Do you have pain in the front of your knee or near your kneecap? Do you feel it when you use stairs, squat, run, or jump? Well, you may have a common form of knee pain called Patellofemoral Pain Syndrome or ‘PFPS.’
The Patellofemoral Joint
What is PFPS? Let’s talk about where the diagnosis got its name – the patellofemoral joint. The patellofemoral joint is the connection of the femur (thigh bone) to the upper portion of the patella (kneecap bone). Your kneecap attaches to both your femur and tibia (shin bone) through tendons and ligaments. To give a brief anatomy description: the quadriceps (thigh muscle) is composed of 4 muscles, hence “quad” in the name. These 4 muscles are the rectus femoris, vastus lateralis, vastus medialis, and vastus intermedius. They all come together to form the quadriceps tendon, which then connects to your patella. From your patella, you have the patellar tendon which attaches to the bottom portion of the patella and attaches to the tibial tuberosity (located at the top of the shin bone.)
So… what is PFPS?
Patellofemoral Pain Syndrome (PFPS) is a common knee condition that encompasses pain at the front of the knee in and around the patella. Pain can also be located over the patellar tendon or extend up into the thigh muscle (quadriceps) depending on the level of severity. PFPS is a condition that causes pain of the patellofemoral joint complex and/or the surrounding soft tissue. The cause is often multifaceted and can be related to lack of muscle flexibility, imbalance of muscle strength, patellar tracking issues, patellar alignment, and/or overuse. It’s very common in individuals that play sports, especially teenage to young adults, and it is even more common in women.
Frequently, pain will be provoked with stairs, deep squatting, jumping, and running. Because of this, it is also known as “runner’s knee” or “jumper’s knee.” Pain can also be worsened after being in a position which requires the knee to be bent for a prolonged period of time (for example: sitting at your desk chair). Symptoms of PFPS may include: knee stiffness, mild swelling, pain in the front of the knee with stairs/squatting/running/jumping/prolonged sitting, and pain in the front of the knee after sitting for a prolonged period of time.
PFPS is diagnosed with a physical examination by your health care provider. Typically, the examination involves activities that would be symptom provoking for someone with PFPS, such as squatting, jumping, or loading of the patellofemoral joint in some way. If needed, your doctor may order other imaging, like an x-ray, to rule out other causes of your pain.
Treatment of PFPS
PFPS is usually treated with conservative care. If your PFPS is due to a vigorous increase in activity or overuse, treatment can be simple – rest and ice. Try your best to avoid activities that cause increased pain. This will allow inflammation to decrease and your tissues to heal. Sometimes rest isn’t enough to improve your condition, and you may need to seek further treatment from your doctor who will often prescribe physical therapy to assist with improving motion, joint mobility, and strength.
PFPS is a frequently treated diagnosis in the outpatient physical therapy setting. Treatment in PT will involve an evaluation from a physical therapist where he/she will dive into your strength, flexibility, range of motion, and various movement mechanics. The evaluation allows the therapist to devise an individual program to address your knee pain and chief complaints. You would be prescribed specific exercises to target muscles that will help support your knee, promote optimal alignment, and improve mechanics. Certain braces, taping mechanisms, and manual therapy techniques may also be useful, and your therapist may discuss these options with you.
The goal of physical therapy will be to get you back to doing what you love to do – free of pain!