Patellofemoral Pain Syndrome

Pain in the front of the knee

What is patellofemoral pain syndrome?

Patellofemoral pain, also colloquially known as Runner’s knee, refers to pain in and around the kneecap. It is the most commonly felt type of knee pain across the population and generally affects females and older individuals. There are a variety of risk factors for this condition such as a sudden increase in physical load, the structure of the knee joint and a lack of strength in the muscles surrounding the knee and hip.

When do I know if I have patellofemoral pain?

Signs and symptoms of a patellofemoral pain may include:

• Pain felt in and around the knee cap
• Pain when doing squats, going up or down stairs
• Swelling at the front of the knee with no trauma
• Tenderness around the knee cap
• Unable to put pressure on the knee cap in activities such as kneeling
• Pain and stiffness in the knee when getting up after sitting for a prolonged time

How is patellofemoral pain diagnosed and managed?

It is usually diagnosed through a subjective interview and physical examination carried out by a Doctor or Physiotherapist. The medical specialist might order some scans to help determine if there is a specific cause for your pain. Should you choose to visit a Physiotherapist first, he or she will be able to manage the majority of cases safely and effectively.

Physiotherapy for pain in front of the knee

The Physiotherapist will carry out an assessment of the knee, hip and ankle region. This would include an assessment of the range of movements in the lower limbs, examining your movement postures as well as your strength. The role of the Physiotherapist is to ensure that any flexibility or strength issues are being addressed to assist with a more pain-free knee movement.

Signs and symptoms of patellofemoral pain may include:

• Advise and education pertaining to your condition
• Soft tissue therapy
• Movement with mobilisation
• Heat therapy
• Electrotherapy
• Dry needling
• Shockwave therapy
• Taping to maintain good patella alignment
• Movement training
• Returning to sport training
• Personalised home exercise program

What sort of movements should I be avoiding if I have patellofemoral pain?

The type of movements that should be avoided (temporarily!) in the case of such pain would be movements which involve placing pressure onto the patellofemoral joint. Such movements include squatting, kneeling, going up and down the stairs. In addition, high impact activities such as running, jumping or hopping should also be avoided or modified for the time being.

However, not all individuals have the same levels of pain and it would thus be worthwhile visiting a Physiotherapist who can assess your condition and give you specific advice on what exercises you are able to continue doing.

Will I need surgery for my patellofemoral pain?

In most cases, the condition is managed conservatively through Physiotherapy for at least 3-6 months. However, in the event where conservative management does not help to improve the symptoms or if the pain is unremitting and severe, a surgical intervention might be warranted.

Reducing my front of knee pain

There are a variety of ways to help reduce pain at the front of the knee surrounding the knee cap

• Wearing an open patella knee brace
• Minimise movements which place pressure on the knee joint such as squatting, kneeling
• Use of heat or ice therapy, either of which helps with the pain better
• Use of a walking aid to help offload weight bearing
• Use of a topical pain-relieving cream
• Taping of the knee cap to reduce the pressure on your knee cap