Q: I have a condition where my knee caps do not follow the correct track. My knees make a grinding noise when doing steps and they hurt a lot. I have tried the strengthing exercises but these only work for a while. Is there anything else I can do?

During the course of daily activities, the knee joint supports two to four times the body's weight.

Arthritis or injury may alter the knee joint alignment, causing a greater load across the medial compartment, with a potential to accelerate the degenerative process and cause pain.

Another possible source could be patellofemoral pain syndrome, A common condition that causes pain in the joint between the patella (kneecap) and femur (thigh bone). It can be caused by softening or cracking of the articular cartilage under the kneecap. This is known as chondromalacia. A malalignment of the kneecap or tight tissue around the kneecap can also create tension that may cause pain.

Pain related to patellofemoral pain symdrome is usually in the front of the knees and may be experienced when climbining stairs, and especially going down the stairs. When sitting for prolonged periods, an individual would occasionally feel the urge to straighten their legs out to decrease discomfort, and squatting and kneeling make the pain worse. Normally, it is generally an aching pain, but can also be sharp or burning, and some patients feel as if their knee is "giving way" or experience a grinding sensation behind the kneecap.

A physical exam is needed for a diagnosis, and X-rays, CT Scans and or MRI Scans may be used to confirm the diagnosis.