Plica Syndrome

Dr Ozello's Sports Medicine Report: Plica Syndrome
The main characteristic of plica syndrome is knee joint cracking and popping while squatting or rising. Anterior knee pain with motion is a hallmark symptom of plica syndrome. Pain can be brought on by rising from a chair, squatting, walking stairs or other activities that load the patellofemoral joint. Palpable tenderness may be present. A prior knee injury or trauma may have occurred, or there may be no history of injury or trauma. Keep in mind that neurologic interference usually precedes orthopedic conditions.
As a result of overuse or injury, plica tissue can become inflamed or irritated due to friction across the patella or the medial femoral condyle. When the plica tissue is inflamed or irritated, it can cause plica syndrome.
***Disclaimer: Viewing this video does not take the place of seeing a medical professional, working with a nutritional professional, working with a fitness professional and receiving proper training in the medical profession. Please visit a medical professional for evaluation, diagnosis and treatment. Please work with a nutritional profession to develop individualized nutrition strategies. Please work with a fitness professional to learn proper exercise technique and to develop a proper training program. Never perform an exercise that elicits or intensifies symptoms. If an exercise elicits or intensifies symptoms, stop immediately and use a viable substitute. Always perform all exercises through a symptom free range of motion. Begin your training at your current health, fitness and strength levels. Increase intensity in small gradual calculated increments. Please use nutritional strategies that are designed to work for your individual needs.
A plica is a band of thick, fibrotic tissue that extends from the synovial capsule of a joint. It is an embryonic remnant. The knee joint is the most common location of plica tissue.
There are four different locations plicae can exist in the knee. The suprapatellar, infrapatellar, medial and lateral. A person can have more than one plica.
The suprapatellar plica is located between the knee joint and the suprapatellar bursa. The infrapatellar plica is found between the intercondylar notch and the synovium around the infrapatellar fat pad. The medial plica is found between the infrapatellar fat pad and medial aspect of the knee joint. Medial plicae are the most common type of plicae and are the most common location of Plica Syndrome. Lateral plica is the rarest and is found between the infrapatellar region and the lateral patellar facet.
Normal plicae can become painful. Inflammation can then lead to a tight, fibrotic plica that can manifest in symptoms, especially during knee flexion.
If left untreated, Plica Syndrome has the potential to cause damage to the joint cartilage.
Postural faults and lower extremity joint dysfunction can be contributing factors to the development of Plica Syndrome. Lower extremity joint misalignment and incorrect foot biomechanics can contribute to poor posture and lower extremity dysfunction. If one area of the kinetic chain is not functioning properly, another area must carry a greater workload, thus setting up that area for injury.
Postural faults involved with Plica Syndrome may include unlevel pelvis, femoral internal rotation, dynamic knee valgus, tibial internal rotation and hyperpronation.
Professional Care: Evaluation to determine exact diagnosis and contributing factors. Two orthopedic tests for Plica Syndrome are the Stutter test and the Hughston test.
The prognosis for plica syndrome is favorable when treated promptly before the potential complication of cartilage damage becomes too advanced.
Chiropractic treatment restores proper skeletal alignment and motion and optimizes nerve flow.
Prevention and rehabilitation plans should be tailored to your individual needs. Self-treatment for plica syndrome would involve lower extremity stretching and strengthening exercises to combat postural faults and incorrect biomechanics. Weak muscles need to be strengthened. These muscles may include deep core, deep spine muscles, gluteus medius, gluteus maximus, hamstrings, quadriceps and ankle dorsiflexor muscles.
Self-treatment also includes avoiding activities that elicit and/or intensify symptoms.
References
Plica Syndrome www.ncbi.nlm.nih.gov/books/NB...
Dr Donald A Ozello DC of Championship Chiropractic in Las Vegas, NV
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