KNEE PAIN WITH RUNNING?
Do you feel pain in your knee?
Does running or jumping cause pain in your knee?
Can climbing or descending stairs cause pain in your knee?
Is your pain localised to the front of the knee or kneecap?
Does kneeling cause pain in your knee?
You might be suffering from patellofemoral pain syndrome, which is also known as "runner's knee" or "jumper's knee". Patellofemoral pain syndrome (PFPS) is a broad term for pain that is localised at the front of the knee and includes pain in the kneecap. In this blog post, we'll discuss what PFPS is, the symptoms associated with it, and some treatment options including physiotherapy. Keep reading to learn more!
Knee pain can significantly impact on activities of daily livingWHAT IS PATELLOFEMORAL PAIN SYNDROME? Patellofemoral pain syndrome (PFPS) simply put is pain that is located at the front of the knee. The cause of this pain can stem from numerous factors.
- Increasing volume squatting exercises - eg. starting an 8 week fitness challenge
- Sudden increase in running distance
- Repeated stress on the knee going up and down stairs
- Drastic change in frequency of activity - eg. going from no exercise to 5-6 times/week
- A change in footwear or activity surface - eg. running on sand
- Malalignment of the patella (kneecap) on the thigh bone
Normal alignment vs malalignment - the kneecap should line up to the verticalThe kneecap sits on a groove in the femur, or thigh bone. This groove helps the kneecap to move up and down with minimal resistance from adjacent structures. Think of this as a ball that flows downstream on a river. Good alignment means the ball will not hit the adjacent bank and move through minimal resistance. Malalignment happens due to an imbalance of forces and causes the ball to make contact with the bank. The forces that can disrupt patellar alignment are:
- Weak gluteus medius (hip stabiliser) muscles
- Weakness or tension in the thigh, specifically weakness inner quad or tension of the outer thigh
Forces that pull on the kneecap must match for good alignment and trackingWHAT ARE THE SYMPTOMS As mentioned above, the symptoms for PFPS are:
- Pain with repeated bending of the knee - squatting, jogging, stair use
- Pain localised at the front of the knee
- Pain with prolonged sitting or kneeling
- Audible and painful clicking, popping or cracking
- RICE: Rest, ice, compression and elevation can alleviate pain. This is an initial stage management.
- Stop the Aggravating Activity: This is important after resting initially. Cessation of the aggravating activity or activities prevents further pain onset which can lead to injury.
- Activity or Equipment Modification: It might be technique or equipment that needs to be changed. For example, changing squat or running technique, or the footwear being used as it could be too worn and require replacing.
Fixing squat technique can be crucial to managing PFPSHOW CAN PHYSIOPHI HELP MY PATELLOFEMORAL PAIN SYNDROME? The following is a few examples of what we can provide to effectively manage your knee pain.
- Manual therapy can be effective in relieving pain by reducing malalignment of the kneecap
- Massage therapy to rebalance the tension on the kneecap to aid with effective patellar tracking
- Taping can be very effective in correcting patellar malalignment in the initial stages of injury management
- Advice and education to explore the aggravating activities, build strategies and help you to return to achieving your goals while being pain-free
- Exercises to help regain the strength and stability in contributing weaker muscles.
- Espí-López, G. V., Arnal-Gómez, A., Balasch-Bernat, M., &Inglés, M. (2017). Effectiveness of Manual Therapy Combined With Physical Therapy in Treatment of Patellofemoral Pain Syndrome: Systematic Review. J Chiropr Med, 16(2), 139-146. https://doi.org/10.1016/j.jcm.2016.10.003
- Fatimah, I., &Waqqar, S. (2021). Effects of tibiofemoral mobilization in patients of Patellofemoral pain syndrome. J Pak Med Assoc, 71(11), 2506-2510. https://doi.org/10.47391/JPMA.04-585
- Gaitonde, D. Y., Ericksen, A., & Robbins, R. C. (2019). Patellofemoral Pain Syndrome. Am Fam Physician, 99(2), 88-94.
- Jayaseelan, D. J., Holshouser, C., & McMurray, M. W. (2020). FUNCTIONAL JOINT MOBILIZATIONS FOR PATELLOFEMORAL PAIN SYNDROME: A CLINICAL SUGGESTION. Int J Sports Phys Ther, 15(4), 643-649.
- Kasitinon, D., Li, W. X., Wang, E. X. S., &Fredericson, M. (2021). Physical Examination and Patellofemoral Pain Syndrome: an Updated Review. Curr Rev Musculoskelet Med. https://doi.org/10.1007/s12178-021-09730-7
- Lantz, J. M., Emerson-Kavchak, A. J., Mischke, J. J., & Courtney, C. A. (2016). TIBIOFEMORAL JOINT MOBILIZATION IN THE SUCCESSFUL MANAGEMENT OF PATELLOFEMORAL PAIN SYNDROME: A CASE REPORT. Int J Sports Phys Ther, 11(3), 450-461.
- Pelletier, A., Sanzo, P., Kivi, D., &Zerpa, C. (2019). The effect of patellar taping on lower extremity running kinematics in individuals with patellofemoral pain syndrome. Physiother Theory Pract, 35(8), 764-772. https://doi.org/10.1080/09593985.2018.1457114