What is Patellofemoral Joint Pain and How Can I Relieve It?
The most common cause of knee pain is dysfunction of the patellofemoral joint.
How the patella sits and moves in relation to the femur is extremely important to proper knee function. The patella should be able to move relatively freely to allow for large movements of the knee joint. The patella has multiple structures that attach to it and help to pull it all different directions during movement.
The largest muscle group that attaches to the patella is the quadriceps, however there are also fibres from the iliotibial band and surrounding ligaments that attach to different aspects of the patella.
Unfortunately, repetitive activities like running and climbing stairs without the proper mechanics and strength in the surrounding musculature, results in some of these structures that pull on the patella becoming weak and tight. This often causes the patella to track towards the outside during movement which in turn can cause irritation of the patella and knee joint.
The iliotibail band runs on the outside of the thigh and becomes tight with poor biomechanics
High impact activities such as running and stair climbing become painful
Maltracking causes inflammation & without proper management can become a chronic problem
How is Patello-femoral Joint Pain Treated?
The initial stages of management for patellofemoral joint pain is often centred around education as well as providing strategies to reduce pain and inflammation like using an ice pack or anti-inflammatory cream. It is also important in this early stage to try to avoid activities that make the pain worse, for example, intense running, stair climbing or heavy squatting. This does not mean complete rest however. Many people with this type of problem have traditionally been advised to have complete rest, we know that long term, this is not a helpful approach.
After the pain starts to settle, it is important to restore efficient movement and function of the knee through a combination of manual treatment and resistance training to reduce the tightness in surrounding myofascial structures and improve the strength of the surrounding muscles. A key way to address the tightness in the iliotibial band and gluteal muscles is by using a massage ball or a foam roller.
Release of the iliotibial band and gluteal muscles with a massage ball
A Word on Strength Training
Strength training of the whole lower body is paramount to improve biomechanics and offload the patellofemoral joint to give you the best chance to return to the activities that you enjoy doing most. A key component of the rehabilitation plan should be to strengthen up key as well as global lower limb muscle groups to prevent deconditioning and reduce risk of reocurrance.
Samantha Hood AEP
We've included some exercises from Samantha Hood's ACL rehab protocol which are great examples of gym based exercises you can try to improve your lower limb strength. There are also many ways to modify these if you would prefer to exercise without gym equipment, want help with that? Ask Sam shooting her an email or making an appointment.