Item added to basket

product name

Basket total £ 0.00
  • product added £ 0.00
checkout

Exercises for Knee Pain caused by Patello-Femoral Syndrome

Miranda, in London, England asks:

"I get knee pain when I attempt to exercise and my physio says it is Patello-Femoral syndrome. She has tried taping it, but I still get pain. Are there any exercises that will take my pain away?"

Marc R. Bernier, MPT CSCS responds:

"Patello-Femoral Stress Syndrome (PFSS) is a generic term that is often used to describe generalized knee pain that centers around the kneecap (patella). The pain that is associated with this condition is thought to be the result of either abnormal tracking (movement) of the patella during flexion/extension of the knee, or excessive stress being placed on the patello-femoral joint during functional activities. Over the years, many theories have been proposed as the primary cause of this condition:

  1. Quadriceps / Vastus Medialis Oblique (VMO) muscle weakness
  2. Muscular tightness
  3. Iliotibial band (IT Band) tightness
  4. Hyper-pronation of the foot
  5. Bone structure abnormalities

"As a result, treatment methods typically focused on the following:

  1. Strengthening of the quadriceps (more specifically, the VMO)
  2. Stretching of the quadriceps, hamstrings and IT Band
  3. Orthotics to control hyper-pronation
  4. Patellar taping to correct abnormal tracking of the patella

"Unfortunately, despite our best efforts, the above treatments seemed successful only 50-60% of the time.

"The latest research into this condition has led to an increased focus on the proximal (anatomy closer to the trunk) influences on the patello-femoral joint, mainly the role of the Gluteus Medius muscle of the hip. This muscle is located at the top of the buttocks and can usually be palpated just above the back hip pocket. This muscle is responsible for both abducting (raising out to the side) and externally rotating the leg. However, it's more important function is its role when the leg is in a weight-bearing position. During running, cutting and planting maneuvers it prevents the thigh from 'buckling' and rotating inwards, which is the 'position of danger' for knee injuries (especially Anterior Cruciate Ligament injuries). It is also a position that causes significant stress to the patello-femoral joint, as the Patella will have a tendency to be pulled laterally (towards the outer side), causing stress to the Patello-Femoral joint and soft tissue that surrounds it.

"Several studies have shown that weakness of this muscle may be a primary cause of PFSS, especially in females. A study performed on long distance runners with Ilio-Tibial Band syndrome revealed a 90% success rate by implementing a Gluteus Medius strengthening program alone. I have also seen a very high correlation between hip weakness and PFSS incidence in females, and implementation of a hip strengthening program has resulted in a drastic increase my success rate in resolving this condition.

"The program I implement with my patients (especially the female athletes) is a two phase program, and is based on the premise that the hip will control the position of the knee. The first phase focuses solely on Gluteus Medius strengthening. Strengthening of this aspect of 'the core' will better enable the patient to control the lower extremity and keep the knee out of the 'position of danger'. Once this baseline strength has been established (2-3 weeks minimum), the second phase of Quadriceps/Hamstrings/Gastrocnemius strengthening can be initiated. It must be emphasized that implementing a general lower extremity strengthening program before resolution of the hip weakness will result in continued knee pain."

Side Lying Abduction

Photo of lying on side raising a leg upwards

 

Side Lying 'Clamshells'

Photo of lying on side, legs together and bent at the knee

Photo of pulling the knees apart

Prone Hip External Rotation

Photo of lying on front with physio holding leg      Photo of lying on front with physio pulling leg towards him

Single Leg Bridging

Photo of lying on back, with body pushed up by shoulders and one leg

'Donkey Kicks'

Photo of leaning forwards on a table top with one leg exteneded straight back

Standing Abduction with Surgical Tubing

Phot of standing with leg attched to surgical tubing, fixed at other end      Photo of pulling the leg out sideways, strecthing the tubing

 



Article published: 23rd May 2005
Femoral Maltracking >


Donjoy Tru-Pull Lite Knee Brace - Orthotic Supprt for Treatment & Rehab of Patella Injuries - Arthritis

£71.99 inc VAT


More Details

Delivered in 2-3 days

Quantity

PhysioRoom Instant Ice Pack - Mouldable Pouch for Pain Relief of Sports Injuries - Single Use

From £0.99 inc VAT     1+ £1.99 each
    6+ £1.79 each (Save 10%)
  12+ £1.49 each (Save 25%)
  30+ £1.19 each (Save 40%)
  60+ £0.99 each (Save 50%)


More Details

PhysioRoom Instant Ice Pack - Mouldable Pouch for Pain Relief of Sports Injuries - Single Use has a rating of 5.0 stars from 22 reviews (22 reviews)

Quantity

PhysioRoom Resistance Exercise Bands

£4.49 inc VAT


More Details

PhysioRoom Resistance Exercise Bands has a rating of 5.0 stars from 11 reviews (11 reviews)

Quantity

PhysioRoom Resistance Band Exercise Loop

£3.10 inc VAT


More Details

PhysioRoom Resistance Band Exercise Loop has a rating of 5.0 stars from 28 reviews (28 reviews)

Quantity

PhysioRoom 5.5m x 15cm Resistance Band Box - Choose between 5 Levels Of Resistance

£6.98 inc VAT


More Details

PhysioRoom 5.5m x 15cm Resistance Band Box - Choose between 5 Levels Of Resistance has a rating of 5.0 stars from 25 reviews (25 reviews)

Quantity

Related Articles

Injury A to Z: Patella