01 Apr Do Your Knees Hurt After Watching A Movie?
Do Your Knees hurt when you stand after sitting for an extended period? Do Your Knees crack & crunch when you squat down? Do you get pain climbing up or down stairs? Are you getting pain under your knee cap?
If any of these symptoms sound familiar, there is a good chance you are suffering from patellofemoral dysfunction.
Patellofemoral pain is a common musculo – skeletal complaint, and is one of the most common causes of knee pain in all age groups, including teens and young adults.
If left untreated, symptoms often get progressively worse. Early diagnosis and treatment may result in a quicker recovery, and less pain.
What is Patellofemoral Pain Syndrome?
Patellofemoral pain syndrome (PFPS) also known as “Runners Knee” or “Moviegoers Knee” refers to pain arising from the joint between the patella (kneecap) and the underlying femur (thigh bone) which comes on gradually with symptoms increasing over a period of time.
This anterior knee pain occurs when the patella does not move or track correctly during knee flexion and extension resulting in inflammation; it is common in people who do a lot of sport, in particular adolescent girls.
The problem can occur at any age, but is most commonly seen in young women (especially around the age of 14), and post knee surgery or injury.
If left untreated the mal- tracking can lead to degenerative damage to the cartilage on the underside of the patella (articular cartilage) resulting in chondromalacia patella.
What causes Patella Mal– Tracking?
Muscle imbalances/weakness or inflexibility in the muscles that support the knee, and mechanical errors can cause poor knee tracking:
- Tightness of the lateral (outer) structures – vastus lateralis (VL), TFL, iliotibial band (ITB) and lateral retinaculum
- Weakness of the Vastus Medialis Oblique (VMO)
- poor quads control -misfiring of the VMO compared to the VL
- Weakness and/or tightness of the Hamstrings
This results in the patella moving too far laterally as the tight structures pull it across and the muscles on the inside are not strong enough to control this force.
Mechanical irregularities including misaligned joints in the foot or ankle, small or misshaped patella:
- Over pronation – increase rolling inwards of the feet leading to collapsed arches
- Increase Q angle (larger than normal angle between the quadriceps and the patella tendon) more common in women due to a wider pelvis
These result in an increased internal rotation of the lower leg affecting the alignment of the patella. With repeated bending and straightening, such as during activities involving walking, running, jumping and cycling the underneath surface of the kneecap can become irritated when patella maltracking is present.
Other causes leading to PFPS
An individual can increase the load on their patellofemoral joint by:
- increasing training volumes (e.g. increased distance or frequency of exercise)
- increasing running or walking speed
- changing footwear or the surface for training
- adding hills/stairs to exercise
- increasing prolonged kneeling (e.g. gardening)
- increasing body weight, or training with weights, such as squats and lunges
Any single or combination of the above can lead to diffuse pain in the anterior aspect of the knee.
PFPS is commonly aggravated by walking, going downstairs or sitting for prolonged periods with a bent knee. Associated with this pain may be grinding under the patella, sensation of the knee giving way or there may be swelling especially after exercise.
Can physio help?
Physiotherapy reduces patellofemoral pain by integrating clinical expertise and evidencebased treatment in the assessment and management of your knee. Evidence supports the most effective treatment for patellofemoral pain is physiotherapy.
Physiotherapy interventions attempt to restore the biomechanics of the patellofemoral joint by a combination of the following as required:
- strengthening the Quads especially VMO
- Hip muscle stretching & training
- patella mobilisation
- taping to improve patella tracking
- exercise & activity modification
- gait & running analysis
- orthotics prescription & footwear advice
- soft tissue massage & stretching
PFPS does not produce any long-term effects as long as it is properly diagnosed and appropriately treated. Recovery can take anywhere from just a number of weeks for a single episode of knee pain, to many months for chronic patellofemoral pain.
Surgery is only an option for extreme or chronic cases, when Physiotherapy hasn’t corrected the cause of the patellofemoral pain.
As a speciality musculoskeletal physiotherapy practice, Noosa Sports Physios are experts in developing targeted treatment plans that will reduce patella femoral pain.
Let our highly skilled professionals help you with patellofemoral techniques to control pain, increase flexibility and mobility, and improve muscle strength.