HOW CAN I DETERMINE WHETHER I AM EXPERIENCING PATELLOFEMORAL PAIN?

The patellofemoral joint, is the joint between the knee cap (patella) and thigh bone (femur). Patellofemoral pain syndrome, commonly referred to as runner’s knee or movie goer’s knee, is a prevalent musculoskeletal condition characterised by pain around or behind the patella. This condition can affect people of all ages and activity levels, from athletes to those people who are less active. Patellofemoral pain syndrome can significantly impact daily activities and exercise routines, making it essential to recognise its signs and symptoms for early diagnosis and management. In this comprehensive guide, we will delve into the various aspects of patellofemoral pain syndrome, including its causes, symptoms, diagnosis, treatment options, and preventive measures.

Understanding Patellofemoral Pain Syndrome

Patellofemoral pain syndrome occurs when the patella does not track properly within the femoral groove during knee movement, leading to increased pressure and irritation of the surrounding structures. This misalignment can result from a combination of factors, including biomechanical issues, muscular imbalances, overuse, trauma, or structural abnormalities of the knee joint.

Patellofemoral Pain Syndrome Symptoms

Location of Pain: One of the hallmark symptoms of patellofemoral pain syndrome is anterior (towards the front) knee pain, which is typically localised around or behind the patella. People may experience a dull, aching sensation.
Pain Aggravated by Activities: Patellofemoral pain syndrome is often exacerbated by specific movements or activities that place increased stress on the knee joint. Activities such as running (runner’s knee), jumping, squatting, climbing stairs or prolonged sitting with knees bent (movie goer’s knee) can bring on pain.
Swelling and Tenderness: In some cases, individuals with patellofemoral pain syndrome may experience swelling and tenderness around the knee joint, particularly around the patella. The area may feel tender to the touch, and swelling may be more pronounced after engaging in physical activities or prolonged periods of knee flexion (bending).
Gradual Onset: Unlike acute injuries, patellofemoral pain syndrome typically develops gradually over time rather than suddenly. Some people may initially experience mild discomfort or occasional episodes of knee pain during certain activities, which progressively worsen with continued movement or exercise.

Diagnosis of Patellofemoral Pain Syndrome

Diagnosing patellofemoral pain syndrome involves a comprehensive evaluation of your medical history and a physical examination. During the physical examination, your Physio will assess your range of motion, muscle strength, joint stability, and perform specific tests to determine which movements reproduce your usual knee symptoms.

Imaging studies such as X-rays, magnetic resonance imaging (MRI), or ultrasound are rarely required but may be ordered to assess the structural integrity of the knee joint and identify any underlying abnormalities to rule out other knee-related conditions if the physical examination is unclear.

Diagnosis of Patellofemoral Pain Syndrome

Treatment Options for Patellofemoral Pain Syndrome

The treatment approach for patellofemoral pain syndrome typically involves a combination of conservative measures aimed at reducing pain and inflammation, correcting biomechanical issues, strengthening the surrounding muscles, and modifying activity levels to avoid overload and aggravating the condition. Some common treatment options include:

Rest and Activity Modification: Resting the affected knee and modifying activities that exacerbate pain can help alleviate symptoms and prevent further irritation of the patellofemoral joint. You may need to temporarily reduce or modify your participation in high-impact activities such as running, jumping, or squatting until symptoms improve.
Physiotherapy: Physio treatment plays a crucial role in the management of patellofemoral pain syndrome by addressing underlying biomechanical issues, improving muscle strength and flexibility, and promoting optimal movement patterns. Your Physio will prescribe specific exercises to target the muscles around the knee, hip, and core, as well as techniques to improve lower limb alignment and stability.
Orthotics and Bracing: Foot orthotic (shoe inserts) or knee braces/taping may be recommended to provide support to the patellofemoral joint and improve alignment of the entire lower limb during physical activity.
Pain Management: Your GP or Pharmacist may recommend over-the-counter anti-inflammatories or pain medication to provide short term pain relief while you get started on your physio rehab.
Biomechanical Correction: Addressing biomechanical issues such as muscle imbalances, tightness, or weakness in the lower extremities may be necessary to improve patellofemoral joint alignment and function. This may involve targeted stretching and strengthening exercises, gait analysis, or specialised training programs to improve movement patterns and muscle coordination.
Surgery: Surgical intervention for patellofemoral pain syndrome is very uncommon and is typically considered as a last resort when conservative treatments have failed to improve symptoms and function. Surgical procedures may include arthroscopic techniques to address cartilage damage, realignment procedures to correct patellar tracking issues, or patellar tendon release to alleviate excessive pressure on the patellofemoral joint.