By Victoria Athey BSc MSc MCSP. Physiotherapist and Sports Massage Therapist at 360Athletic
Knees Crunching? Painful? Stopping you from doing things you love? Or even making simple things like the stairs difficult?
This blog post is for you! It is focused on that extremely deliberating pain at the front of the knee countless individuals, especially gym goers, experience called PFPS.
PFPS – standing for Patellafemoral pain syndrome varies from discomfort during exercise classes/training to so severe people struggle to walk or go up and down the stairs without pain.
But what is it and most importantly what can we do to treat it so you can return to your hobbies and day to day life WITHOUT pain?
What is PFPS?
Pain at the front or sides of the kneecap arising from the joint between the femur (thigh bone) and patella (kneepcap).
Although the underlying cause of PFPS is still unknown, it is clear that irritation may be due to many contributing factors that can vary between individuals. Therefore physio is SUPER important to let us workout the most effective treatment for YOU.
How to Rehab PFPS?
Rehab will obviously vary from individual to individual (as we now understand that different factors affect different people) however some key principles to follow are:
- DE-LOAD – initially we need to focus on a period of de-loading to allow the joint and your pain to settle. This does NOT mean complete rest (fear not gym lovers) but it does mean being sensible about modifying activities that aggrevate your symptoms. We can discuss how to do this in your physiotherapy appointment.
- GRADUAL RE-LOAD – We do not want you to avoid doing things you love or normal activities forever therefore once we have settled your knee back down we want to reload and introduce activities back in. It is ESSENTIAL to take this as a gradual pace otherwise you risk re-injuring and going back to square one. Graded return will also help to prevent the injury from re-occuring in the future so is an important phase to fully understand.
- STRENGTHEN – An exercise program set up to target YOUR muscular imbalances, tightness or weakness can be really help to improve your lower limb biomechanics – this is believed to help prevent PFPS. Common exercises are outlined below.
- MANUAL THERAPY – You will likely need some pain relief during these phases and this is where things such as taping, heat, ice, soft tissue massage and manual therapy in general may be useful adjunctives to your rehabilitation program to help provide some level of pain control.
- PATIENCE – Yes unfortunately, PFPS can be a frustratingly longstanding condition. Therefore developing patience and perseverance are key for successful treatment outcomes! Let us work together to get you back to PAIN-FREE knees.
Exercises to Help PFPS
- Address Hip Abductor Weakness – These are located on the outside of your legs by your hips. Weak hip abductors are a VERY common contributor to all knee pain but especially for PFPS.
- Strengthen The Knee Supportive Muscles – Adductors, hamstrings, quadriceps, calf complex! Yes there are a lot of muscles that actually support the knee often forgotten. Muscular imbalances or weakness around your knee should be targeted to ensure maximal support of the joint and offload over working structures.
- Develop Proprioception And Balance – Often this is targeted by general lower limb exercises, focusing on correct alignment e.g. squat, lunge, single leg exercises
- Use Soft tissue Therapy, Stretching And Trigger Pointing – By addressing the muscles that are tight we can also help to even out imbalances and give short term relief. Common tight muscles include hamstrings, quadriceps, hip flexors, and the calf complex.