Overcoming Patellofemoral Pain Syndrome of the Knee

Patellofemoral pain syndrome (PFPS) refers to pain at the front of the knee, in and around the kneecap (patella). PFPS is one of the most common types of knee pain experienced in the United States, particularly among athletes, active teenagers, older adults, and people who perform physical labor. Patellofemoral pain affects more women than men and accounts for 20% to 25% of all reported knee pain.

Patellofemoral pain syndrome (PFPS) refers to pain at the front of the knee, in and around the kneecap. (The kneecap, or patella, is the triangle-shaped bone at the front of the knee joint.) Pain occurs when friction is created between the undersurface of the kneecap and the thigh bone (femur). The pain also is usually accompanied by tenderness along the edges of the kneecap.

Current research indicates that PFPS is an “overuse syndrome,” which means that it may result from repetitive or excessive use of the knee.  In our office, we see PFPS in our runners, cyclists, Crossfit, and functional fitness enthusiasts.

Some factors that contribute to this type of pain include an abnormality in the way the lower leg lines up with the hip, knee, and foot and improper tracking of the kneecap.

Some movements that can be painful in the presence of  PFPS include running walking, steps, squats, and lunges.  In addition, there may be increased symptoms first thing in the morning or after a prolonged bout of sitting (i.e. when muscles are stiff and inactive).

In our physical therapy office, the first recommendation that we usually make is to take a short break from the aggravating activity. This allows for an environment for the inflammation to settle down and the region to heal. While taking a break usually helps with pain, we know for our patients to get back to the activities that they enjoy, we have to address the root of the issue.

In many cases, PFPS is coupled with poor mobility of the hips and the ankle. This can be combined with weakness of the hip, thigh, and the buttock muscles.  In addition, if there are imbalances at the core and hip muscles, the way an active person moves can be affected which may lead to faulty knee mechanics.  However, the only way to know what is contributing to pain and injury is to perform a complete assessment.

When pain and stiffness is found via the assessment, our approach includes manual mobilization to alleviate pain and improve mobility. Pain improvements can be made very quickly with soft tissue mobilization and/or dry needling of the quadriceps and calf muscles.

If weakness is found, we teach activation exercises to help our clients better engage muscles that are not firing well. Once pain is controlled and muscles engage better, our next step is teaching our patients to develop core and lower body strength with resistance.

When addressed with a through physical therapy assessment and plan of care, PFPS is a condition that can resolve without medications or procedures. However, any sort of repetitive activity with poor mechanics can become a more serious issue.  If you feel like you may be developing PFPS, the physical therapists at Movement Solutions would be glad to provide a through assessment and give you a diagnosis for your condition.  We can begin this process with a free 15-minute phone consultation to talk about how your knee is affecting you and discuss your treatment options.  If you prefer an office visit, we can offer a free Discovery Visit so we can take a look at your injury so we can provide clarity of what you’re dealing with and confidence that we can help.  Whether you decide to have continued care with us or another office, we want to you to get back to you active way of life. Call us at (864)-558-7346 and ask how we can help.

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