What is Patellofemoral Pain Syndrome. How do we fix it?

Patellofemoral Pain Syndrome (PFPS) is a common condition characterized by pain around or behind the kneecap, typically aggravated by activities that involve bending the knee, such as running, squatting, or climbing stairs. It is a very common diagnosis, and the good news is this tends to be a diagnosis of exclusion, meaning that they’re aren’t any disrupted ligaments/muscles/meniscus/etc in the knee.. Understanding the underlying factors contributing to PFPS is crucial for effective treatment. One primary cause is improper tracking of the kneecap due to muscular imbalances, weak hip stability, stiff/weak ankles, or poor biomechanics during movement.

Addressing PFPS involves a multifaceted approach tailored to the individual. Firstly, as with all injury recovery, it depends on the person’s function and what their goals. No two people’s rehab should look the same. Secondly, a lot of attention has recently been given about strengthening the quadriceps however what the research shows is although that is important what is equally if not more important is strengthening your hip abductors/known as your glutes. We will target the glutes specially if the symptoms are really aggressive and quad stregthening is too much.  Additionally, strengthening is the only thing. Techniques such as foam rolling and stretching specially tight quadriceps can help reduce pains and improve flexibility. Finally, educating patients on proper body mechanics during daily activities and sports is essential for long-term management and prevention of PFPS recurrence.

In conclusion, Patellofemoral Pain Syndrome can significantly impact one's quality of life, but with the right guidance and treatment, it is manageable. As a physical therapist, my goal is to empower individuals with the knowledge and tools to address PFPS effectively, allowing them to return to their desired activities pain-free. By addressing muscular imbalances, improving biomechanics, and promoting overall joint health not only will you recover from PFPS but may even be stronger and more flexible than you were before.

Run longer/faster and with less pain

If you’re an avid runner, you know that your legs can take a beating. The miles of impact can add up. Although running is a skill we’ve been doing for thousands of years, aspects of our modern lifestyle have made it hard for us to develop the fine stabilizing muscles needed for efficient running. In the realm of running, the focus often falls on the legs—strengthening the calves, quads, and hamstrings. However, one critical muscle often overlooked is the glutes. From a physical therapy standpoint, prioritizing glute strength is paramount for runners seeking to improve performance and prevent injury. The gluteal muscles play a pivotal role in stabilizing the pelvis and controlling hip movements during running. Any weakness in the glutes can lead to biomechanical imbalances down the chain causing compensation to the knees, ankles, and low back. This weakness can contributes to issues such as IT band syndrome, patellofemoral pain syndrome, and even lower back pain.

By incorporating targeted glute strengthening exercises into their training regimen, runners can enhance their hip stability, stride efficiency, and overall running mechanics. If you have more muscles working as a team, this not only reduces the risk of overuse injuries but also lets you run faster and longer. So, whether you're a seasoned marathoner or a novice jogger, don't overlook the importance of glute strength in your training routine.

If you are unsure if you have a glute weakness in your running, it’s best to go see your physical therapist for a running analysis. However if you want to get a head start here are some of my favorite glute strengthening exercises.

https://youtube.com/shorts/08en9Adlz7I?si=5qfKlOGbr99rI2_Q

What is patellofemoral pain syndrome?

Patellofemoral pain syndrome is a fancy word for pain around the kneecap. Although we’re not 100% sure about the mechanisms of pain we do have a few classification categories to help us get effective treatment.

Patellofemoral pain syndrome with mobility deficits: You can be either really stiff around the knee or too mobile in the foot.

Patellofemoral pain syndrome with muscle power deficits: You can have some quad and glute weakness .

Patellofemoral pain syndrome with overuse and overload disorder: You could just be training too hard causing knee pain.

Patellofemoral pain syndrome with movement coordination deficits: You could be doing some movements wrong causing the pain.

Once we can come up with the appropriate classification then we can figure out how to treat it best.