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Runner’s Knee – Patellofemoral Pain Syndrome

Patellofemoral pain syndrome is a common running injury that involves the back of the kneecap rubbing abnormally against the groove of the thigh bone. It is more common in females than it is in males (wider hips requiring greater strength and stability), and in runners who have flat feet (excessive pronation). Pain is often present when going up or down stairs, squatting, and lunging, in addition to running. Pain can also be present after prolonged sitting.

The underside of the patella is covered with articular cartilage, a smooth slippery cover for the joint surfaces and allowing for an efficient patella glide/track in the femoral groove. Two muscles attaching to the patella help control its position in the femoral groove as the leg straightens – vastus medialis obiquus (VMO) and vastus lateralis (VL). The VMO runs along the inside of the thigh, and the VL lies along the outside of the thigh. If the timing between these two muscles is off or the VMO is weak, the patella may be pulled off ‘track’ – the femoral groove. Muscle imbalance around the hip can also contribute to patellofemoral problems, as can poor foot biomechanics (pronation, or flat feet)and during walking and running.

Patellofemoral problems start off as irritation of the underlying joint cartilage. If left untreated, and the irritation will persist and may develop into osteoarthritis of the patellofemoral joint with cartilage wear and tear. At that stage symptoms can be controlled but the osteoarthritis can not be reversed. It is unlikely you will be able to return to your sport or normal activity without treatment

Physio is the first line of treatment for patellofemoral pain,andand we focus on keeping you as active as possible by using tape to control your kneecap position while we correct the underlying cause of your pain. Manual therapy will be used in acute phase of your condition, in order to optimise/control inflammation and restore muscle length. Strengthening of the specific muscles can also begin in the acute phase to a pain-free level, and may be targeting a weak VMO muscle, weak gluteal muscles or foot intrinsic muscles. Using an EMG biofeedback device, we can accurately identify which muscles require strengthening, and couple this in with your home program in order to get you back to running faster.

Once acute symptoms have settled, a detailed Running Gait Assessment will be most beneficial,and as this isandspecifically designed to diagnose any other factors that can cause knee pain in runners, and allows the implementation of an effective programs to improve your strength, stability and running technique to reduce your risk of re-injury. Completing our RunRight coaching program or joining our Runfit can get you on the most effective program to build on your improved technique.