Posted on June 12th, 2013
One of the most common forms of anterior knee pain that we see at PhysioCare is ‘patellofemoral pain’. Patellofemoral pain arises from the joint between the knee cap and the thigh bone. It is usually felt around/under the knee cap, but can cause pain anywhere around the knee – even behind the knee. The pain is usually aggravated by squatting and going down stairs/hills.
Patellofemoral pain is caused by an imbalance of the muscles around the knee. The muscles and ligaments on the outside of the thigh become tight and those on the inside of the knee become too weak, resulting in the knee cap being pulled out sideways as the knee bends & straightens. This maltracking of the patella can cause irritation and inflammation of different structures inside and around the knee.
Patellofemoral pain usually comes on gradually following an increase in exercise/activity, particularly involving running, stairs or hill climbing. There are many biomechanical factors that may contribute to the development of patellofemoral pain. For example, having flat feet can lead to patella maltracking, so often orthotics are beneficial. Weakness of the buttock muscles can also effect the alignment of the knee and thus contribute to patellofemoral pain. Training errors, shoe type and running surfaces all play a part too.
Treatment of patellofemoral pain depends on the individual factors which have contributed to it. Firstly, reduction of pain and inflammation is addressed with ice, rest, ultrasound, anti-inflammatories, manual therapy and therapeutic taping. Then we need to address the muscle imbalance and biomechanical faults that have lead to the development of the problem. This may include massage, orthotics, stretches and strengthening exercises.