It occurs after a fall directly on the kneecap, on the street or in the garden, for example; in sportsmen and women, usually associated with a weak quadriceps muscle; and is strongly associated with a magnesium deficiency causing chronic arthritis and a condition called Chondrocalcinosis.
The good news is that Patello Femoral Pain Syndrome in all its forms responds well to Chiropractic management.
Richette et al did a literature search on ChondroCalcinosis and concluded:
Chondro-calcinosis, as the name suggests, is the deposit of Calcium crystals in the cartilage of joints.
It presents as an acute inflammation of the synovial joint - synovitis - known as "pseudo-gout" and
Chronic arthritis.
It's not uncommon, affecting about 10% of people aged 60.
In people younger than 60 a metabolic disorder should be considered.
Long-lasting magnesium depletion is strongly associated with chondrocalcinosis.
Magnesium
Most of the magnesium in the body is tied up with calcium in the bones. Many drugs including anti-hypertension drugs, anti-contraceptive pills, cortico-steroids, anti-coagulants, diuretics all leach the body of magnesium. If you are taking any of these drugs long term, then you are in the high risk group of suffering from chondrocalcinosis and chronic arthritis.
Foods rich in magnesium include
the dark green vegetables such as spinach (79mg/100g) and broccoli (21mg) (but beware: 30% is lost in the water used to boil them),
is the first step in the management of pain and swelling. Making an ice-cup is simple: fill a paper cup with water, place it in the deepfreeze, and tear away a slither leaving the ice standing proud.
Mobilising the kneecap. This can cause some after-pain but it's temporary and rarely a problem. The crystals of calcium are ground down.
Quadriceps exercises are important. PFPS is often associated with a weak Vastus medialis or lateralis, which allows the patella to track to the side. Strengthening the weak muscle, using quad-setting exercises is vital in the long term.
CHIROPRACTIC COALFACE
Mrs P is a typical case. Only 51 she has pain stretching through her whole back, wrists, hips and knees for as long as she can remember. She has had operations on her wrists and right knee.
She presented first for treatment of her right knee some four months ago, having had moderately successful chiropractic treatment for her back and neck from another chiropractor who doesn't specialise in knees. Walking upstairs was particularly painful in her knee.
The X-ray above confirmed the diagnosis: Mrs P has Patello Femoral Pain Syndrome but the underlying cause is Chondrocalcinosis. Can you see the calcium depositis in the cartilage in the X-ray at the top of the page?
She takes no chronic medication, nor has any history of any metabolic diseases. But she does have chronic arthritis pain throughout her body.
CLARKES TEST
the definitive test for PFPS was strongly positive, particularly when the kneecap was pressed against the medial condyle.
The chiropractic treatment of PFPS is simple, non-invasive and effective. Strengthening of the Vastus Lateralis muscle was an important long-term part of the treatment. She responded remarkably quickly.
I gave her the option of magnesium tablets, or a diet high in green leafy vegetables (especially spinach), hummus, sunflower seeds and dried beans. I'm glad she chose the latter! In the future she may also have to take the mineral supplement depending on how she responds to the spinach and seeds. A fish oil supplement is also in the offing.
Whilst kneecap pain is readily treated with chiropractic pain eminating from within the knee is a far greater challenge to the clinician, be s/he medical or chiropractic. The cartilage lining the ends of the bones does not regenerate of itself.
ARTHRITIS PAIN IN KNEE
