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Uditt asked...

I get severe pain in my knee caps.

I get a severe pain in the front of my knee caps after work. I do not sit for long periods. I always leave the office at lunchtime for a walk. I take cod liver capsules and glucosomine sulphate with chlodrin. Folic acid and calcium tablets. Please advise why

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The answer

Pain around the front of the knee area without any obvious injury is common, particularly in young to middle aged females who are physically active. This is usually caused by poor foot posture and imbalance of thigh muscle strength, leading to misalignment of the kneecap in a condition known as 'patellofemoral maltracking'.  The kneecap tends to rub rather than glide smoothly up and down which results in pain, clicking and sometimes swelling.  To resolve this problem you first need to look at your footwear and make sure the instep of the arch is well supported − if the foot position remains stable this will indirectly encourage smoother tracking of the kneecap.  Secondly, you need to develop equal balance of the four muscles around the knee known as ' the quadriceps'.  It is the smaller of these muscles known as 'VMO ' which is usually the weakest, so to work this muscle you need to do specific exercises such as non weight-bearing, straight leg raises.  I would advise seeking advice from a physiotherapist as to a suitable exercise programme.  As the muscle balance improves, the kneecap will rub less, resulting in less pain but it is likely to take many weeks of persistence to sort this out completely.


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