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 KNEE
CAP PAIN
Ross
Hauser, M.D.
When there is a problem with this part of the knee it manifests as pain in the
front of the knee after strong exertion (running, walking, or stair climbing.)
This may be due to erosion of the
cartilage
on the under side of the patella, poor tracking of the patella in its groove on
the front of the knee, or an inflamed
tendon on the lower edge of the
patella.
The patella
is covered on its back side with the thickest layer of
articular cartilage of all the
joints in the body. Erosion of this cartilage is called "chondromalacia
patellae." On
x-ray it is seen as a decrease in the amount of cartilage
underneath the kneecap. It may be caused by trauma or occur spontaneously. If
the patella is fractured, pain may still persist after the fracture heals.
Prolotherapy is excellent at relieving
all of these pains.
Prolotherapy helps chondromalacia patellae or patellar tracking problems because
the pain-producing structure is generally the patellar tendon or the
musculoskeletal support around the patella. Prolotherapy for chondromalacia
involves intra-articular (inside) injections as well as injections on the
outside of the knee, stimulating the growth of many musculoskeletal structures
around the patella. It is for this reason the knee gets stronger and the pain of
chondromalacia is relieved.
Patellar
Tendonitis
Another common condition is patellar
tendonitis, which can occur at the sides,
the top, or the bottom of the patella. It commonly occurs in athletes who do a
lot of jumping, such as basketball players, volleyball players, and ballet
dancers. This is why it is also known as "jumper's knee." By injecting the
appropriate site with Prolotherapy, these injuries are effectively and
permanently treated and the pain is relieved. This is because Prolotherapy helps
strengthen the patellar tendon (though some would call this the patellar
ligament since it goes between two
bones, the patella and the tibia). While Prolotherapy causes a strengthening of
the patellar tendon,
cortisone
and its related anti-inflammatories,
weaken it. For this reason patients should avoid cortisone injections into the
patellar tendon because of the risk of it weakening and thus leading to rupture
of the tendon. This occurs because cortisone weakens the ligament/tendon-bone
junction. Cortisone and the other anti-inflammatories have a lot of other bad
effects.
Do Not
Be Desperate for Surgery or Scopes
Patients
with pain often succumb to surgical procedures, even drastic ones. A good
example of drastic surgery is the recommendation to surgically remove the
patella in order to remove the pain. This sometimes does relieve the pain, but
at a significant cost to the body. The strength to extend the knee is reduced by
about 30 percent, and the force exerted in the knee is increased. There are a
host of other risks associated with surgery. The athlete must realize that with
each procedure and each shaving or cutting of tissue,
NSAIDS
(non-steroidal
anti-inflammatory drug)
prescription, or
cortisone shot, the odds of developing long-term arthritis are greatly
increased. The key to keeping the knee strong is to stimulate the area to heal,
not to cover up the pain with a cortisone shot or NSAID. Even worse is to
eliminate the painful area by shaving or cutting. This just delays the pain for
a few years until the remaining tissue becomes degenerated. The best approach is
to stimulate the area to heal. The best way to do that is with Prolotherapy. |
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