Patellofemoral pain

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Patellofemoral pain syndrome is a broad term to describe pain in and around your knee and kneecap. The patellofemoral joint between your kneecap (or patella) and thigh bone (or femur) is complex, consisting of muscles, tendons, ligaments, cartilage, and other supporting tissues that act like a pulley system for your quadriceps in order to move your lower leg and allow you to do many activities, like run, jump, get up from sitting, climb stairs, and squat. If the knee is overused and the kneecap becomes misaligned, it twists and torques the supporting tissues, causing pain often in the front of the knee.

 

People with this condition usually describe a dull, aching pain around the front or edges of the knee, the kneecap may be tender to the touch.  There may be a sensation that the knee is swollen and there may also a rubbing, grinding, or clicking sensation when moving the knee joint. Patellofemoral pain is common in runners (which is why it’s sometimes called ‘runner’s knee’), but there are several risk factors.

 

  • People who do lots of running, jumping, or high-impact activities and put repetitive strain on their knees can experience this condition, particularly if they increase the intensity or frequency of their exercise too quickly.

 

  • Muscle weakness or imbalances, especially in the hip or thigh muscles that stabilize the knee joint, and other improper biomechanics, can also result in the patella being misaligned (or not “tracking” properly) during activity.

 

  • Someone who has experienced an acute knee injury or had knee surgery is also particularly susceptible to patellofemoral pain syndrome. 

 

Once the condition has developed, even sitting for prolonged periods can cause pain once you stand up, due to the added pressure on the flexed knee joint while sitting. Patellofemoral pain can usually be remedied in the short term with rest and temporarily modifying exercise to more low-impact activities; if left untreated, the pain can get worse over time and lead to chronic pain or structural damage in the under surface of the patella.

WHAT CAN PHYSIOTHERAPY DO?

Your Physical Therapist will assess not only your knee but the function of your lower limb in order to treat patellofemoral pain.  The patella is often the “victim” of other forces converging on the area and we need to find out what these are so we can correct the cause of the problem. The therapist will look at your hip, knee, and ankle during this process. 

 

Treatments involve restoring normal function of the knee, working on hip and knee strength, balance and stability, as well as the mobility of the patella itself.  We may also use modalities to help speed up the healing process such as:

  • IMS

  • Ultrasound

  • Shockwave

  • Manual Therapy

  • Electrical Muscle Stimulation (EMS)

  • Cryotherapy

  • Taping

 

When the area is responding well, we will help you progress your activities so you may resume what you love to do without pain and keep it that way.  We will teach you how to maintain your knee with some simple long-term exercises.