The knee is the largest joint in the body and can often be the most troublesome. One of the main problems that people present with is patellofemoral pain syndrome (PFPS). This causes pain and discomfort in the front of the knee, often on the inside of the knee cap. It is usually an overuse injury which starts off with a low grade pain, however without treatment and with continued aggravation it can worsen to severe pain.
Why does it happen?
As you bend and straighten your knee, the knee cap (or patella) naturally moves up and down in a groove in your thigh bone (or femur). Many different muscles attach to your knee cap, causing it to glide up and down. If they aren’t working correctly then your patella knee cap won’t glide in a straight line and can cause friction against your thigh bone (femur). This is called patella mal-tracking or malalignment. This can progress to cause damage to cartilage, ligaments or fatty tissues under the patella, which leads to pain and inflammation.
Symptoms: They vary from person to person and vary due to the severity of your condition.
Often pain occurs with going up and down stairs, prolonged sitting and running. However, it can progress to the point that the pain can be constant, even with lying down!
What causes patella mal-tracking?
• Weak inner thigh muscles; There is a tendency to favour using the outside of your legs with squatting and other daily activities. This causes a buildup of musculature on the outside of your quads and a weakness on the inside of your quads. The tightness on the outside of the leg pulls the patella outwards.
• Tight muscles; In particular tightness on the outside of the quads, calves and certain muscles around the hip.
• Poor hip control: due to decreased hip strength and core strength. In standing, walking and running this puts an increased pressure on the inside of your knee.
• Stiff ankles and hips
How Physiotherapy can help you:
As PFPS occurs due to overuse, rest from any aggravating activity is crucial to aid recovery. This gives the knee joint a chance to heal as aggravation is stopped. However, for anyone who is keen to remain active, we try to identify a form of exercising/activity modification that you can be doing without causing you pain. Ice and anti-inflammatories are also recommended to reduce any swelling and pain.
Here at IFC we are conscious that you want to get back to whatever activity it is that you enjoy. Therefore, our aim is to identify what exactly cause of your pain is. This will lead to a treatment and rehab programme tailored for you and your condition, aiming for you to return to your activity as soon as possible. PFPS rehab usually contains:
• Home strengthening regime for muscles at the hip, knee and ankle.
• Balance and motor control exercises
• Running technique correction and movement re-education
• Clinical Pilates
Also with identifying the cause we also provide pain relief in order to decrease your symptoms on a day to day basis. We do this through:
• Soft tissue massage: for the tight muscles around the knee joint
• Patella mobilisation: to promote correct alignment
• Dry needling
• Taping techniques