(Patello-Femoral Pain Syndrome)
What is it?
Patellofemoral joint syndrome (PFJS), patellofemoral pain syndrome (PFPS) or Runnerâ€™s Knee is a condition describing irritation in and around the knee cap. The knee is a hinge joint, primarily moving in one plane of direction only. The patella or kneecap is a bone that acts as leverage for the quadriceps tendon to exert more power. As a result of movement, the knee cap slides comfortably up and down a bony groove when bending and straightening your knee. However, if something causes the patella to move in a dysfunctional way then the kneecap can become irritated, causing pain and discomfort.
What are the symptoms?
Pain is often felt on the inside or behind the knee, generally during activities that place a sheering force on the knee joint. These activities include running, going up and down stairs and squatting. There may be associated crepitus, clicking or grinding as well as the feeling of instability. The nature of this pain is primarily mechanical, as opposed to inflammatory. Therefore, the pain will get worse with increased activity and improve with rest.
What causes it?
There are many different factors that can cause symptoms of Runnerâ€™s Knee. The quadriceps is made of four separate muscles, therefore imbalances between medial versus lateral quadriceps can cause a pulling force on either side of the knee cap when the knee straightens. Other soft tissue structures that are tight, weak or not activating will also cause the knee cap to not move in the appropriate way.
Other biomechanical factors above or below the knee are also significant to identify. For example poor ankle mobility, foot posture and hip control are common examples of deficiencies that may contribute to Runnerâ€™s Knee pain.
How can physiotherapy help?
Initially, the first step is a thorough assessment and patient history to confirm what the main issues are and whatâ€™s causing them. This will include discussion of past and present problem(s), followed by a biomechanical analysis. This may include assessment of muscle imbalances, posture, running technique, mobility and motor control deficiencies.
Following the analysis of contributing factors, your physiotherapist will propose a management plan to assist your pain and help you reach functional goals. In the short term, your physio will treat your pain via massage, taping, dry needling and trigger point therapy. Depending on what the main problems are you may work through targeted exercises with your physiotherapist during treatment and at home. Over the course of a series of appointments, your management plan will progress until you have achieved appropriate physiotherapist and patient goals.