Knee Pain: PatelloFemoral Pain Syndrome

What is the PatelloFemoral Pain Syndrome?

Patellofemoral pain syndrome (PFPS) is pain in the front of the knee around the kneecap area, usually causes by the tracking of the kneecap. In most cases of PFPS, the kneecap gets pulled outwards, instead of sitting mostly centered in front of the knee. This causes pulling on the inside of the knee. It could also increase pressure on the outside of the knee joint, as the kneecap is convex sitting in the concave grove of the knee.

Symptoms often includes pain with bending/straightening the knee, stair use, running, squatting, jumping, etc.

patellofemoral pain syndrome

Common Causes

  • Weakness/decreased control of hip muscles
  • Muscle imbalance of the outside muscles of the quads (Vastus lateralis) and the inner part of it (vastus medialis).
  • Tightness of the outside part of the quads (vastus lateralis) and ITB
  • Bad “posture” during certain physical activity (Running, sports, weight training, etc.)
  • Decreased control/range of the foot/ankle

I want to emphasize that you should NOT blame arthritis or “thinned cartilage” for your pain without having a physiotherapist assess it. More often than not, it is not the main cause for this kind of pain. You can usually make a big difference and be pain free, despite the XRAY or MRI findings, as it has been shown by research that medical imaging findings do not always correlate with pain and dysfunction.

Treatment

Physiotherapy is quite effective in treating most PFPS. Treatment is conservative and could usually involve the following techniques.

Other Conditions Could be Mistaken for PFPS

  • Knee plica syndrome
  • Referred pain from low back or hip
  • Peripheral nerve impingement
  • Meniscus sprain/tear
  • ACL sprain
  • Pez anserinus bursitis/tendinitis
  • Patellar tendinitis

 

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About the Author:

Lily ZhangLily Zhang is a registered physiotherapist with training specializing in the McKenzie Method.  She graduated from McGill University and is currently working in Barrhaven (Ottawa, ON). She has over 10 years of professional training/clinical experience in orthopedic physiotherapy.  You can Follow Her Blog @PhysioVive Facebook Page.

 

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