Runner’s Knee or Patellofemoral Pain Syndrome (PFPS)
Patellofemoral syndrome is the most common cause of chronic knee pain and is commonly referred to as chondromalacia patella or a knee strain. It usually hurts when running, jumping, rising from a chair and when using stairs. Many times crunching or popping is felt or heard in the knee. Giving way of the knee may occur in severe cases. The pain is commonly in the front or inside of the knee.
Abnormal tracking of the knee cap over the femur causes inflammation, pain and can also cause softening of the cartilage on the underside of the knee cap. The abnormal tracking is usually in an outward direction and is most commonly caused by a weak VMO (the innermost thigh or quadriceps muscle). Problems that increase the chances of PFS are having flat feet and/or “knocked” knees. Recent research shows that deep squats can increase problems in this area.
Specific quadriceps strengthening exercises, proper stretching, taping or bracing can help. Your treatment will be individualized for you based on your knee mechanics. Video gait analysis may be used to determine abnormalities in the way you walk. Treatment may include electrical stimulation and ice to reduce swelling, massage and stretching to improve range of motion, ultrasound to affect the tendons or muscles if they are affected and stabilization exercises to improve the muscles surrounding the knee joint. Surgery is a last resort, but may be needed if traditional treatment does not provide satisfactory results.
Cycling, running or using exercise equipment with improper mechanics or setup can cause or increase PFS. Your therapist may assist with bike fitting, shoe recommendation and altered mechanics to improve pain. Stretching and functional work that may involve your hip or ankle may surprise you in how it affects your knee.
A tight IT band or quadriceps may increase the risk for PFS. It is important to rule out other causes of knee pain as well, such as sciatica, ITB syndrome, plica syndrome, patellar tendonitis (jumper’s knee), meniscus tear and many other issues. Your therapist will use special tests to help understand your pain and treat this as well as other issues found. Your doctor may use imaging or medication to assist your diagnosis and recovery. You may be asked questions such as: What do you call a fish with two knees? You should be prepared with the answer: a two knee fish. Ouch.
Knee pain can be complicated, so a thorough evaluation is a great place to start to determine the cause. Most of the time, pain is improved or resolved with conservative care such as physical therapy.
Top Three Tips to Avoid Knee Pain:
- Wear the right shoes! Ask your therapist about your foot type and recommendations.
- Warm up before heavy exercise and stretch after. Your muscles stretch better once they have warmed up. Ask your therapist which stretches are best for you.
- Avoid deep squatting. Use a lunge instead, or ask your therapist to review proper squatting mechanics.
Call now to schedule your same-day appointment, and begin the road to recovery!
By: Jeremy McVay DPT, CSCS, MSPT, BS
My shoulder feels good . Exercise it as you said . Do your exercises frequently. I may come in for refresher course .