A common question I get is ‘why is my knee making clicking noises when I bend down or use the stairs, and what can I do about it?
This is a question that I receive almost every day. I recently treated a 55 year old female with a 5 week history of pain and clicking in the front of her right knee, worsening when ascending and descending stairs. She could not recall any recent changes to her exercises or work demands, and had no previous knee injuries or symptoms. She also reported pain on squatting and kneeling, and that her symptoms worsened throughout the day. I conducted a series of assessments to rule out any other knee problems involving the joint or ligaments, and to reach the diagnosis of patellofemoral joint (PFJ) pain. PFJ pain is a common issue amongst men and women of all ages. Despite the absence of breaks, tears or sprains, patellofemoral pain can cause significant discomfort.
A healthy patella (‘knee-cap’) sits in a groove at the front of your femur (thigh bone), and glides up and down on this groove like a train on a track. The patella is also held in place by a number of muscles both on the inside of your thigh, and the outside. It is a figurative ’tug of war’ between these two muscle groups, and as long as both groups are evenly matched, the patella will remain on its track. Problems arise when the muscles on the outside are too tight, often combined with weakness of the inside muscles. The outer structures start to overpower the inner ones, pulling the patella sideways off its track. This is what causes discomfort and ‘clicking’. You may have seen athletes with tape around their knees, most often this is to control the patella position and stop it from going off-track while running or jumping.
My client’s treatment involved loosening the Ilio-Tibial Band (ITB), which runs down the outside of the thigh, combined with muscle activation and strengthening exercises for the thigh muscles on the inside of the knee (VMO muscle). Another contributing factor to her symptoms was her weak gluteal (butt) muscles, which caused her knees to turn inwards while squatting, thus placing more outwards stress on the patella. Therefore, gluteal strengthening exercises have now been added to her home exercise program.
Due to the wide range of factors that can contribute to this disorder, an individualised program (designed and overseen by an experienced therapist) is recommended in order to achieve the best possible outcome. If these symptoms sound familiar, and you would like to find out more about how we could help you, please call us on (02) 9743 2311 or click here to book online.
Tim Nesbitt-Hawes | Physiotherapist