Normally the knee cap (patella) travels within a groove (femoral groove) when bending or straightening the knee. Patellofemoral Pain Syndrome (PFPS) can occur when the knee cap shifts out of the femoral groove during movement.
This tracking disorder can be caused by one or more problems:
Imbalance of muscle contraction of quadriceps (poor motor control)
Laxity of ligaments around knee
Increased Q angle (the angle from the tibial tuberosity and anterior superior illiac spine). wide hips and knock knees can increase the Q angle and increase the knee cap pulling out of the groove with movement
Flat feet (pes planus) - causes rotation of tibia which can cause the knee cap to track incorrectly
Symptoms can include:
Anterior knee pain (over/under knee cap and around knee)
Pain gets worse when walking (especially on an incline), squatting, going up stairs, kneeling, getting up from a chair, running or even sitting for long periods of time
Swelling of the knee
Grinding or popping sensation in knee
Over time if left untreated this condition may lead to osteoarthritis and chondromalacia of the knee.
Physiotherapy as a conservative treatment
Goals of physiotherapy include:
Re-establishing proper motion of the knee cap
Strengthening and stabilizing the knee joint.
Interventions from a Physiotherapist May Include:
Strengthening exercises - Quadriceps strengthening is the most recommended because they play a significant role in knee cap movement.
Stretching exercises - Hip, hamstring, and IT band stretching, calf stretching
Bracing (J brace)
Taping (McConnell taping, Kinesio taping)
Rest, Ice, compression, elevation (RICE)
What is McConnell Taping?
Introduced in 1984 by Jenny McConnell, a physiotherapist.
Primary goal is to pull the patella away from the painful area to reduce pain
Apply a underlying cover strip (Hypafix)
Apply leukotape from the outside of the knee to the inside