New Year, New Knee – Managing Knee Pain

Year after year, getting in to shape is one of the most popular New Year’s resolutions. According to a recent poll published by BUPA, the most common resolution is ‘exercising more’ at 38% of votes. Unfortunately, after only a few weeks, most will be unsuccessful in achieving their goals. The most common mistake made by people is they recognize what they want to accomplish, but do not think about how they are going to achieve it. When these goals are exercise related it’s important to identify a plan that considers exercise selection and programming. One of the most common injuries when getting back into exercise is “Runners Knee” also known as patellofemoral pain syndrome (PFPS).

Patellofemoral pain syndrome is a broad term that describes pain in the front of the knee, around the patella and the kneecap. This pain is usually felt when running, squatting or walking down stairs. It can also be felt after sitting for extended periods of time. These symptoms can sometimes cause weakness or feelings of instability within the knee.
In most cases patellofemoral pain syndrome is caused by physical activities that put repetitive stress on the knee. It commonly occurs when there is a sudden change in activity levels such as increasing duration and intensity or starting a new exercise programme. It can also occur due to muscle imbalances or weaknesses with the muscles around the hip and knee not keeping the kneecap properly aligned. Examples of this include weakness of the inner portion of the quadriceps muscle, known as the VMO, which allows the patella to track too far laterally. A tight iliotibial band can also place excessive lateral force on the patella and can externally rotate the tibia causing misalignment.

If patellofemoral pain syndrome is suspected, a full examination of the knee should be performed. The exam should look at identifying the features that may alter patellofemoral mechanics as well as any recent changes in activity patterns.

Treatment for this condition should be comprehensive and specific to each case. The initial phase of rehabilitation should be aimed at reducing load through the joint. This may mean reducing exercise amount to levels that do not cause pain or stopping exercises such as squats and lunges if identified as causing the initial pain. Ice can also be used to reduce symptoms, but further treatment is necessary to avoid reoccurrence.

Physical rehabilitation programmes which focus on correcting tracking patterns of the patella should form the basis of treatment with several studies showing it to be effective in the long-term management of symptoms. Specific exercises can be prescribed with ongoing progressions to assist in a fast recovery.

If you would like more information about achieving your health and fitness goals or managing knee pain contact Absolute Balance by mail or view our website

Michael Buswell (B.Sc. – Exercise Physiology)
Accredited Exercise Physiologist (AEP) (ESSAM)

Dixit, DiFiori, Burton, Mines (2007, January). Management of patellofemoral pain syndrome. Retrieved from