Patellofemoral Pain Syndrome

Experiencing knee pain underneath the kneecap with running or walking? If so, you may be one of many

Experiencing knee pain underneath the kneecap with running or walking?  Is it exacerbated by going up and down hills and stairs? If so, you may be one of many experiencing Patellofemoral pain syndrome (PFPS).  PFPS is a common knee issue that we see coming through our doors at SoleFit. This is a result of improper kneecap tracking, and can be caused by a variety of factors. To treat this issue, there are several things your pedorthist may suggest including short term and long term options. 

Short term treatments: 

Check your current walking/running footwear. Look for abnormal wear patterns that could be affecting your feet, ankles and knees. Also take a look at your gait (walking and/or running) in the shoes to determine if the support is adequate (either too much or too little) for your specific biomechanical needs.

Recommend training tweaks (if you are a runner), such as immediately reducing the duration of your runs, but increasing the frequency. These strategies can help reduce stress on the knees by not eliciting a pain response, and thus improving recovery time. Over time this will make it much easier to effectively increase training volume. 

Possible knee bracing and/or taping options for the knee in the short term. This can include patella tracking braces/sleeves to guide and stabilize the knee cap while recovering.  Taping around the patella to improve tracking can be another helpful and cost effective option. Custom orthotics or off the shelf arch supports can also potentially help reduce the discomfort involved with PFPS in the short term.

Evaluation of the impacts of daily habit, poor posture, and work ergonomics. Examples of this might be excessive periods of time sitting, hunched body positions, and limited low impact movement during the day.

Suggestions to improve comfortable range of motion in the hips, knees and ankles.  This can be done via daily static stretching, small amounts of yoga, or using a mobility tool like a foam roller, massage stick, or products like Yoga Tune Up balls.

Finally, your pedorthist can also suggest effective warm up and cool down exercises to improve recovery. For most people with patellofemoral syndrome this would focus on  quadriceps/ hip flexors, hamstring and glutes. Also, a dynamic warm up routine is recommended for all avid walkers and runners. SoleFit’s video can be found here.

Long term treatments:

Knock knees (genu valgum), bowed knees (genu varum) and hip drop (Trendelenberg gait) are common causes of PFPS that can be addressed by strength evaluation and exercise over the long term. Patterns of hip dysfunction and/or foot weakness are common root causes of PFPS and should be identified in order to contribute to long term improvement.

Mobility work with a massage therapist or other allied health care practitioner can also be helpful to maintain proper mechanics through the hips, knees and lower leg.  This can really complement at-home exercises and warm ups in order to catch problems before they start.

Evaluation of intensity and volume of training is essential when returning to activity. Start with much less than you’re used to, let pain be your guide, and spread your training over more sessions of less time/intensity. 

Proper guidance and attention to form and technique according to the activity (running, resistance training, sport specifics) with a strength/sport coach, or personal trainer.

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