"Runner's Knee" & Why You Need a Physiotherapist

Patellofemoral Pain Syndrome (PFPS), often referred to as "runner’s knee," is a condition characterized by pain around or behind the kneecap (patella). This pain typically arises from issues with the way the patella moves over the femur (thigh bone) and can be caused by various factors including muscle imbalances, alignment issues, and overuse.

Causes and Symptoms

Causes:

• Muscle Imbalances: Weakness or tightness in the muscles around the knee, particularly the quadriceps, hamstrings, and iliotibial (IT) band, can affect patellar tracking and alignment.

• Overuse: Activities that involve repetitive knee bending, such as running or jumping, can lead to PFPS.

• Biomechanical Issues: Abnormal foot mechanics, such as overpronation, or improper alignment of the knee can contribute to PFPS.

• Previous Injury: Prior trauma to the knee or damage to the cartilage under the patella can also lead to PFPS.

Symptoms:

• Anterior Knee Pain: Pain is typically felt around or behind the kneecap.

• Pain with Activity: Discomfort often increases with activities that involve knee bending, such as climbing stairs, squatting, or sitting for long periods.

• Crepitus: A sensation of grinding or clicking in the knee may occur.

  
  

Physiotherapy Management

Physiotherapy can play a crucial role in managing and treating PFPS. Here’s how a physiotherapist can assist:

1. Assessment and Diagnosis: A physiotherapist will perform a thorough assessment to identify the underlying causes of PFPS. This includes evaluating muscle strength, flexibility, joint alignment, and movement patterns.

2. Exercise Therapy:

   • Strengthening Exercises: Targeting the quadriceps, hamstrings, glutes, and hip abductors can help improve patellar tracking and reduce stress on the knee joint. Exercises might include squats, lunges, and leg raises.

   • Stretching: Stretching the IT band, hamstrings, and calf muscles can help alleviate tension around the knee and improve flexibility.

   • Core Stability: Strengthening the core can contribute to better overall alignment and support for the knee.

3. Manual Therapy: Techniques such as joint mobilizations, soft tissue massage, and patellar mobilizations can help reduce pain, improve joint mobility, and address any tissue restrictions.

4. Biomechanical Corrections:

   • Gait Analysis: Evaluating and correcting walking and running mechanics to reduce undue stress on the knee.

   • Footwear and Orthotics: Recommendations for appropriate footwear or custom orthotics if there are issues with foot mechanics contributing to the problem.

5. Pain Management: Modalities such as ice, heat, and TENS (transcutaneous electrical nerve stimulation) can be used to manage pain and inflammation.

6. Education: Educating patients about activity modifications, proper body mechanics, and techniques for preventing recurrence. This might include advising on modifications to sports or daily activities to avoid aggravating the knee.

7. Functional Training: Helping patients gradually return to their activities or sports with a focus on proper technique and progressive loading to ensure that the knee can handle increased demands without pain.

8. Postural and Ergonomic Advice: Offering guidance on how to modify work or daily activities to reduce knee strain and prevent further issues.