Patellofemoral Pain Syndrome
Patellofemoral Pain Syndrome (PFPS) aka “runners knee” is pain at the front of your knee, around your kneecap (patella). It is more common in the athletic pop that is involved with running and jumping.
Symptoms:
dull, aching pain in front of your knee which is aggravated when you:
walk up or down stairs
sitting with knees bent for prolonged periods
kneeling or squatting
Certain ways to help prevent this type of knee pain are:
strengthening the quadriceps and hip abductors
correcting body alignment during functional activities
warming up properly before strenuous activity
gradual increase in workout intensity
General Management outline for PFPS
(Please note that this is a general recovery time-frame, recovery times differ from patient to patient)
Stage 1 (0-2 weeks)
soft tissue releases aimed at reducing tightness in the area to assist with the knee cap alignment eg. foam rolling
correction of hip/pelvis alignment including leg and foot (+/- orthotics)
education of walking, stairs, squat and lunge alignment/form
prescription of correct application of ice principles as needed
activity modifications to prevent aggravations
knee or foot strapping as per requirement
prescription of exercise based on your individual assessment
Stage 2 (2-4 weeks)
introduction of evidenced based strength training
continue early therapy interventions as needed
Stage 3 (4-8 weeks)
Progression of rehabilitation exercises focusing on correct alignment
Commence core stability and introduce more dynamic control exercises in standing
Final stage (8-12 weeks)
Commence high end dynamic strengthening exercises for full return to sports and work
Common Questions:
Will I need surgery on my knee?
No. True PFPS does not require surgery as there is generally nothing to operate on.
Will I need a scan of my knee?
Not usually. An MRI and/or X-ray may be indicated if you do not respond well to treatment . This will show us if there is an underlying reason which might explain why physiotherapy did not work. If we find another problem with your knee, such as a cartilage tear, then we will discuss your case with a knee surgeon. They will review your treatment and advise if surgery may be helpful.
Will rest help?
To a certain extent, rest will help reduce your symptoms. However, rest will not reverse the underlying causes, eg. weak muscles. Therefore, although rest may reduce symptoms, people find their pain generally returns when they start to exercise again.
Cross training (participating in other forms of sports to maintain your fitness) is useful while you are unable to do your preferred activity. We can help advise you on sports which put less stress through your knees, such as swimming instead of running.
When can I go back to my sport?
Returning to your sport(s) purely depends on how much pain you are in. If you have a lot of pain and are not able to compete in your sport, it may be advisable to rest from your chosen sport during your recovery. If you only have mild discomfort then it can be OK to take park in sport. Participating in sports with pain from PFPS does not mean you are damaging your knees; it just means that doing your sport will be uncomfortable.
Ongoing load management and objective testing are crucial components for athletes who wish to return to sports safely and successfully. Our team will guide you step by step throughout your rehab journey.
If your knee is impacting your return to sports/working out, please don’t hesitate to reach out. Book Now to get yourself back on track!
Resources:
Patellofemoral Pain Syndrome https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4169618/
Patellofemoral Syndrome (American Medical Society for Sports Medicine) https://www.sportsmedtoday.com/patellofemoral-syndrome-va-37.htm
