Patellofemoral pain syndrome (PFPS) or Anterior knee pain is a common complaint for runners. Who hasn’t felt their knee giving them grief running up or downstairs or hills? Or maybe you have trouble kneeling? Either way it’s likely you’ve suffered or still are.
The patellofemoral joint comprises of the patella and the trochlear groove of the femur. The patella is a large sesamoid bone inside the quadriceps tendon. The patella increases the moment arm for the extensor muscles (quadriceps) of the thigh and provides protection to the knee joint surfaces. Increasing activities that load the patellofemoral joint (PFJ) is an important factor that causes pain, it can be frequency, magnitude and/or intensity that leads to tissue overload. Loading the PFJ and surrounding tissue faster than the body can adapt the body will move into a zone of supraphysiologic overload and eventual pain.
Other factors to consider with PFPS are anthropometrics, biomechanics, hip and quadriceps muscle strength and pain sensation.
Common complaints: Insidious onset – no acute injury or mechanism Often develops gradually Poorly defined pain at the front of the knee
Pain with bent knee activities (squat, prolonged sitting, stairs, jumping, running)
PFJP management is multifactorial:
1. Taping can be a highly effective way to reduce pain and assist with the ability to complete exercises and even continue running if not too acutely sore.
2. Education providing reassurance and load management advice will be a major part of treatment
3. Hip and quadriceps strength and mobility exercises.
4. Gluteal strength and stability exercises
5. Finally running retraining can be helpful with an increase in cadence a simple way to reduce PFJ loading.