Knee Pain / Patellofemoral pain syndrome by David Webby

 

What is it?

 

Patellofemoral pain is a medical term used to describe pain either on or around the knee cap (patella), or the knee joint. It often occurs with running or other vigorous activities, and may become stiff and painful with climbing stairs, squatting or kneeling.

 

This may occur with runners, predominantly females more than males, who may have aggravated the knee due to excessive loading or malalignment of the patella.

It can occur with anyone, where there is excessive stress on the patellofemoral joint, particularly if they are very active at sports, or have a sudden change in activities.

It can also occur in children due growth plate inflammation, or alignment issues. 

​

Causes:

​

Patellofemoral pain can occur from malalignment of the patella in the trochlear groove of the Femur bone, as it tracks back and forth with flexion of the knee. 

Inflammation of the Bursas within the joint, or irritation to the synovial membrane that lines the groove, can result in degeneration of the cartilage over time.

 

Malalignment of the patella can be due to poor muscle strength of the Quadriceps muscles, namely Vastus Medialis, which can allow the patella to move out of the groove, thus irritating the soft tissues and cause inflammation.

 

Excessive foot pronation can also cause malalignment tracking of the patella.

Sudden change or increase in certain activities can also irritate the soft tissues.

Hip and Gluteus muscles are also important in controlling knee alignment function.

 

How can we help?

 

Initial treatment with Ice, and Anti-inflammatories, may help in the short term to reduce the inflammation of the knee.

 

It is important to get a thorough history recording of your symptoms, followed by a professional assessment of your biomechanics and gait to ascertain the underlying issues of your pain.

Assessment of footwear is also very important.

 

Malalignment of patella tracking can be reduced with the correct subscription of Orthotic devices to reduce the contributing forces. 

Loading of forces at the knee may be due to excessive foot pronation.

 

Orthotics and supportive shoes may make a huge difference but it is also important to include a balance, stretching and muscle strengthening program.

 

Change or reduction in activities to reduce forces at the knee may also be required. 

Reducing your length of stride to 180 to 200 strides per minute can help reduce the rearfoot inversion moment. 

Changing from a heel strike to forefoot strike for runners has also proved successful in treatment, and reducing forces at the knee.

 

For a professional assessment and treatment, please us or book an appointment online with one of our Podiatrists.