Ask the PT: About Knee Pain

I recently developed pain and a crackling sound in the front of my knee when gardening.  It’s worse when I get up from the ground or squat down to lift things.  What can I do to alleviate this?

Response from Dustin Renaud,MPT of PT Cumberland

The likely source of the crackling or grinding experienced in your knee is a condition called chondromalacia patella (or CMP).  This condition occurs when the knee cap (or patella) is not moving properly over the thigh bone (or femur).  In normal knee function, the patella tracks smoothly within a groove between the condyles of the femur.  When the patella is either tilted or shifted due to a muscular imbalance, the resulting increased pressure between the two bones will cause softening of the cartilage under the knee cap or pain in the area of increased pressure.  This abnormal pressure can cause a crackling sound, pain and/or swelling in the front of the knee.  

CMP is typically caused by excessive tightness of the muscles and soft tissue around the knee, including the hamstring, IT band, and quadriceps, combined with general weakness of the inside muscles of the knee.  This can either be related to a recent injury or chronic muscle imbalance related to posture or daily activity.  Those who are more likely to develop this condition include females, knock-kneed or flat-footed runners, or those with an unusually shaped patella undersurface.  X-ray or MRI can be used to confirm the diagnosis of CMP but is not required.  Symptoms of this condition include pain in the front of the knee during prolonged sitting, and from activities such as running, squatting, and climbing stairs.

Physical therapy treatment of CMP is effective in improving pain control and daily function.  Treatment consists of a thorough evaluation to determine the involved musculature and structures followed by the development of a comprehensive treatment plan.  Stretching of the tightened soft tissue with strengthening of the muscles surrounding the knee and hip is important to ensure proper mechanics of the involved leg and to limit excessive stress to the patella.  This will allow for proper tracking and decrease abnormal pressure of the patella against the femur. For more information on how you can alleviate knee pain, call Physical Therapy of Cumberland at 333.9787 or contact us on the form below.