Patellofemoral Pain Syndrome (PFPS)

Longevity Exercise Physiology Drummoyne,EdgecliffMarrickville,Bella VistaRandwickLindfield and Balmain today discuss patellofemoral pain syndrome and the role of exercise in improving pain.

Patellofemoral Pain Syndrome is when pain is felt behind your knee cap (patella) where your femur and patella join and is extremely common. Typical activities that tend to cause pain include stair climbing, squatting, running and jumping. This pain is normally a result of poor kneecap alignment, causing the patella to move to one side and rub against the femur bone. Muscle imbalances and poor biomechanics may cause poor alignment of the patella:

Muscle imbalance

Patellofemoral pain can arise due to weakness and inflexibility of lower limb muscles.

Quadriceps weakness

The quadriceps muscles attached to the patella and if there are imbalances between the medial and lateral muscles, the patella can be pulled out of line. In particular, weakness in vastus medialis oblique (inner thigh) can cause the patella to be pulled laterally.

Exercise recommendation

Exercises that strengthen the quad are most important in rehabilitation of PFPS.
o Sit to stand or squat
o Single leg squat
o Leg press
o Step up
o Straight leg raise
o Wall slides

Gluteal and hip weakness

The glutes are made up of the gluteus medius, minimus and maximus. Poor hip and gluteal strength, particularly the gluteal medius can cause knees to internally rotate (roll in) which shifts the patella laterally. Increased internal rotation and hip adduction may increase the load on the patellofemoral joint and cause pain.

Exercise recommendation

Exercises that strengthen the hip abductors and adductors should be included in an exercise program when these muscles are weak.
o Hip adduction (squeeze ball/fists between legs)
o Clams
o Hip abduction (side lying leg raises)
o Crab walks
o Deadlift
o Gluteal stretching

Poor biomechanics

Pronation of the foot (flat feet) causes internal rotation (roll in) of the ankle and subsequently the femur. These biomechanics result in lateral deviation of the patella. These issues may be corrected with arch support such as orthotics.

When an individual with these biomechanics repetitively runs or walks, anterior pain is produced and may progress to pain at rest.

As a result of the COVID lockdown, Longevity has seen an increasing number of people presenting with PFPS. We believe this is due to the fact that people were not able to attend gyms for their resistance training, losing strength in their quadriceps and glutes. More individuals also resorted to walking and running as their form of exercise during this period. A  sudden increase in load, muscle weakness and poor biomechanics resulting in a flare up of pain.

If you or anyone you know is struggling with patellofemoral pain syndrome, consult a Longevity Exercise Physiologist for an individualised exercise program to reduce your pain.

Contact Longevity today  to see how we can help! 1300 964 002

Written By Shannon Coolican

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