Patella Femoral Pain Syndrome, sometimes called runners knee, is pain located around the front of the knee, including the cartilage and soft tissues surrounding patella.
Tenderness is often associated with activities such as Running, squatting, kneeling, stair-climbing (especially on descent) and swimming breaststroke. Also it can become “stiff” with driving or sitting down for prolong periods. Often reported to have a grating sensation or giving-way.
These issues are due to the compressive and shearing forces on the underside of the patella. Caused by a variety of muscular issues at the thigh or hip.
Common causes are Tight/inflexible Sartorius (flexor & adductor), rectus femoris (middle quad & hip flexor), biceps femoris (hamstring), vastus lateralis (lateral quad) or iliotibial band (ITB).
These muscular imbalances can cause poor patella tracking, pulling it towards one side causing improper movement with knee flexion & extension, most commonly associated with a poor strength ratio of vastus medialis and vastus lateralis under 1:1
The risk factors associated in increasing your likelihood of developing some form of PFPS are
Female gender
Having history of ITB issues
Poor lower limb posture in standing – Knock kneed, Hyper pronation, excessive internal rotation of hip or tibia.
Physical therapy treatment for PFPS has been shown over many studies to help reduce pain and improve function. Literature is also showing that exercises targeting both the hip and knee to be more beneficial rather than focusing on the distal portion of the leg. An exercise regime includes a strengthening and stretching of the hip has been shown to have a greater benefit than just a lower leg exercise treatment.
While the exact interventions are variable, the general exercise prescription is daily exercises 2-4 sets of 10 repetitions, for >6 weeks. Including exercises such as hip abduction & external rotation and hip extension, knee exercises leg press, squats, calf raises and hamstring curls.
