Stella Oyefesobi
Going
up and down the stairs, an activity we all take for granted, could
bring up fear and reluctance in some people due to ensuing pain.
Knee pain, when on the stairs, is a
complaint shared by many people who usually feel fine while walking; but
pain begins either suddenly, or happens each and every time while they
are on the stairs, with some days being less intense than others.
All the same, it can be a real problem
that limits activities of daily living and overall quality of life,
especially for those living in houses with one or more flights of steps.
Although there are several possible
causes of knee pain, many knee problems feel worse on the stairs; but
the three main problems where knee pain on the stairs is one of the most
prominent features are: patellar tendinitis, chondromalacia and
osteoarthritis. The focus today will be on patellar tendinitis and the
other conditions will be reviewed in subsequent articles.
Patellar tendinitis
The patella (kneecap) is the small bone
in the front of the knee. The patellar tendon is a thick band-like
structure that connects the bottom of the patella to the top of the
large shin bone (tibia).
The muscles on the front of the thigh,
the quadriceps muscles, straighten the knee by pulling at the patellar
tendon via the patella. This makes the patellar to glide up and down the
groove in the thigh bone (femur) as the knee bends and straightens.
Patellar tendonitis is the condition that occurs when the tendon becomes
inflamed and irritated.
What causes patellar tendinitis?
Activities that subject this tendon to
large amounts of stress will inevitably cause “micro tears” leading to
inflammation and pain as well as degeneration in the tendon tissue.
In athletes, the most common of such
activity is jumping, therefore patellar tendinitis is also known as
‘Jumper’s Knee’. Running, walking or cycling may also place repetitive
stress on the patellar tendon.
In non-athletes, patellar tendinitis can also be caused by problems with the way your hips, legs, knees or feet are aligned.
Having wide hips, being knock-kneed, or
having flat feet, can be predisposing factors for patellar tendonitis,
because such body mechanics will place more stress on the tendon during
normal activities.
Recognising patellar tendinitis
There could be pain and/or swelling of
the patellar tendon at the lower tip of the kneecap which may also
extend to the bump on the upper part of the shin bone.
The pain, probably accompanied with
crackling noises in the knees, may increase with activities, such as
jumping, running, or walking and may be worse when walking downhill or
descending stairs.
What to do
Until the pain subsides, protect your
knees from further damage and unnecessary aggravation. Bouncing up and
down the stairs puts more stress on the kneecaps. When ascending stairs,
the top leg carries more of the weight, so go up with the stronger leg
leading.
Whereas, when descending, the leg on the
lower level carries less weight.Therefore, you should come down with the
more painful leg first; and pointing your toes down gives couple of
inches to reduce the stress on the knees. Hold on to the handrails for
added support.
Purchased from a pharmacy store, a
fitting knee brace/elastic bandage over the knee or an elastic strap on
the patellar tendon will assist in supporting the knee joint and help
the alignment.
Applying ice packs for about twenty
minutes twice a day will reduce the inflammation especially if the knee
is already being protected from further injury. Massaging the knee with
ointment, particularly over the patellar tendon if it can be tolerated,
may relieve pain and reduce swelling.
Additionally for athletes, preventive
measures and management techniques will include appropriate warm ups and
stretches before physical activities. There should also be adequate
rest and recovery between events.
Ibuprofen and such other medications
would be useful in treating the pain and swelling, but talk to your
doctor before starting. Definitely see a doctor if you are experiencing
severe pain, even when not bearing weight or if the pain is accompanied
with fever, redness or warmth around the knees or calf muscles; or if
there’s no improvement after three days of home treatment.
Effective physiotherapy
Few weeks of physiotherapy treatment has
proven to be very effective in the treatment of patellar tendinitis with
iontophoresis and ultrasound for pain reduction; and stretching
activities with eccentric strengthening exercises of the quadriceps
muscles to restore proper alignment to the knee.
Left untreated and with continued use,
tendinitis can cause permanent damage to the patellar tendon and can
lead to loss of flexibility due to scarring of the tissues which may
require medical surgery.
No comments:
Post a Comment