Understanding Patellofemoral Pain Syndrome (pain on the front of your knee)

WHAT IS IT?

Patellofemoral pain syndrome (PFPS) is pain at the front of the knee, around or under the patella

(kneecap). Patellofemoral pain syndrome is sometimes called "runner's knee", as it can be

more common in people who run and who play sports that involve running and jumping.

WHY DOES IT HAPPEN?

• Training errors or overuse – Poor training rest or improper form/technique or programming.

• Muscle dysfunctions - muscles around the hip and knee are either weak or tight, leaving imbalances lying which don't keep the kneecap in line and functioning adequately.

• Injury – Previous injury to the kneecap, such as dislocations or fractures.

• Tight soft tissue surrounding the knee – Muscles and soft tissue such as the tensor fascia lata, iliotibial band, lateral retinaculum and vastus lateralis are tight cause maltracking of the patella when movement occurs.

• Age – Patellofemoral pain syndrome typically affects teens and young adults.

• Sex – Women are twice as likely as men are to develop patellofemoral pain. This may be because women have wider pelvises which increases the angle at which the bones in the knee joint meet.

• Certain Activity/Sports - Running and jumping sports can put extra stress on the knees. This is especially true when adding more training.

SIGNS & SYMPTOMS

• Symptoms can be on, around or underneath the kneecap.

• The symptoms generally gradually build up over time, although can come from trauma.

• Stiffness, pain or both when knees are bent after prolonged sitting.

• Pain with activities such as climbing or descending stairs, squatting or running.

• Pain can be achy, but it can be sharp at times

• Can have the feeling of the knee giving way

TREATMENT

Sometimes, temporarily backing off aggravating activities can help reduce symptoms. But to prevent patellofemoral pain from reoccurring, guidance from a physio or athletic therapist is needed. A well-structured rehabilitation program is usually effective in treating PFPS. However, there is no one program that will be effective for all patients. The rehabilitation program should focus on correcting and addressing the findings identified on the physical examination. A detailed assessment of the imbalances of patellar tracking is therefore essential to tailoring treatment.

EXERCISES TO TREAT PFPS

1. Foam Roll and Stretch Quadriceps

Start in a forearm plank position with the roller under your quads. Bracing yourself with your

upper body and core, begin to slowly roll down the roller until it reaches just above your

knees. Then, roll in the opposite direction until you reach your hip. Do this for 45 seconds.

When you hit a tender spot, hold yourself there for a few breaths.

Stand on your left foot and grab your right shin by bending your leg behind you. Tuck your

pelvis in, pull your shin toward your glutes, making sure your knee is pointing to the ground.

Try not to pull the knee backward or sideways. Hold for 45 seconds and then switch sides.

2. Side Lying Leg Lift

Lie down on your right side on a mat or the floor. Your body should be in a straight line with

your legs extended and feet stacked on top of each other. Place your arm straight on the

floor under your head or bend your elbow and cradle your head for support. Place your left

hand out front for extra support or let it rest on your leg or hip. Raise your left leg off the

lower leg. Stop raising your leg when you feel the muscles flex in your lower back or

obliques. Repeat 15-20 reps each leg, 3 times.

3. Split Squat Holds

Set up in a split stance position with your hands by your side, looking straight ahead, and

your back knee in contact with the floor. Drive through the front foot just enough so that the

back knee rises off the floor 1-2 inches. Hold for up to 10-15 seconds each leg. Try load your

weight forward to challenge the quadriceps muscles and tendons.

4. Front Step Downs

Start with both feet on top of a step/box. Next, standing on the painful leg, slowly lower the

unaffected leg down forward off the step/box to lightly touch the heel to the floor. Then return

to the original position with both feet on the step/box. Maintain proper knee alignment, knee

in line with the toes and not allowing the knee to drop inside the body. Repeat 10 -15 reps

each leg, 3 times.