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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 order to overcome PFPS, the first common-sense recommendation 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.  If pain persists receiving, receiving hands-on therapy in the form of soft-tissue work or joint mobilization can be effective for pain relief.  Once your pain subsides, you know then address the root causes of patellofemoral knee syndrome.

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 buttock muscles.  In addition, if you have imbalances at the core and hip muscles, you may compensate in the way you walk, squat, lunge, run or perform other athletic movements.  The best way to know what is contributing to your knee pain is to have a movement analysis performed.

If you have weakness, learning activation exercises to engage muscles that are not firing well is key.  Exercises that can be effective during this phase include quad sets, bridges with a foam roller, and calf raises.  Once your muscles engage better, the next step is to restore movement.  The basic function of the knee is the bend and straighten.  In addition, normal movement requires being able to bend and straighten at the hip, knee, and ankle, and foot at the same time (e.g. squats and lunges).  Being able to move at these joints and through these patterns is necessary for a healthy knee.

Once, you have a good base of movement, the next step is to develop core and lower body strength with resistance.  Exercises like kettlebell front squats, kettlebell deadlifts or swings, and lunges or split squats are effective strength exercises.  If you can generate tension in the right places and maintain good technique, practicing movements like these will keep your knees healthy for a long time.

Most of these exercises can be found in our Exercise Library.

When addressed through a specialized physical therapy treatment plan, you can overcome patellofemoral knee syndrome. However, ignoring pain and engaging in repetitive activity can result in a further decline of your knee health.  If you’re worried about your knee pain, the physical therapists at Movement Solutions would be glad to help you.

We invite you to request a knee consultation with one of our specialists.  This is an opportunity to ask questions, obtain clarity about your knee pain, and foster confidence that we can help you.  If working together seems to be a good fit, we can discuss the next step.

If you’re in knee pain but unsure about what you should do, call us at (864) 558-7346 and ask how we can help.

Physical Therapist Dr. Tim Varghese

Dr. Tim Varghese

Movement Solutions

"We Help Active Adults, Ages 40-60+ Overcome Pain And Injuries And Get Back To Their Favorite Activities Without Unnecessary Medications, Injections, Or Surgeries."