Knee Pain (patellofemoral pain syndrome)

We are a Galway City physiotherapy and sports injury clinic that specialises in treating knee pain. Patellofemoral Pain Syndrome (PFPS) is an umbrella term used for pain arising from the patellofemoral joint itself, or adjacent soft tissues. Historically, PFPS has been referred to as anterior knee pain but this is misleading as the pain can be felt in all aspects of the knee.

PFPS can be due to a patellar trauma, but it is more often a combination of several factors (multifactorial causes): overuse and overload of the patellofemoral joint, anatomical or biomechanical abnormalities, muscular weakness, imbalance or dysfunction. It is more likely that PFPS is worsened and resistive to treatment because of several of these factors.

Causes

One of the main causes of PFPS is the patellar orientation and alignment. When the patella has a different orientation, it may glide more to one side of the facies patellaris (femur) and thus can cause overuse/overload (overpressure) on that part of the femur. This can result in pain, discomfort or irritation.
Sometimes the pain and discomfort is localized in the knee, but the source of the problem is somewhere else. Pes planus of the feet (pronation) or pes cavus of the feet (supination) can provoke PFPS. Foot pronation (which is more common with PFPS) causes a compensatory internal rotation of the tibia or femur that upsets the patellofemoral mechanism. Foot supination provides less cushioning for the leg when it strikes the ground so more stress is placed on the patellofemoral mechanism. The hip and strength of the gluteal muscles can also influence the knee and provoke PFPS.

Symptoms

Patient’s usually present with the complaint of anterior knee pain that is aggravated by activities that increase patellofemoral compressive forces such as: ascending/descending stairs, sitting with knees bent, kneeling, and squatting.

Treatment

Common interventions for the treatment of PFPS are listed below:

  • Manual Therapy
  • Open vs. Closed Chain Exercises
  • Quadriceps strengthening
  • Patellar Taping
  • Orthotics
  • Proximal Muscle strengthening
  • Modalities
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Knee Pain (patellofemoral pain syndrome)

Knee Pain (patellofemoral pain syndrome) FAQs

What is Patellofemoral Pain Syndrome (PFPS)?
Patellofemoral Pain Syndrome (PFPS), also known as runner’s knee, is a condition that causes pain around or behind the kneecap. It is often the result of overuse, improper knee alignment, or muscle imbalances that affect the way the kneecap moves across the femur during physical activity.

What are the symptoms of Patellofemoral Pain Syndrome?
Symptoms of Patellofemoral Pain Syndrome include dull, aching pain at the front of the knee, particularly when running, squatting, climbing stairs, or sitting for long periods. Some patients may also experience a clicking or grinding sensation in the knee joint.

How can West Coast Physio help treat Patellofemoral Pain Syndrome?
At West Coast Physio, treatment for Patellofemoral Pain Syndrome focuses on exercises to strengthen the quadriceps, hamstrings, glutes, and core muscles to improve knee alignment and reduce stress on the kneecap. It also includes stretching tight muscles and manual therapy to relieve pain and restore proper movement patterns.

How long does it take to recover from Patellofemoral Pain Syndrome?
Recovery times for Patellofemoral Pain Syndrome vary depending on the severity of the condition and adherence to your treatment plan. Mild cases may improve within a few weeks, while more chronic or severe cases could take several months. West Coast Physio will work with you to create a personalized treatment plan.

What can I do to prevent Patellofemoral Pain Syndrome?
To prevent Patellofemoral Pain Syndrome, focus on strengthening exercises for the muscles around the knee, including the quadriceps, hamstrings, and glutes. Proper warm-up and stretching before exercise, maintaining good posture, and using appropriate footwear can also help reduce the risk of knee pain. West Coast Physio can help guide you through injury prevention strategies.

Can I still exercise with Patellofemoral Pain Syndrome?
It’s important to modify activities that aggravate the condition. Low-impact exercises such as swimming, cycling, or walking can often be performed without worsening symptoms. At West Coast Physio, we will guide you on which exercises are safe and beneficial during your recovery.

When should I seek help from West Coast Physio for knee pain?
You should consider seeking help from West Coast Physio if you experience persistent knee pain that interferes with daily activities or exercise, or if the pain worsens with activity. Early intervention can help manage Patellofemoral Pain Syndrome and prevent the condition from becoming chronic.

Is Patellofemoral Pain Syndrome the same as runner’s knee?
Yes, Patellofemoral Pain Syndrome is often referred to as runner’s knee because it is a common condition in runners and athletes. However, it can affect anyone who places repetitive stress on the knee joint, including cyclists, jumpers, and even those with sedentary lifestyles.

PFPS is one of the most common injuries we see in runners and other endurance athletes here at West Coast Physio. We often advise people on correct running techniques and strength training that will result in reduced pain and improved function. Give us a call and we would be happy to assist.

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