Pain in the front of your knee? You may have Patellofemoral Pain Syndrome

Pain in the front of your knee?  You may have Patellofemoral Pain Syndrome

 

Patellofemoral joint (PFJ) pain is a generalised term to describe pain around or behind the knee cap that is not caused by any specific pathology or lesion. People with PFJ pain may experience:

  • Pain with activities such as: running, stair ambulation, squats, loaded leg exercises and walking/running up and down hills
  • Pain with prolonged sitting
  • Clicking or clunking in the knee cap
           Knee joint anatomy

          Knee joint anatomy

PFJ pain is caused by altered mechanics around the knee cap resulting in excessive load on the patellofemoral joint – the joint between your kneecap (patella) and thigh bone (femur) (Fig 1).

There are many causes for increased load on the patellofemoral joint.  They can be separated into intrinsic and extrinsic causes.

 

 

Extrinsic causes are factors outside of the body.  They can include:

  • Sudden increases in activity (frequency and/or volume).  This can include running, stair ambulation, squats, loaded leg exercises and walking/running up and down hills.
  • Not wearing appropriate foot ware
  • Training on hard surfaces

Intrinsic causes are factors within the body.  They can include:

  • Increased femoral internal rotation (thigh twisted inwards)
  • Increased valgus position of the knees (knock knees)
  • Increased tibial rotation (rotation of the shin bone)
  • Increased subtalar pronation (flat feet)
  • Loss of muscle and joint flexibility
  • A change in knee cap position
  • Tightness in soft tissues around the knee
  • Decreased muscle control around the knee, hip, pelvis and lower back

All these intrinsic factors can alter the way the patella glides within it’s groove on the femur, resulting in increased load on the PFJ.

Physiotherapy treatment for PFJ pain involves having a detailed assessment of the above causes and having them treated accordingly. 

Treatment can include

  • Taping as seen in the video below
  • Massage, stretching or dry needling to tight muscles
  • Physiotherapy rehabilitation addressing the above causes

PFJ pain can be a multifactorial problem as listed above.  It is also worth noting that it can coexist with other conditions, therefore if you are experiencing pain in the front of your knee it is important to have a detailed assessment by a physiotherapist or sports physician.


Daniel Di Mauro is a McKenzie Credentialled Physiotherapist with Advance Healthcare in St Albans. The clinic operates within several minutes drive of suburbs such as Sunshine, Patterson Lakes and Keilor, for all your physiotherapy and sports injury needs.