What is patellofemoral pain?

Patellofemoral pain syndrome (PFPS) is the term given to pain originating from the patellofemoral joint (knee cap and thigh bone).    It is usually associated with inflammation.  Pain is usually felt at the front of the knee or under the patella.  Pain is typically an ache and is aggravated by activities such as walking up and down stairs or hills, running, jumping and squatting.

What is the cause of patellofemoral pain?

 The knee is made up of 3 bones, the femur (thigh bone), patella (kneecap) and the tibia (shin bone).  The patella sits within a groove in the femur and slides up and down it as the knee is flexed and extended.  The patella is enveloped in the quadriceps tendon and therefore forces from the quadriceps muscle dictate the directional movement of the patella within the groove.  What is usually seen in PFPS is that the outer quadriceps muscle (vastus lateralis) is stronger than the inner (vastus medialis) resulting in the patella moving laterally (towards the outside) within the groove.  This abnormal movement pattern can cause irritation of the joint and the surrounding structures.  Symptoms gradually increase as the irritation progresses.

Factors that can contribute to PFPS are:  poor foot biomechanics such as over of the forefoot (flat footed), tightness in particular muscles, especially the ITB’s and quadriceps, poor control of the hip, such as weakness in the gluteals muscles and weakness in the VMO muscle.  Inappropriate footwear, training surface or training activity can also have an effect.

What can a physio do to help PFPS?

 Your physio can assist in your recovery from PFPS by performing manual therapy or dry needling to assist in lengthening tight lateral structures of the knee.  They can provide progressive strengthening exercises for the knee and hip and also a stretching and balance program.  They may suggest the use of an orthotic or review by a podiatrist to improve foot biomechanics.  You will initially be told to rest from all activities that aggravate your symptoms.  This usually means no impact sports/exercise for a short period of time to allow the body to heal.  Exercise should not be worked into pain as this will delay recovery.  Ice may also be prescribed.  Sports taping may also be applied to assist in controlling the movement of the patella.

How long will it take to recover?

 Improvement from PFPS is individual and is dependent on exercise compliance, however most people respond with 3-4 weeks of physiotherapy.

What should I do if I think I have PFPS?

Call  the physio at Back2Balance Physiotherapy to make an appointment on 3352 5311 for an assessment and advice.