24/04/2024
PATELLOFEMORAL PAIN SYNDROME (PFPS).
INTRODUCTION:
🔴Patellofemoral pain syndrome (PFPS) is also known as runner’s knee or jumper’s knee. This medical condition causes pain under or around the kneecap (patella). PFPS can occur in one or both knees. It affects both children and adults.
⬛Who is likely to have patellofemoral pain syndrome (PFPS)?
Anyone can develop patellofemoral pain syndrome. PFPS is more likely to occur in females and athletes, including children and young adults. People can experience PFPS most often when they participate in sports with frequent running, jumping or squatting. Others may experience PFPS if they are walking or sitting for extended periods of time, kneeling or climbing stairs.
CAUSES:
°Overuse of the knee joint.
°Problems with kneecap alignment.
°Certain anatomy or body types.
°Weak muscles surrounding the knee.
°Improper equipment use or sports training techniques.
°Changes to footwear.
°Hard playing surfaces.
SYMPTOMS:
Many people experience a dull, aching pain in the front of the affected knee. Your symptoms may also include:
🔹Pain during activities that bend the knee, including squatting or climbing stairs.
🔹Pain after sitting for extended periods of time with your knees bent.
🔹Crackling or popping sounds in your knee when standing up or climbing stairs.
🔹Pain that increases with changes to your usual playing surface, sports equipment or activity intensity.
DIAGNOSIS:
If you have knee pain or notice other symptoms of PFPS, especially after exercising or sitting for long periods of time, contact your doctor to evaluate your knee.
Physical examination.
X RAY
ULTRASOUND
MRI
MANAGEMENT & TREATMENT:
◾ Rest: Avoid putting any weight on the knee.
◾Ice: Do not apply ice directly to your knee. Instead, apply cold packs wrapped in a towel for no more than 20 minutes at a time, several times each day.
◾Compression: Using an elastic bandage, lightly wrap your knee while leaving an opening over your kneecap. Make sure the bandage is not wrapped too tightly.
◾Elevation: Rest with your knee higher than your heart.
💢Physical therapy: Specific exercises can help you regain knee strength, endurance and range of motion.
💠Activity modification – advice on rest and activity modification, allowing the pain to settle.
💠K TAPING – taping the knee to offload and reduce the pressure on the kneecap can help to reduce your pain. Taping can allow you to carry out your physiotherapy exercises and everyday activities with less pain. Ice can also be applied to the affected area. You may also benefit from taking some anti-inflammatory medication.
💠Patient education – it’s important to understand your condition and to be active in your recovery. You will be given a clear explanation of the diagnosis and any other underlying causes, and we will discuss what is required to address these issues and reach your goals.
EXERCISE PLAN:
🔲Quad stretch
Stand with the foot of the leg you wish to stretch held in your hand, or resting on a chair behind you.Pull in your stomach so your belly button moves up towards your nose and tuck your bottom under.Feel the stretch in the front of your thigh.
🔲GC muscle stretch
Stand facing a wall with your affected leg behind you.Lean your hands against the wall.
Make sure the toes of both feet are facing forwards and you have an arch in the foot.
Keeping your back leg straight and heel on the floor, lean forwards.Feel the stretch in the calf of the back leg.The front knee can bend if needed.
🔲Soleus stretch
Stand facing a wall with your affected leg behind you.Lean your hands against the wall.
Make sure your toes are facing forwards and you have an arch in the foot.Keeping your heel on the floor, bend your knees.Feel the stretch in the calf of the back leg.
🔲Hams stretch
Lie on your back.Bend the hip of your affected side to 90 degrees, until the knee faces the ceiling.Hold behind your thigh with both hands.Keeping your thigh and back still, straighten your knee.Feel the stretch in the back of your thigh.Your opposite leg can be slightly bent or straight.
🔲Quad set
Sit with your affected leg straight and supported on the floor or a firm bed. Place a small, rolled-up towel under your affected knee. Your other leg should be bent, with that foot flat on the floor.Tighten the thigh muscles of your affected leg by pressing the back of your knee down into the towel.Hold for about 6 seconds, then rest for up to 10 seconds.
Repeat 8 to 12 times.
🔲SLR
🔲Prone LR
🔲Clamshell
🔲Reverse Clamshell
🔲Side lying leg lifts
🔲Wall squat
🔲Bridging
🔲Adductor squeeze
🔲Heel Walking
🔲Toe walking
💠Manual therapy – your physiotherapist may use manual therapy such as massage or soft tissue release techniques to the surrounding muscles. This will help improve movement and reduce muscle stiffness or soreness.
💠Specific strengthening exercises – physiotherapist will design a safe resistance program to ensure all your muscle groups are strong and working in synergy, to aid your recovery and prevent recurrence of injury.
Resistence Exercises:
Exercise #1 - TERMINAL KNEE EXTENSION
Exercise #2 - LYING HIP EXTENSION
Exercise #3 - FRONT LEG EXTENSION
Exercise #4 - LYING KNEE EXTENSION
Exercise #5 - LYING GLUTE EXTENSION
Exercise #6 - STORK STANCE TKE
🔹🔹🔹Plyometric exercises🔹🔹🔹
⚡🔋Modalities🔋⚡
⚙TENS
⚙Infrared radiation
⚙Ultrasound therapy
⚙Acupuncture
💢Orthotics: Special shoe inserts stabilize and align your foot and ankle. Better alignment takes stress off your lower leg and knee.
💊💉Medicine: During this time it is also advisable to take a nonsteroidal anti-inflammatory OTC drug like ibuprofen or naproxen for the pain.
🍅🍒🍓🥦🍍Foods: During RICE, eat specific kinds of anti-inflammatory food, such as broccoli, spinach, and tomato, green tea, olive oil, pineapple, salmon, berries, whole grains, oily fish, and walnuts/pecans.
