Patellofemoral Pain / Runner’s Knee

What is Patellofemoral Pain / Runner’s Knee?

Overview of Patellofemoral Pain

Patellofemoral Pain Description

• Patellofemoral pain is the preferred term used to describe pain in and around the kneecap. With the patella being the kneecap and the femur being the thigh bone.

• It’s otherwise known as Patellofemoral joint (PFJ) syndrome, Runner’s Knee, anterior knee pain and chondromalacia patellae.

• Patellofemoral pain is an ‘umbrella’ term used to embrace all conditions associated with kneecap pain in the absence of other pathologies.

Patellofemoral Pain Contributing Factors

• Extrinsic

  • During physical activities the extrinsic load is created by the body’s contact with the ground and is therefore moderated by body mass, speed of gait, surfaces and footwear.

  • The number of loading cycles and frequency of loading are also important. Therefore, when an individual experiences an increase in the magnitude of the PFJ load (e.g. higher training volume, increased speed of running, hill/stair running or bounding), this may overload the PFJ.

• Intrinsic

  • Patella tracking

    • Remote factors: femoral internal rotation, knee valgus, tibial rotation, subtalar pronation, and muscle flexibility.

    • Local factors: patella position, soft tissue tension and neuromuscular control

Patellofemoral Pain Symptoms & Presentation

• Pain: non-specific or vague, maybe on the inside, outside or underneath the knee cap.

• Onset: running (especially downhill), steps/stairs, hills, any weight-bearing activities involving the knee to bend (long distance running)

• Aggravating activities: long distance running, squats, stairs, prolonged sitting, kneeling.

• Typically worsens gradually with activity

• May have tenderness on the inside or outside boarder of the knee cap but may also be tender underneath the knee cap.

• May have small amounts of swelling above or below the kneecap.

• Associated with clicking or grinding when bending or straightening and experience episodes of giving way or collapsing

• May have reduced knee range

Patellofemoral Pain Treatment

Patellofemoral Pain Management

• Treatment aims:

  • Reducing pain and inflammation

  • Addressing extrinsic contributing factors

  • Addressing intrinsic contributing factors:

    • ‘Remote’ factors

    • Local factors

• Treatment methods

  • Muscle release – massage/dry needling

  • Joint mobilization

  • Strength retraining exercises: quad muscle retraining (especial vastus medialis) and hip muscles (adductors and external rotators).

  • Taping/bracing

Patellofemoral Pain Prognosis

Symptoms may take up to 6 weeks to subside.