More Running, More Problems?

Anatomy

The patella, also known as the kneecap, moves every time you bend or straighten your knee. The groove that this tracks in is called the trochlear groove. Your quadriceps tendon helps to stabilize the patella from the femur and the patellar tendon stabilizes to the tibia. When patellofemoral pain syndrome occurs, the nerves sense pain around the kneecap from either the tendons, the fat pad under the patella, or the synovial tissue. If the issue goes untreated long enough, it can turn into chondromalacia patella, a condition where the articular cartilage starts to break down.

What does Runner’s Knee feel like?

People who are experiencing this report a dull pain in the front of their knee. There can also be pain in and around the kneecap that occurs when you are active or sitting for a long period of time. Other symptoms include feelings of weakness or instability.

Runner’s Knee is aggravated with squatting, sitting, climbing stairs, and running.

Who may experience this?

Runner’s Know most often occurs in athletic groups, females, and young adults. However, this can also occur in nonathletic populations as well. Causes include repeated stresses on the knee, sudden changes in physical activity, or abnormal tracking of the kneecap. Abnormal tracking leads to more pressure on the back of the patella and irritation of the soft tissue around it.

What causes PFPS?

There are several potential causes of PFPS. It varies from person to person, but the most common reasons are:

• Weak thigh muscles
• Tight hamstrings and/or Achilles tendons
• Poor foot support
• Weak hip abductors
• Overtraining
• Kneecap that is too high or being pulled laterally

How can physical therapy help?

Your physical therapist will test your mobility and strength and see if there are any limitations within the muscles surrounding your knees. They may also perform a gait analysis to see if there is any pattern in your gait that is leading to your knee pain. Once they find out what is causing your pain, they will create a personalized program for you.

Strengthening: These exercises will most likely be focused around the hip and knee. This has been shown to be very effective for managing patella femoral pain.

Taping: Taping has been shown to help alleviate pain and give you a temporary break in your activities. However, this will not solve the issue alone and you must pair it with a strength and mobility program. You can also learn how to do taping at home on your own.

Coordination: If there is weakness in your hip or patterns learned that lead to your knee collapsing inward or your foot collapsing into pronation, it can cause these pains. By learning how to control these patterns during stair climbs, squatting, running, and jumping, it can re-coordinate the nervous system and the patterns.

There are other conditions that can lead to your symptoms, including chondromalacia patellae and patellar tendinopathy. These lead to similar symptoms but have different causes. This is why it is important that you have your physical therapist check you out and create a program tailored specifically to you.

Overall

PFPS pain is often here to stay and is usually based on mechanics, weaknesses, and tightness. So, if you are experiencing this, please reach out to your local physical therapist or set up an appointment with us in Falls Church, VA and the surrounding Arlington area.

Author

Alana Hamilton Alana Hamilton is a physical therapist at Advantage Physical Therapy in Falls Church, Virginia. She is a proud Hokie from Virginia Tech with a major in Biology and a minor in psychology and sociology. Following graduation, she immediately got her doctorate in Physical Therapy from Radford University. She is an avid fan of Pilates, running, and hiking. On the weekends, she can be found hanging out with her family and baby as well as doing Spartan races with her old physical therapy classmates and friends. She is a big believer that during rehabilitation, "Motion is the Lotion" and that staying active is key to remaining healthy.