Sore knees and Patellofemoral Pain Syndrome – What is it and how to know if you have it.

What is Patellofemoral pain syndrome (PFPS)?

To understand patellofemoral pain syndrome (PFPS), you need to understand what parts of the body are normally the cause of pain. It is important to understand PFPS is an umbrella term to describe pain on the front of the knee. The parts of the body normally causing pain are the joint between the knee cap and the thigh bone, the tendons that attach above and below the knee cap, and the soft tissues under the knee cap that acts as a cushion in movement called ‘the fat pad’.

What causes Patellofemoral pain syndrome?

A knee can become painful in PFPS with 3 main causes:
  1. overuse and overload of the patellofemoral joint,
  2. muscular weakness,
  3. and imbalance or dysfunction within movement.
What are the most commonly used strategies to treat Patellofemoral pain?
The most effective way to treat PFPS is to address the reason for overuse/muscular weakness/imbalance and dysfunction in movement, and these factors overlap significantly. All three factors are normally present to some extent. There is also an aspect of
reducing habits of body positioning and movement that can have an effect on the irritation of knee structures. Learning to understand your knee pain and your own particular case of knee pain can be extremely beneficial for long term results.

What is the best way of treating Patellofemoral pain?

The best way to resolve PFPS long term is often to NOT focus on where it hurts. Rather focussing on the CAUSE of the irritation is what gets the best long- term results. It’s well researched that tPFPS is caused from overuse or ‘too much stress’, so what is causing this increased stress? Well, that can depend on many things. Who you are and what you do can be a huge influence. In some cases, it is related to level of activity, so it might be that you have recently started exercising more or have recently started a workplace activity requiring repetitive movement. For this reason, although some general advice can be helpful, you’ll find any leading practitioner will always recommend a very thorough assessment, of not just your knee, but also the rest of you body and all your lifestyle factors to make sure they are advising an individualised and successful treatment plan for you.

Written by: 
Ryan Michell,
Physiotherapist,
Proactive Health & Movement
https://www.proactivehm.com.au/our-team/ryan-michell/

These factors are normally happening alongside muscular weakness
and imbalance and dysfunction in movement.
The interesting thing is that PFPS often affects one knee more than
the other or only one knee at a time. In these cases, it is very
important to consider your biomechanics or ‘the way that you
move’. People can often use one foot or leg more than the other and
this can lead to increased risk of injury, not just in the knee, but also
in the ankle, leg, foot and hip of the same leg.
Depending on the structural source of pain an individualised
combination of hip, knee, and entire body progressive exercises
over a period of 12 weeks plus are recommended to reduce pain,
increase function and prevent pain returning in the future. There is
also a focus on correcting movement abnormalities and using
symptom management techniques like taping in the acute stages of
rehabilitation.
Depending on your goals, you may want to continue progressing
your strength and conditioning program and include specific training
for sporting activity or running. Alternately, once you have gained
enough condition to get rid of you pain maintaining that level with
the same level of strengthening exercises is recommended.

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