What is Patellofemoral Pain Syndrome?
Anterior Knee Pain
What is it?
Patello-femoral syndrome normally causes pain over the anterior or front aspect of the knee joint.
The pain is most frequently present during growth spurts with females more likely to suffer the pain compared to males. The pain may also begin following an injury such as falling on the front of the knee or twisting on the knee. However, the pain can occur later in life and can be caused by arthritic changes at the patello-femoral joint.
Daily activities that people report are the most limited include walking, climbing up and down stairs or squatting. People with patella related pains tend to also notice more cracking or a grating noise when moving their knee.
Surgery may be required in severe circumstances. However in the majority of cases Physiotherapy is sufficient to reduce the pain.
What causes the pain?
The patella sits within a groove on the femur and its main role is to act as a fulcrum of movement when the quadriceps is contracted. The most important stabilising muscle of the quadriceps is the vastus medialis oblique. Whilst the majority of the bulk of the quadriceps provides the power.
An imbalance between the power and stabilising muscles of the quadriceps can result in the kneecap rubbing over the surface of the groove. With repetition this can then result in pain.
Factors that can contribute to this imbalance include growth spurts, altered foot biomechanics, and weak gluteal strength.
A thorough physiotherapy assessment is able to firstly help with controlling the pain but also identify the factors that are contributing to the pain.
What physiotherapy treatment can I have?
Physiotherapy treatment of this condition can be divided into a few stages.
In the acute or early stage pain relief is the main focus. Ice can be useful to help with both pain relief and any swelling. Non steroidal anti-inflammatories may also help with reducing the pain and swelling.
Taping around the knee joint is useful to reduce the knee pain and can make walking and running pain free. Orthotics can help to correct the biomechanics in the leg and foot.
Deep tissue massage of the tissues around the patella, stretching tight muscles and the use of a foam roller on the muscles of the leg is also helpful with pain control.
With suitable pain control the important muscles around the patella will then respond to strengthening. For severe pain this process may take several months of massage, strengthening, stretching and taping before the pain settles.
In the majority of cases, the pain will respond quickly with taping and massage and over a few months progression of the exercises.
