Have you ever had pain at the front of your knee? Did it progressively get worse over time? You might have had patellofemoral pain syndrome (PFPS). Research suggests that one in four people will experience PFPS at some stage of their life. It first presents as a dull ache, however, over time it gradually appears earlier inactivity and becomes more severe.
What is PFPS?
PFPS is a common overuse injury affecting knee function. It is a fancy term to describe the kneecap being pulled to the outside of the knee presenting as pain or discomfort. This pulling is caused by tight anatomical structures, muscle imbalances and on occasion an acute injury. The pain culprit is having weakness in the muscles on the inside of the knee compared to the outside of the knee. This imbalance is what causes the kneecap to pull out of position. It isn’t often just one structure that is out of balance, it is multiple; PFPS has been linked to poor strength in the gluteals too.
The activities that normally cause pain for a person with PFPS are activities that are weight bearing where the knee is bent. The most common ones are walking up stairs, squatting, kneeling, running and cycling. Also sitting for long periods of time with the knee bent, otherwise known as “moviegoers knee” can aggravate the injury.
How can exercise help?
While other treatments such as medication and icing can temporarily ease the pain, specific exercises can target the source of the pain and correct muscle imbalances to prevent the injury reoccurring. Research suggests that quadriceps strengthening is the “gold standard” for treating PFPS. Other exercises can also be performed to strengthen other areas of the body, like the gluteals and core, in order to take the pressure off from the knees and create stability. The aim is to strengthen the quadriceps, gluteals and core muscles in order to build a strong network of support for correct functional movements.
What exercises are best?
The first step is to strengthen those inner thigh muscles supporting the knee. This sometimes requires retraining of the muscle because it’s activation is nil or very poor, essentially it is asleep and we need to wake it up. Being aware of the need for activation is important and a good step forward in rehabilitation.
An exercise to help increase activation in this region is a seated leg extension. Sitting in a chair, touch the inside of the thigh near the near. Slowly bring the leg to a straightened horizontal position. Under your hand, you should feel the muscle activating. Bend the knee back to its starting position, repeat this 10 times ensuring a strong constant contraction.
If you have knee pain or have in the past book in an appointment with an accredited exercise physiologist at Optimum Health Solutions to assist you.
