Knee’d to Know: How to Beat Patellofemoral Pain
Introduction
Patellofemoral Pain Syndrome (PFPS), often referred to as “runner’s knee,” is one of the most common causes of knee pain, affecting approximately 25% of the general population at some point in their lives. This condition can significantly interfere with daily activities like climbing stairs, running, squatting, and even prolonged sitting. As physiotherapists, we see PFPS regularly across all age groups—from young athletes to office workers.
Causes and Risk Factors
PFPS typically results from excessive or abnormal loading of the patellofemoral joint, leading to irritation of the structures around the kneecap. Several factors contribute to its development:
Common Causes:
Overuse or repetitive activities that overload the knee
Poor tracking of the patella (kneecap)
Muscle imbalances in the lower limb
Risk Factors Include:
Weakness in the quadriceps, glutes, or hip stabilizers
Flat feet or excessive pronation
Tight hamstrings or calf muscles
Poor biomechanics during activities such as running or squatting
Sudden increases in training volume or intensity
Previous knee injuries
Symptoms
Early Symptoms May Include:
Dull, aching pain around or behind the kneecap
Discomfort during activities like running, jumping, squatting, or using stairs
Pain after sitting for prolonged periods ("movie-goer’s sign")
Advanced Stages Can Present With:
Increased pain during more basic daily activities
Clicking, grinding, or popping sensations in the knee
Feelings of knee instability or weakness
Diagnosis
Diagnosis of PFPS is primarily clinical, based on a thorough patient history and physical examination. Physiotherapists assess:
Pain location and activity triggers
Range of motion and joint mobility
Muscle strength and flexibility
Gait analysis and functional movement tests
Special tests are also used to confirm patellofemoral involvement.
In some cases, imaging such as X-rays or MRI may be requested to rule out other causes of knee pain.
Physiotherapy Approach
Physiotherapy plays a central role in both the treatment and prevention of PFPS. Our approach focuses on addressing the underlying biomechanical issues rather than simply treating the symptoms.
Physiotherapy Interventions May Include:
Targeted strengthening: Building strength in the quadriceps, glutes, hips, and core to improve knee alignment and load distribution.
Manual therapy: Hands-on techniques to address soft tissue restrictions or joint stiffness.
Taping techniques: To help improve patellar tracking and reduce immediate pain.
Movement retraining: Correcting poor movement patterns during walking, running, or squatting.
Progressive loading programs: Gradually increasing load tolerance to safely return to sport or activity.
Patient Education and Self-Management
Education is a cornerstone of managing PFPS. Empowering patients with knowledge allows for better self-care and long-term prevention.
Helpful Tips:
Gradually increase physical activity to avoid sudden overload.
Perform prescribed strengthening and mobility exercises consistently.
Use proper footwear with adequate support.
Incorporate regular stretching for the hips, calves, and hamstrings.
Avoid prolonged sitting or repetitive activities that aggravate symptoms.
Apply ice after aggravating activities if necessary to reduce inflammation.
Conclusion
Patellofemoral Pain Syndrome is common, but highly treatable with the right approach. Early intervention can lead to quicker recovery and a full return to activity. If you’re experiencing persistent knee pain, don’t wait—seek a physiotherapy assessment to address the underlying causes and get on the path to recovery.
Call to Action
If you're dealing with knee pain that won’t go away, let us help. Contact us at Integrative Physiotherapy and Wellness to schedule a comprehensive assessment and personalized treatment plan.
Written By: Stacey Stys
References
Crossley, K. M., Stefanik, J. J., Selfe, J., Collins, N. J., Davis, I. S., Powers, C. M., & Macri, E. M. (2016). Patellofemoral pain consensus statement from the 4th International Patellofemoral Pain Research Retreat. British Journal of Sports Medicine, 50(14), 842–850.
Witvrouw, E., Callaghan, M. J., Stefanik, J. J., Noehren, B., Bazett-Jones, D. M., Willson, J. D., ... & Crossley, K. M. (2014). Patellofemoral pain: consensus statement from the 3rd International Patellofemoral Pain Research Retreat. British Journal of Sports Medicine, 48(6), 411-414.
Petersen, W., Ellermann, A., Gösele-Koppenburg, A., Best, R., Rembitzki, I. V., Brüggemann, G. P., & Liebau, C. (2014). Patellofemoral pain syndrome. Knee Surgery, Sports Traumatology, Arthroscopy, 22(10), 2264-2274.
