Patellofemoral pain syndrome is one of the more common knee problems for active populations. Some estimates show a prevalence of up to 29% of adolescents, and up to 23% in the general population. This ailment is characterized by pain at the front of the knee, usually in the area of the kneecap itself. People with patellofemoral pain usually have increased pain with activities such as squatting, jumping, and going up or down stairs, but depending on the severity of the problem, may even have pain with simple bending of the knee. Most of the time, there is no traumatic injury, rather, you just start to notice a little twinge of pain one day. If the condition worsens, it can become very painful, and many people significantly limit their activity as a result of this pain, and fear that there is some damage in their knee.
Find The “WHY”
Step one of the Iron Standard process is to find the “why” behind your pain. For us, this means identifying what is the true cause of the problem. The human body is a complex system, and oftentimes you have to examine the system as a whole to determine what is causing a problem in one specific place. Patellofemoral pain is a perfect example of how this can play out. In most cases, this condition is actually caused by weakness or mobility limitations at the hip, ankle, and foot rather than at the knee. Specifically, the most common limitations that we see clinically are hip abductor weakness and ankle dorsiflexion limitations which both tend to lead to medial collapse with dynamic movements such as squatting and jumping.
Ease The Pain, Ease The Mind
The good news about this condition is that there is little evidence that the pain is caused by any serious tissue damage and most people are able to recover with simple conservative management. With this knowledge, one of the top pieces of advice that we like to give our patients and clients is that you should find ways to keep moving as much as you can without directly flaring up your knee pain. This includes any normal upper body resistance training, and any cardiovascular training that does not increase your knee pain – spin bike, recumbent bike, elliptical trainer, rower, etc. In addition to this, the use of tools such as foot orthoses and kinesiotaping may help reduce your pain temporarily, although we don’t recommend reliance upon these as a long term solution. It would be wise to avoid more strenuous activities that do cause pain for a short time – most commonly, this will be things like repetitive jumping and running.
Optimize Your Life
At Iron Standard, we never want to settle for just getting you back to baseline. Our end goal is to enable you to go above and beyond what you thought you were capable of. Obviously, the first step in that is to take care of your current problem. In the early stages of rehab for patellofemoral pain, exercises will be focused primarily on ensuring that you have proper hip mobility, strength, and motor control, good quad strength, and good ankle and foot mobility and control. Here are some videos demonstrating some of the initial exercises that we typically use with patients who present with patellofemoral pain.
Finally, our long term goal is to get you back to everything you want to do, and we want to improve your body’s resiliency to avoid future problems. With that in mind, we want to progress to more traditional strength training and conditioning exercises such as the ones shown below.
Give these a shot and let us know what you think! As we said, patellofemoral pain can be a complex problem. These exercises could be a good place to start, but if you need more specific advice, please reach out, we would love to help!