Patellofemoral pain (Sometimes called ‘runners knee’ or ‘PFJ pain’ is one of the most common knee conditions our physiotherapists treat. It can occur in sports people as well as non-athletes. Patellofemoral pain can be very frustrating as it can take a while to settle.
Patellofemoral pain refers to pain around the patella (knee cap). This is usually a dull ache at the front of your knee, and usually has a gradual onset and may worsen over time. It usually causes pain with running, walking up and down stairs, sitting for long periods of time with your knees bent, or squatting. Often the pain occurs during activity as well as following. There may be some creaking or crackling sounds in your knee also.
Whilst there is not one main cause of patellofemoral pain, is has been associated with several factors including;
- overuse injuries; such as running and jumping sports that irritate the patella due to the repetitive motion and forces around the patella and femur
- Surgery; patellofemoral pain is a common result of knee surgery particular ACL repairs in particular when a patella tendon graft is used
- Acute injury such as dislocation or fracture to the patella
- Muscle weakness and imbalances of the muscles around the hip and knee joints
- Biomechanical factors such as foot and ankle positioning (over pronation or supination), alignment/position of the patella
Adolescents and younger adults are most of risk of developing patellofemoral pain, with women more likely than men.
Patellofemoral pain is not caused by an acute accident (such as a fall for example). Therefore if there has been a direct or acute injury to the knee, you may be suffering from a different type of knee injury in which a physiotherapist would be able to diagnose.
Stop the activity that is causing the pain; for sportspeople this means stopping until you see a physiotherapist. You may need a short break from sport and stick to low impact exercises to offload the patella while you work on improving the strength around the knee or any biomechanical issues.
Physiotherapy aims to address the causes of your patellofemoral pain in order to not only relieve pain but also to reduce the risk of the pain returning. A strengthening program will be required in order to address any muscle imbalances of the hips and knees, and will be tailored to your individual needs following assessment. Quadriceps and gluteal strengthening is important. Biomechanical factors such as insoles for shoes may be required. It may also be necessary for manual therapy from your physiotherapist which may include techniques like massage, trigger point release, mobilisation of your patella.
Because patellofemoral pain has many causes, it is important to address all of these in order to prevent the pain recurring. Left untreated, it is unlikely to improve on its own.
Surgical treatment is rarely required, as most people respond very well with conservative management via physiotherapy, as long as they are consistent with the exercise regime provided.
If you are suffering from patellofemoral pain, or have a knee injury our physiotherapists at Seville Health can help.