Introduction
Patellofemoral Pain Syndrome (PFPS) is a common condition characterized by pain around or behind the kneecap (patella) that worsens with activities such as squatting, kneeling, or stair climbing. As a physiotherapist, I encounter individuals dealing with PFPS frequently, and I understand the challenges it poses to daily life and physical activity. In this blog, I aim to shed light on the symptoms, causes, and effective treatment strategies for PFPS.
Symptoms
The hallmark symptom of PFPS is pain around or behind the kneecap, which may feel like a dull ache or sometimes a sharp pain. This pain typically worsens with activities that involve loading the knee in a bent position, such as squatting, getting up from a seated position, or sitting for prolonged periods with the knees bent. Other common signs and symptoms include:
- Grinding or popping sensation in the knee joint during movement.
- Swelling of the knee or tenderness around the kneecap.
- Pain during or after activities involving running, jumping or cutting movements
Causes
PFPS often develops due to imbalances or dysfunction in the muscles of the lower body. Some common contributing factors include:
- Weakness or tightness in the muscles of the thighs and hips
- Poor biomechanics, such as excessive inward movement of the knees during activities (known as dynamic knee valgus).
- Overuse or repetitive stress on the knee joint, especially in athletes or individuals engaged in activities that involve running, jumping, or squatting.
- Structural issues such as lower body alignment, bony structure or previous injuries.
Treatment
As a physiotherapist, my approach to treating PFPS involves a comprehensive plan tailored to the individual needs and goals of each patient, as well as the findings of my physical assessment. Here are some key components of the treatment:
- Pain Management: Initially, the focus is on reducing pain and inflammation through activity modification or rest, taping or bracing, and potentially ice or other modalities.
- Manual Therapy: Hands-on techniques including soft tissue release, assisted stretching, Dry Needling and joint mobilization can help improve flexibility of stiff muscles and joints, and restore normal joint biomechanics.
- Strength Training: Strengthening exercises are crucial for addressing muscular imbalances and improving dynamic knee stability. These exercises could address weaknesses at the hip, thigh or lower leg. Exercises may include squats, lunges, hip strengthening and more, with a focus on controlled movement.
- Biomechanical Correction: Analyzing movement patterns and addressing faulty mechanics, such as dynamic knee valgus, through exercises and movement retraining can help alleviate pain from PFPS.
- Activity Modification: Temporarily modifying or avoiding activities that exacerbate symptoms, such as high-impact sports, crouching, stairs, ladders, etc. can facilitate healing and prevent further irritation.
- Gradual Return to Activity: Once symptoms improve, a gradual return to activity is recommended, incorporating progressive loading and functional exercises to build strength and endurance while minimizing the risk of recurrence.
Conclusion
Patellofemoral Pain Syndrome can be a frustrating and painful condition, but with the right treatment approach, resolution of symptoms is possible. As a physiotherapist, my goal is to empower individuals with PFPS to regain function, and return to the activities they love. By addressing muscular imbalances, optimizing biomechanics, and implementing targeted interventions, we can work together to overcome PFPS and promote long-term knee health and well-being.
This blog was written by physiotherapist Kevin Stoll. To book an appointment with Kevin or any of our other skilled therapists, call 250-314-0788 or book online HERE.
