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Physiotherapy for Patellofemoral Pain Syndrome


Runner's knees during a race

Patellofemoral pain syndrome (PFPS) is considered to be one of the most common forms of knee pain. It is described as pain in front of or around the patella (kneecap) and is often referred to as “runner’s knee”. This pain often gets worse with running and activities that require bending at the knee, such as going up and down stairs, squatting or even sitting. Relative weakness in the quadriceps muscle is the most notable risk factor for PFPS. It is twice as likely to occur in women, can present in adolescents or adults and in both sedentary and active populations. Within the last year, 1 in 14 adolescents and 1 in 5 people in the general population have experienced PFPS.


What causes Patellofemoral Pain Syndrome?

It is commonly considered to be an overuse injury, or an injury that occurs with a sharp increase in training load for the knee. It is often seen with an increase of compression at the patella, or when the patella isn’t tracking properly. Compression at the patella can occur from an increase of tension from the quadriceps muscles, or from a displacement of tissue called Hoffma’s fat pad that sits underneath the patella and is responsible for cushioning and providing shock absorption.

Drawing of various forces acting on the patella and considered during physiotherapy for knee pain
(Redrawn from Neumann DA: Kinesiology of the musculoskeletal system—foundations for physical rehabilitation, St Louis, 2002, Mosby, p. 463.)

Maltracking can happen when the forces that pull the patella laterally or medially exceed the pull of their counterparts. Most frequently, the lateral forces out-pull the medial forces, making it difficult for the patella to track smoothly over its pathway on the femur called the trochlear groove.






Physiotherapy in Edmonton for Patellofemoral Pain Syndrome

Physiotherapists can assess the knee and help determine which tissues may need to be addressed to decrease the pain at the knee. The assessment should also include looking at the ankle, hip and back to address any contributing factors along the kinetic chain. The treatment options might include education around load management, stretching, strengthening, taping, soft tissue mobilization or dry needling. These techniques can reduce the pain at the knee, allow those with PFPS to return to activity more quickly and help reduce the likelihood of re-injury.


Our team is here to help. Get started today with some physiotherapy in Edmonton if you have been struggling with knee pain.

References:

  1. Lankhorst N.E., Bierma-Zeinstra S., Middelkoop M., (2012) Risk Factors for Patellofemoral Pain Syndrome: A systematic review. Journal of Orthopaedic & Sports Physical Therapy. 42(2). Pp. 81-94

  2. Smith B.E., Selfe J., Thacker D., Hendrick P., Bateman M. (2018) Incidence and prevalence of PFP: a systematic review and meta- analysis. PLoS One. 13(1).

  3. Powers C.M., Witvrouw E., Davis I.S., Crossley KM (2017) Evidence based framework for a pathomechanical model of patellofemoral pain. British Journal of Sports Medicine. 51(24). pp. 1713-1723

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