Patellofemoral Pain Explained
Patellofemoral Pain Syndrome is a common cause of pain around the knee cap. When the knee bends or straightens, the knee cap normally glides smoothly in a groove on the thigh bone called the Patellofemoral groove’.
However, for a number of reasons the knee cap may stray from this path, usually towards the outside of the knee. This is called ‘Patellofemoral Maltracking’ and produces abnormal stresses on the under-surface of the patella that can cause knee cap pain.
If allowed to progress, these stresses can cause damage to the cartilage between the knee cap and Femur.
Most Common Causes
- Tightness in the lower limbs – calf, hamstring , quadriceps muscles
- Weakness or lack of co-ordination in muscles that should help maintain normal patella tracking.
- Altered hip, knee or foot posture.
- Anatomical variations in our makeup such as a shallow Patellofemoral groove.
Sign & Symptoms
Patellofemoral maltracking is one of the most common causes of knee pain and can be caused by numerous factors.
The most common symptom of Patellofemoral mal-tracking is pain at the front of the knee that occurs when running up, or most commonly, running down hill.
Pain can also result from prolonged sitting i.e. driving long distances.
Treatmenting Patellofemoral Pain
Ice & Pain relief prescribed by your GP can often be the first step to take.
General stretches to reduce tightness which may be pulling on your kneecap or causing patella mal-alignment will need to be prescribed.
Targeted muscles generally include
- ITB – Iliotibial Band
3. Strengthen & Improve Coordination
Greater emphasis will need to be placed on exercises to strengthen and improve the coordination of the Vastus Medialis Oblique (VMO) muscle.
The VMO forms part of the Quadriceps muscle group and is located just above the knee cap, on the inner aspect of the thigh.
It is believed to help maintain the knee cap in its correct position in the Patellofemoral groove.
Strengthening of the Quadriceps muscle group as a whole, working on the gluteal muscles as well as foot posture will also be of priority.
Methods of improving muscle function with a physiotherapist may involve:
- Effective and functional exercises – Closed Chain Exercises (where the sole of the foot is in contact with a flat surface)
- Sports Taping techniques
- Advice on footwear
During the enforced rest from running activities many people find that they are able to do pool running and exercises as a means of maintaining fitness, but it is important that these exercises are pain free.