability of the patella (knee bone). Patients should then be divided into one of two groups: one that focuses on reducing pain and the other that focuses on stabilizing the patella.

Patients should be treated based on their unique symptoms

The physical therapist must recognize that patients will have their own unique symptoms. Each treatment program should therefore be based on their examination, and each patient must be explained why they have the symptoms and what needs to be done to reduce them. A standard treatment program for anterior knee pain consists of three phases: The goals of phase 1 are to reduce pain and swelling, improve balance and flexibility, and restore normal walking form (gait). Treatment should include ice therapy, flexibility training, gait modification, and in some cases, taping, foot orthotics, and shoe replacement. For phase 2, the goals are to improve balance of the legs, increase thigh muscle (quadriceps) strength, and restore good knee function, and treatment should include balance and coordination training, stationary bicycle training, quadriceps strengthening, and knee exercises. Finally, the goals of phase 3 are to return to previous physical activity level, and should include functional training, sport-specific exercises, and both education and individual guidelines for the patient depending on their needs and abilities.

-As reported in the October '14 issue of Knee Surgery, Sports Traumatology, Arthroscopy

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