Knee Pain

Patellofemoral pain is a medical term used to describe all pain at the back of the patella (knee cap) where it articulates with the femur (thigh bone). It is one of the most common knee pain complaints in both active sports people and the elderly.

Non-specific or vague pain is often reported. This may be on the inside, outside or at the base of the patella and made worse by activities that load the patellofemoral joint (PFJ). Sitting for prolonged periods and walking up or down stairs usually aggravate the symptoms.

Factors that increase PFJ load lead to the development of pain. These can be both extrinsic and intrinsic.

Extrinsic factors include: body mass, speed of gait, training surfaces and footwear. Training errors are also common such as high training volume, increased speed of running, and running up and down hills/ stairs.

Intrinsic factors are those that impact on the movement of the patella within the femoral groove (patella tracking). These include: muscle weakness sand/or imbalance, inward rotation of the knee and leg, high knee valgus and a pronated foot type.

Treatment of patellofemoral pain involves addressing both the extrinsic and intrinsic cause of pain.

Immediate treatment should focus on the reduction of pain and inflammation including rest from aggravating activity, icing and stretching.

Extrinsic factors must be addressed and modified if necessary:

• Reduce training volume
• Running on soft surfaces
• Running on flat ground

Intrinsic treatment should occur early on with a health professional and may include:

• Improved soft tissue compliance
• Patella taping and braces
• VMO and glute strengthening
• Footwear and in-shoe foot orthotics