What is it?
Patellofemoral pain (PFP), or more well-known as ‘runner’s knee’, describes knee pain at the front of the knee as well as pain localised around and behind the knee cap and is typically associated with poor knee biomechanics, altered alignment and tracking of the knee cap and muscle dysfunction. The cause of pain in PFP is complex, however, it is thought to be due to additional loading and stress on the joint, and on the bones and cartilage around the knee joint, which may cause the knee cap to have larger contact forces causing irritation and painful symptoms.
Common signs and symptoms
Knee pain associated with PFP is typically felt around the patella (knee cap) and can be felt as if the pain is coming from behind the patella. PFP is usually a condition that has been bothering the knees for a longer time with typically no single event or trauma that precipitated the pain. PFP may resolve at times and then return, and this cycle can persist for years.
Pain can be provoked by activities such as climbing stairs, running, squatting and prolonged sitting. Pain may also come on during your activities and persist afterwards, or only after the activity such as the day after. It is important to be assessed by a health professional as some of these signs and symptoms may also be present in other conditions.
Risk factors of this condition?
There are many factors that can increase the risk of PFP as there are many causes that can contribute to symptomatic PFP. These include:
- Reduced muscle strength of the quadriceps and gluteal muscles
- Mismatch between the medial quadriceps muscles and the lateral quadriceps muscles strength and activation
- Tight muscles and structures such as the hamstrings, iliotibial band and calf
- Patella alignment
- Posture and movement biomechanics during aggravating activities such as during running and jumping
- Overuse or overload of the knee joint
How is it treated?
The main treatment for PFP is an exercise-based programme that can be individualised by your physiotherapist, where the best evidence for treatment is in improving control and increasing the strength and biomechanics of your hip and knee muscles. Muscle tightness which can also contribute to PFP may be considered in addition to an exercise programme, where manual therapy and taping can be used in conjunction for pain management. In some cases where foot posture may contribute to PFP, foot orthotics can be considered as a short-term treatment to reduce pain. As always, treatment is dependent on how you present and some treatments may work whilst others may not.
