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Patellofemoral pain syndrome (runner's knee)

Patellofemoral pain syndrome (runner's knee)

This is one of the most common knee injuries that we see and treat in the clinic. Patellofemoral pain syndrome (PFPS) refers to pain felt at the front of the knee (anteriorly) and is a multi-factorial injury that requires a multifaceted treatment approach. This article aims to simplify and explain this condition and it’s physiotherapy management!

Holly McIntosh ·
~3 minute read

What is it?

The patellofemoral joint is located at the front of the knee where the patella (kneecap) meets the end of the thigh bone (femur). The patella is positioned in a groove at the end of the thigh bone, and glides back and forth through this groove as the knee bends and straightens.

Patellofemoral pain arises when this joint becomes overloaded, which can be a result of training and technique errors, or muscle imbalances causing poor tracking of the patellofemoral joint. Common complaints are pain with squatting, lunging or when walking up and down stairs.

We often describe PFPS as a “hurtful” condition rather than a “harmful” condition, as there is usually no tissue injury, but rather pain, discomfort and irritation with activity.

What causes patellofemoral pain syndrome?

Rule number one in preventing PFPS is load management!! Poor load capacity within our muscles, joints and tendons can lead to injury. So it is important to slowly develop this capacity through gradual and progressive increases in training load. In simple terms, don’t do too much too soon!!

Muscle imbalances around the knee and more proximally around the hip and pelvis can also result in knee pain and injuries. In particular, weakness of the quadriceps and gluteal muscles are common on the injured side.

Poor alignment of the hip and knee are risk factors for PFPS, as this can lead to poor tracking of the patellofemoral joint. This can be particularly problematic in runners or those performing sports that involve repetitive single leg landings as this requires a lot of knee stability.

How is it treated?

Addressing load management is usually the first step in physiotherapy management of PFPS. This may involve a short period of load reduction in order to allow the injury to settle. Following this would be a graduated return to sport or exercise. To read more about load management read here!

And of course, you will be given some homework! This will be focussed on strengthening the appropriate muscle groups, particularly the quads and glutes, as well as correcting any faulty movement patterns. Single leg stability exercises are useful in the rehabilitation of PFPS as they help to train correct knee alignment and can be useful in loading the knee joint itself.

If your knee pain is running-related, a running technique assessment can be carried out, and changes can be made in order to reduce knee loading and prevent future injuries, not to mention helping with your running economy!

What we offer

Here at Four, we are skilled in the assessment and treatment of patellofemoral pain, so don’t hesitate to reach out if this is something you have been experiencing! 

Online bookings are available here.