June 26th, 2018

Knee pain is a common problem that our team sees year-round, so we thought we'd fill you in on what could be going on by talking about one of the most common causes of anterior knee pain: Patellofemoral Pain Syndrome (PFPS), though you may know it as Runner's Knee.

What is patellofemoral pain syndrome (PFPS)?
PFPS is a cause of knee pain that affects 25% of people at some point in their lives and is even more common in runners, hence being known as runner’s knee. It describes pain behind the kneecap (patella) because of damage to or irritation of the articular cartilage where the patella meets the thigh bone (femur).

What causes PFPS?
PFPS is considered to be an overuse injury caused by the irregular movement (tracking) and rubbing of the patella over the femur, while the knee is bending and straightening. It is the repetitive bending and straightening of the knees that makes this condition more prevalent in runners. Instead of gliding smoothly through a groove (called the trochlea) at the femur, the poor alignment of the knee means the patella can mistrack and instead rub against the femur itself. This causes irritation at the joint and damage to the underlying cartilage and bone. Other contributing factors include:

• Muscular imbalances within the quadriceps
• Increase in training intensity
• Overloading the knee during squatting/jumping
• Poor foot biomechanics
• Poor alignment of the lower limbs
• Increasing age 
• Female gender (because of the differences in leg alignment, greater tendency for joint laxity, generally weaker hip muscles and hormonal fluctuations) 

What are the symptoms?
Symptoms of PFPS often come on gradually during high-impact activities such as running, squatting and climbing stairs. Pain may continue on walking and in severe cases, may even be felt during rest. Symptoms can include:

• Pain and tenderness behind the kneecap
• Radiating pain around the knee
• Inflammation
• Pain after prolonged sitting

How is it treated?
Initially, treatment will look at reducing the painful symptoms. Following the PRICE principles (protection, rest, ice, compression, elevation) can help reduce pain and swelling. Treatment will then focus on treating the cause and correcting any alignment issues that may cause the pain to recur in the future. This may involve:

• Orthotics to correct foot & leg posture, and any alignment issues
• Footwear assessment to ensure your shoes are helping facilitate recovery
• Strengthening weak muscles to restore good function
• Stretching to ensure a good range of motion through your joints & muscles
• Gait retraining & running technique analysis
• Activity modification

It is important to treat PFPS effectively to avoid any further damage to the knee joint and the articular cartilage. Because articular cartilage works to protect the bone ends and help them glide smoothly against each other, incurring damage to it can cause more pain and issues in the knees.

Our team are experts in this & the numerous other causes of knee pain and will get you back on your feet and back to doing the things you love! Book in as soon as any knee pain or niggles develop.