Updated: Nov 11, 2019
Patellofemoral Pain (PFP) or Runner’s knee accounts for the highest percentage of pain around the kneecap seen in any sports physiotherapy clinic. Although it is named Runner’s knee, it is also commonly found in non-runners. It typically presents as pain around or behind the kneecap (patella), whilst squatting, walking up and down stairs and running. It may present with crackling sensations and weakness.
The best self-help approach to resolving PFP is to understand that this condition is limited mainly by pain without long-term structural damage despite the intensity of pain. If you have been experiencing PFP for 3 months or more, it will serve you well to know more about how to address it. Here are some commonly asked questions about PFP and how to recover from it.
1. Where is the pain coming from?
Have you ever hit your knee on the corner of a table? If so, you probably experienced sharp and intense pain from that. Thankfully the pain is short-lived. The structures around our patellae are rich with nerve endings, meaning they have a high density of sensors there to pick up stimulus which is potentially harmful. The pain felt is largely a warning signal as no structural damage has occurred.
If the pain is not from damaged structures in the knee, then where is it coming from? The pain is coming from a very effective system of sensors around your knee. The nerve endings around the knee become highly efficient and hence you can feel pain more easily around the kneecap. You can liken it to a faulty car alarm system that picks up movement around it and rings an alarm without anyone breaking into the car.
2. How does physiotherapy help?
Physiotherapy helps to correct or you may say tune that car alarm system to function as it should. How we do that is by identify tight and/or weak muscles around your knee, which also include the muscles which affects your hips and ankles/feet. Your ‘car alarm system’ may be more sensitive due to changes in muscle tightness and strength.
Your physiotherapist will perform a thorough assessment of your knee to determine the contributing factors and root cause(s) of your knee pain. We are experts at helping you solve your knee pain. By seeing a physiotherapist, you will be getting an individualised program to resolve your knee pain. It is important that you understand and work with your physiotherapist to get the best outcomes.
3. Why do I still have the pain after diligently doing physiotherapy?
Having seen many patients with PFP, there are a few reasons why the pain may still persist after physiotherapy.
i) Lifestyle factor is a common reason, PFP persist if you generally lead a sedentary lifestyle (i.e. average steps per day falls below 10,000) but you enjoy high intensity, albeit irregular, workouts or sports. This places the knee through extremes of highs and lows in activity level which does not facilitate the muscles around the knee to adapt positively to stress. These extremes in activity level actually reinforce knee pain.
ii) Fear of hurting the knee further is another common reason. Recent research shows that fear and avoidance of using the knee is most highly associated with persistent PFP. For example, experiencing pain every time you climb stairs for example, naturally feeds into you wanting to avoid stairs to some degree. Avoiding stairs can contribute to ongoing pain. Hence part of benefits of getting physiotherapy is to reduce fear of hurting your knee, get your muscles strong and do more things without the knee pain.
iii) Another reason for ongoing knee pain is persisting in workouts or sports which keeps the knee pain. This pattern of behaviour is usually found in competitive athlete, especially runners. Fear or avoidance is most likely not a factor, but making sure the runner is guided through her training load, improving her better running mechanics and implementing cross training strategies would be most helpful.
Overcoming PFP or Runner’s knee is achievable. So get that initial appointment with your physiotherapist, or contact us to know who to turn to. You will be soon on your way to leading a pain-free and active life without knee pain stopping you.