The most common causes of knee pain are tracking disorders and instability; tendinitis, bursitis, and synovitis; and traction apophysitis.
Patellofemoral malalignment, lateral patellofemoral compression syndrome, and subluxation and dislocation all result from patellar tracking disorders and instability. Women have patella related pain because of their Q angle. An increase in the Q angle causes abnormal stress on the articular surface and can lead to pain/swelling. The author says malalignment does not need treatment unless symptoms develop.
Lateral patellofemoral compression syndrome (LPCS) is associated with contraction of the lateral patellar retinaculum and weakness of the vastus medialis. Patellar mobility is decreased, and can not medially sublux when muscle is relaxed.
Subluxation and Dislocation is a lateral shift that occurs when the knee is in a slightly flexed position. Typical actions which cause subluxation are, deceleration affected leg. It sometimes feels as if the leg is giving way. Initial dislocation is an acute and severe injury. Even if the patella relocates spontaneously the author advises that medical treatment is necessary. After disclocation, most muscle and muscle attatchments on the medial side are torn. Occasionly, a fracture of the patella, or lateral femoral condyle occures. a medical evaluation is necessary.
Treatment for subluxation and dislocation is taking nonsteroidial anti-inflammatory medications, physical therapy for quadracep, and ilio tibial band strength exercises, and application of heat before excercise and applacation of ice afterward.
Chondral and osteochondral disorders are structure and functional changes of the hyaline cartilage and the subchondral bone of the patella. These changes can cause anterior knee pain and similar symptoms to patellar tracking disorders. Changes also occure in chondromalacia patellae, osteochondral fractures, and osteochondritis desecans of the patella. Some people have crepitation, grinding, catching, or locking in anterior knee pain. Also some have swelling and or the feel of their knee giving away.
Tendonitis, bursitis and synovitis which are all inflamation of the knee joint are usually caused by extra curricular activities. The same stresses that causes tendonitis in adults causes inflamation of the tendon at its attachment to bones.
Pain is also caused by the following:
Osgood-Schlatter Disease- the inflamation of the patellar tendon to the tibial tubercal.
Larsen-Johansson Disease-Inflamation of the proximate end of the patellar tendon where it inserts into the inferior pole of the patella.
Bipartite Patella-where the superior lateral quadrant of the patella fails to unite with the rest of the patella.
Most conditions that cause anterior knee pain is in active peiple related to the patellar femoral joint.