Download Could you be suffering from patellofemoral pain?

Could you be suffering from
patellofemoral pain?
What Is Patellofemoral
Pain?
Patellofemoral pain is felt
behind and around the
kneecap and is due to
irritation between the
kneecap (patella) and
underlying groove of the
thighbone (femur), often
from overuse of the knee.
The patella slides in the
groove and is held in place
by quadriceps muscles
and tendons attached to
the inside and outside
edges of the patella. The
patella functions to
increase the force of the
quadriceps thigh muscles
to straighten the knee.
Many factors can cause
alignment changes of the
patella in relation to the
femur and this will affect
the smooth gliding of the
patella causing irritation
and possibly damaging the
under surface of the
patella if left untreated.
When Does the Pain
Commonly Occur?
Pain is often felt with
walking, running, on stairs,
squatting and prolonged
sitting (movie goers' knee)
and can be accompanied
by grinding or clicking
noises, a sensation of
weakness, giving way and
swelling.
What Factors May Predispose to this Condition?

Tight muscles and tendons attached to the outside edge of the
patella

Weak or inactive muscles attached to
the inside edge of the patella

Extremes of foot posture i.e. pronation

Mal-alignment of the knee joint

A patella that sits abnormally high or
low

Tight calf, hamstrings, quadriceps or
hip muscles

Poor pelvic stability and knee control
What Type of Treatment Is Involved?

Activity modification to reduce any irritation to the patella. This
may involve avoiding propulsive maneuvers, activities requiring
quick change of direction, running or jumping.

The application of ice for swelling of the knee and pain control.

The application of tape to correct patella alignment and to
provide proprioceptive feedback.

The application of tape to correct foot and
ankle alignment. This may include increased
pronation or supination of the mid foot or
increased inversion or eversion of the
calcaneus.

Manual therapy techniques to release and inhibit overactive
muscles. These muscles are often the lateral quadriceps, hip
flexors (Psoas major), ITB and tensor fascia lata (the muscle
belly of the ITB), the hamstrings and calf (gastrocnemius, soleus, peroneal muscles, tibalis anterior and posterior).

Stretching to increase flexibility of overactive or tight muscles.
Typically Stretches for the hip flexors, quadriceps, hamstring
and calves are given. The stretches will often be held for 30-60
seconds and repeated 3-6 times per day.

Your physiotherapist may show you self-releasing techniques
with a ball or foam roller for the ITB, tensor fascia lata or hip
flexors.

Your physiotherapist will provide you with a home
strengthening program to improve knee and pelvic control. The
home exercises will be designed to
increase the strength and endurance
of the vastus medialis oblique muscle
(VMO), which is the medial quadriceps
muscle and the most important for
knee stability. You may expect to
perform exercises to improve the
strength and endurance of the gluteal
minimus and medius, pelvic floor and
abdominal muscles to help stabilize
the hip and pelvis. Strengthening
exercises for the hamstring and calf
muscles or exercises to improve foot
and ankle stability may be given if this
is a predisposing factor.

The following are examples of exercises that may form part of
your home exercises program: Squats, wall squats, lunges,
calf raises, bridging, abdominal curls, one leg stance practice,
one leg squat, squat on wobble board, balance exercises on
wobble board and return to sport drills.

Remember that physiotherapy management is also dependent
on your primary goals.
Lively Physiotherapy &
Pilates Studio
Ground Floor
1394 Pacific Highway
Turramurra NSW 2074
(02) 8065 0715
www.livelyphysio.com.au
How long can I expect to need treatment?
Treatment can last from weeks to months depending on the
severity and will involve correcting the predisposing factors.
If you would like further information or would like to make a
physiotherapy appointment please call Lively on (02) 8065 0715.