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Patellofemoral Pain Syndrome Injury Guide

What is Patellofemoral Pain Syndrome?

Patellofemoral pain syndrome in basic terms is pain in the joint at the front of your knee, which consists of your knee cap and thigh bone. This is a result of too much stress being placed on these areas of the body. Ascending and descending the stairs, squats, lunges, running, jumping, prolonged sitting and walking on steep terrain, are all aggerating factors for patellofemoral pain syndrome.

This stress causes the knee cap to become misaligned; it should slide against a specific track on the thigh known as the ‘patellofemoral groove’.

Patellofemoral Pain Syndrome

Symptoms of Patellofemoral Pain Syndrome

  • Pain towards the front of the knee when going up and down the stairs
  • Pain towards the front of the knee when running
  • Pain in the knee while resting
  • The knee locking or giving way
  • Pain that feels deep in the knee cap, grinding or clicking
  • There may be a very small amount of swelling

The onset of symptoms are usually gradual and often occurs in people who do a lot of exercise (If your injury was traumatic, please seek medical advice ASAP).

Patellofemoral Pain Syndrome Treatment

As mentioned individual reasons for why a person suffers from patellofemoral pain syndrome varies, so consulting your doctor should you suffer any of the symptoms is advisable.

For the pain a doctor will typically prescribe an analgesic and recommend the administration of cold therapy. Ice packs, for example, can be applied every two hours for around 20 minutes.

Once the pain is under management gentle exercise in the form of stretching the calf muscles, hamstrings, hip flexors, iliotibial band, quadriceps and hip rotators is beneficial.

How to Prevent Patellofemoral Pain Syndrome

There are many different reasons for patellofemoral pain syndrome so individual causes are best assessed by a doctor. A good all round prevention aid however is to wear a knee brace or strap, which can prove less cumbersome for dancers.

Exercises and advice regarding joint loading under the guidance of a physiotherapist. Taping and bracing can be used if required. Exercises should be your key focus and often include: Closed kinetic chain leg strengthening exercises (where your foot stays in contact with the floor or a footplate), specific exercises for strengthening the quadriceps and flexibility exercises for the leg.

Often, runners who run with bent knees and a low cadence (cadence is the number of steps you take per minute) have this problem. A gradual increase in running cadence under the guidance of a physiotherapist may be beneficial in reducing anterior knee pain in runners. There has been some evidence suggesting that a 5-10% increase in running cadence can significantly reduce loading of the patellofemoral joint. Other evidence however, has shown that simple advice and exercise has had a similar effect on anterior knee pain as increasing cadence.

References:

  1. Barton CJ, Crossley KM, Macri EM. Should we consider changing traditional physiotherapy treatment of patellofemoral pain based on recent insights from the literature? Br J Sports Med. 2018.
  2. Barton C, Balachandar V, Lack S, Morrissey D. Patellar taping for patellofemoral pain: a systematic review and meta-analysis to evaluate clinical outcomes and biomechanical mechanisms. Br J Sports Med. 2014;48(6):417-24
  3. Collins NJ, Barton CJ, van Middelkoop M, Callaghan MJ, Rathleff MS, Vicenzino BT, et al. 2018 Consensus statement on exercise therapy and physical interventions (orthoses, taping and manual therapy) to treat patellofemoral pain: recommendations from the 5th International Patellofemoral Pain Research Retreat, Gold Coast, Australia, 2017. Br J Sports Med. 2018
  4. Roper JL, Harding EM, Doerfler D, Dexter JG, Kravitz L, Dufek JS, et al. The effects of gait retraining in runners with patellofemoral pain: A randomized trial. Clin Biomech (Bristol, Avon). 2016;35:14-22