Getting you on track… and back to the track!

Have you ever felt pain at the front of your knee? Does your knee hurt when walking down the stairs, when running or jumping, or after sitting for a long time?  Does your knee ever make grating or popping noises when moving it? If some of these symptoms sound familiar, you may have patellofemoral pain syndrome (PFPS). This is a general term used to describe pain around the patella (kneecap). There are many factors that can contribute to the development of PFPS:

  1. Muscle imbalances

When playing sports or even just doing normal activities, our muscles work together to optimize functioning for that movement. Certain muscles might get overused and become tight, while muscles that are weak may not get used to their full potential. This is often what is seen in PFPS. Muscles on the side of the hip/thigh, such as the tensor fascia latae and the lateral quadriceps, might be overdeveloped as a result of medial quadriceps and gluteus weakness. This creates an imbalance in the leg and may contribute to poor patellar tracking, which is discussed below.

  1. Patellar mal-tracking

The patella is shaped specifically so that it can glide nicely when we bend and straighten our knee. Any deviance away from this perfect glide may cause irritation to the tissue behind the patella. Often in PFPS, this deviance may be to the side due to the strong pull of the tensor fascia latae and lateral quadriceps muscles. It is also possible that the patella may just naturally sit higher (known as patella alta) and that can lead to poor tracking in the groove as well.

  1. Training/equipment

In addition to other factors mentioned above, the intensity of activity and equipment can also contribute to the development of PFPS. If there’s a sudden increase in training regimen, our bodies may not be equipped to handle the change in forces being placed on the body. This in turn could lead to changing how we move, which may cause excessive stresses on the knee. Additionally, repetitive stress without a variation in the activities we do can also place more stress on the knee if it is not used to dealing with these types of stresses. Improper footwear may also contribute to pain if our feet are not well supported for the activity we’re doing and some types of shoes may change how we perform an activity!

All of this being said… how do we get rid of the pain? Well, addressing all the factors listed above is important and specific reasons for the pain will vary from person to person. It is advised to seek advice from a healthcare professional, such as a physiotherapist, to assist you in determining what muscle imbalances are present, assess how your patella is tracking, and start you on a good program to help you achieve your activity goals. While every treatment plan is individualized, treatments often used are:

  • Creation of a specific exercise program tailored to your needs based on your physiotherapy assessment and your goals, this will include strengthening and stretching exercises
  • Manual therapy including working on joints involved and surrounding tissues
  • Taping or bracing for patella to optimize alignment
  • Acupuncture, use of heat or ice

Often there are various areas to address when treating PFPS and the condition may take time to resolve until all factors are properly addressed. At ALPHA, we can get you on the right track (no pun intended). Don’t wait it out, get it checked out!

Physiotherapist Olivia Skrastins

Physiotherapy Yonge and Eglinton

By Olivia Skrastins
Registered Physiotherapist