(Patello-Femoral Pain Syndrome)
What is it?
Patellofemoral joint syndrome (PFJS), patellofemoralpain syndrome (PFPS) or Runner’s Knee is a condition describing irritation inand around the knee cap. The knee is a hinge joint, primarily moving in oneplane of direction only. The patella or kneecap is a bone that acts as leveragefor the quadriceps tendon to exert more power. As a result of movement, theknee cap slides comfortably up and down a bony groove when bending andstraightening your knee. However, if something causes the patella to move in adysfunctional way then the kneecap can become irritated, causing pain anddiscomfort.
What arethe symptoms?
Pain is often felt on the inside or behindthe knee, generally during activities that place a sheering force on the kneejoint. These activities include running, going up and down stairs andsquatting. There may be associated crepitus, clicking or grinding as well asthe feeling of instability. The nature of this pain is primarily mechanical, asopposed to inflammatory. Therefore, the pain will get worse with increasedactivity and improve with rest.
What causesit?
There are many different factors that cancause symptoms of Runner’s Knee. The quadriceps is made of four separatemuscles, therefore imbalances between medial versus lateral quadriceps cancause a pulling force on either side of the knee cap when the knee straightens.Other soft tissue structures that are tight, weak or not activating will alsocause the knee cap to not move in the appropriate way.
Other biomechanical factors above or belowthe knee are also significant to identify. For example poor ankle mobility,foot posture and hip control are common examples of deficiencies that maycontribute to Runner’s Knee pain.
How canphysiotherapy help?
Initially, the first step is a thoroughassessment and patient history to confirm what the main issues are and what’scausing them. This will include discussion of past and present problem(s),followed by a biomechanical analysis. This may include assessment of muscleimbalances, posture, running technique, mobility and motor controldeficiencies.
Following the analysis of contributingfactors, your physiotherapist will propose a management plan to assist yourpain and help you reach functional goals. In the short term, your physio willtreat your pain via massage, taping, dry needling and trigger point therapy.Depending on what the main problems are you may work through targeted exerciseswith your physiotherapist during treatment and at home. Over the course of aseries of appointments, your management plan will progress until you haveachieved appropriate physiotherapist and patient goals.
