What is patellofemoral pain syndrome (PFPS)?
Patellofemoral pain syndrome (PFPS) describes pain originating from the joint and surrounding tissues between the kneecap (patella) and thigh bone (femur). The pain is usually felt at the front of the knee and typically underneath the knee cap. It is also known as anterior knee pain, chondromalacia patellae, and movie-goers knee.
What causes patellofemoral pain syndrome?
Patellofemoral pain syndrome usually results from overuse of the knee. When the knee bends and straightens, the kneecap (patella) glides up and down within a groove on the end of the thighbone (femoral trochlea). Increased load on the patellofemoral joint causes patellofemoral pain. These increase in load can be caused by many different factors both extrinsic (external to your body) and intrinsic (inside your body).
- Flat feet
- Inward rotation of the thigh bone (femur) or shin bone (tibia). This can be due to weakness of specific muscles or may be structural due to the bone position.
- Tight soft tissues around the knee cap pulling it outwards
- Poor quadriceps (front thigh muscles) control either due to an imbalance in the firing of the inner quadriceps muscles (vastus medialis oblique) compared with the outer (vastus lateralis), an imbalance in the strength between the muscles or an overall weakness of the quadriceps muscles
- Poor flexibility of muscles in particular the calf and hamstring muscles
- Change of footwear
- Change of surface training on
- Increased training
- Increased walking or running speed
- Increased prolonged kneeling
- Increased body weight
- Increased training with weights loading the knee e.g. squats
What are the symptoms of patellofemoral pain syndrome?
- Pain – behind and around the kneecap typically felt with prolonged sitting with a bent knee, going downstairs or downhill, and walking and running.
- Crepitation (grinding noise)
- A feeling of giving way
Diagnosis of patellofemoral pain syndrome
A thorough subjective assessment with specific directed questions and obtaining the full history will then guide the therapists objective assessment to ascertain the exact cause of your pain. Since there are many different factors that can cause patellofemoral pain a thorough assessment by an experienced therapist is essential . The assessment is likely to include looking at your foot position when standing, walking and looking at such things as squats and lunges. Followed by assessment of your range of motion, strength, flexibility and palpation together with tailored special tests.
Here at AMS we pride ourselves in carrying out thorough, appropriate assessments to rule out other causes of pain in this region and your therapist will carry out specific tests to differentiate where the pain is coming from.
Physiotherapy treatment for patellofemoral pain syndrome
Since there can be many different factors contributing to patellofemoral pain the treatment must be tailored to the individuals needs and an appropriate treatment plan will be determined by your physiotherapist following thorough assessment. This may include advice and education on activity modification, soft tissue mobilisations, taping, bracing, stretching, strengthening of the knee and hip muscles to improve kneecap tracking, acupuncture, ultrasound, sports specific rehabilitation and re-injury prevention.
When to seek help from a physiotherapist
Initially it is vital to stop the aggravating activity to allow the knee a chance to recover. If after resting from the aggravating activity for a few days the pain does not subside or comes back when the activity is started again then you should seek help from a physiotherapist.