Patellofemoral pain syndrome (PFPS) is a common overuse injury also known as “Runners Knee”. PFPS is caused by an injury to the soft tissues of the knee and can cause discomfort, pain, and inflammation to the patella. The soft tissue injury can be caused by a variety of issues including, biomechanical dysfunction, increases in training load, training errors, and running in incorrect footwear on unsuitable surfaces. In many cases there is an imbalance between two of the muscles in the quadriceps group, the Vastus Medialis Oblique and the Vastus Lateralis. This imbalance causes issues with the tracking of the patella during flexion and extension of the knee.
Symptoms of PFPS may include:
An Accredited Exercise Physiologist prescribed exercise programme has been shown to dramatically improve both pain symptoms and functional limitations. Initially exercises should be isometric (static) and closed kinetic chain (feet are fixed in position) as this minimizes stress on the patellofemoral joint. Strengthening of the quadriceps is key in the rehabilitation of PFPS. The initial stage of the programme should include supine straight leg raises and static quad activation. It has also been shown that training the hip muscles in conjunction with the leg muscles can help improve symptoms of PFPS. Exercises that focus on abduction such as banded clamshells and lateral rotation exercises should also be included. Taping of the patella during exercise helps to maintain correct patella alignment during exercises. Alternative treatments of PFPS include the use of analgesics, bracing and foot orthoses.
To reduce the chances of developing PFPS or recurrence it is important to:
Peter Webster (B.Sc Exercise and Rehabilitation)
Accredited Exercise Physiologist
References:
Jayaseelan, D. J., Holshouser, C., & McMurray, M. W. (2020). FUNCTIONAL JOINT MOBILIZATIONS FOR PATELLOFEMORAL PAIN SYNDROME: A CLINICAL SUGGESTION. International journal of sports physical therapy , 15 (4), 643–649.
Kölle, T., Alt, W. & Wagner, D. Effects of a 12-week home exercise therapy program on pain and neuromuscular activity in patients with patellofemoral pain syndrome. Arch Orthop Trauma Surg 140, 1985–1992 (2020).
Nakagawa, T., Muniz, T., Baldon, M., Dias, C., Menezes, B., Serrão, V.(2008). The Effect of additional strengthening of hip abductor and lateral rotator muscles in patellofemoral pain syndrome: a randomized controlled pilot study