Understanding Patellofemoral Pain

Patellofemoral pain (PFP), commonly referred to as “runner’s knee,” is a common musculoskeletal condition that causes pain around or behind the kneecap (patella). It typically affects active individuals, including athletes, but can occur in anyone who engages in repetitive knee motion. This condition is often aggravated by activities such as running, squatting, or climbing stairs. To effectively treat and prevent patellofemoral pain, it’s essential to understand its causes, and how it relates to the mechanics of the lower body. Physiotherapy plays a crucial role in rehabilitation, focusing on restoring proper movement patterns, addressing muscle imbalances, and optimizing knee function.

Patellofemoral pain arises when the patella moves improperly within the femoral groove (thigh bone), leading to increased stress on the joint and surrounding soft tissues. This can result in irritation, inflammation, and pain. The primary causes of PFP include poor patella tracking – when the kneecap doesn’t glide well in its boney groove, causing misalignment and pain. Muscle weakness in the ankle, knee and hip muscles can contribute to abnormal movement patterns. The quadriceps (front of the thigh muscle) controls the knee movement, and the hip and glute muscles control the alignment of the lower leg. Repetitive movements such as high impact activities (running, squatting, lunging) can lead to overload of certain structures and result in pain and inflammation. Anatomical variations such as flat feet or pelvic tilts, can disrupt lower body mechanics and contribute to abnormal patellar tracking.

Effective treatment for patellofemoral pain centers around physiotherapy techniques that aim to improve joint function, correct muscle imbalances, and restore normal movement patterns. Some key treatments often include strengthening exercises, targeting the quadriceps (squats, step ups), glute muscles (clamshell, bridge, lateral leg raises) and the abdominals to support proper pelvic alignment. Stretching tight muscles in the lower leg such as the quadriceps, hamstrings, calves and hip flexors can reduce tension that may affect knee mechanics. Patellar taping and bracing may provide temporary relief of pain and help to realign the patellar during knee movement. It is also important to assess gait and posture to identify any mechanical issues such as foot pronation or pelvic tilt. Finally, pain management in the early stages of PFP, such as ice, heat, ultrasound, electrical muscle stimulation or needling techniques, can help manage pain and inflammation.

Patellofemoral pain is a multifaceted condition that requires a comprehensive approach to treatment and prevention. Physiotherapy interventions, including strengthening, stretching, and pain management, are crucial in reducing symptoms and improving knee function. Understanding the role of the lower back, hip, and ankle mechanics in knee function helps address underlying causes and prevent recurrence. With the right treatment and prevention strategies, individuals suffering from PFP can regain full function and return to their daily activities pain-free. The therapists at Bragg Creek Physiotherapy would love to help get you back to the activities you love, with a speedy recovery.

Jennifer Gordon
(BSc.PT, GunnIMS, AFCI)
Physiotherapist – Bragg Creek Physiotherapy
www.braggcreekphysio.com