Full Answer
What is the best treatment for patellofemoral pain?
Treatment. Treatment of patellofemoral pain often begins with simple measures. Rest your knee as much as possible. Avoid or modify activities that increase the pain, such as climbing stairs, kneeling or squatting.
Is patellofemoral pain associated with anterior knee pain in athletes?
DOI: 10.2147/OAJSM.S133406 Abstract Patellofemoral pain (PFP) is a frequent cause of anterior knee pain in athletes, which affects patients with and without structural patellofemoral joint (PFJ) damage.
What are patellofemoral pain exercises?
The aim of patellofemoral pain exercises is encourage normal patella tracking. In particular, to strengthen the muscles on the inside of the knee (vastus medialis obliques), as well as the gluteus medius muscle on the outside of the hip. This exercise is more suitable if you have pain and are unable to perform standing exercises.
What is the first line of treatment for patellofemoral syndrome (PFPS)?
Conservative management, including optimizing muscle balance between the vastus medialis and lateralis around the patella along with formal therapy should be the first line of treatment in patients presenting with PFPS. Surgery should be reserved for patients in which all conservative management options have failed.
What is the best treatment for patellofemoral pain syndrome?
The best way to treat patellofemoral pain syndrome is to rest and avoid activities that cause pain. Ice and anti-inflammatory drugs such as ibuprofen can be used to treat any swelling or pain that may occur. Targeted physical therapy and strengthening exercises will also facilitate recovery.
What are two treatments for patellofemoral syndrome?
Because patellofemoral syndrome often results from overuse and overactivity, resting the affected joint can often help treat the underlying problem. Try these treatment options: Practice the RICE method (rest, ice, compression, and elevation).
How do you prevent patellofemoral pain syndrome?
Can patellofemoral pain syndrome (PFPS) be prevented?Maintaining a healthy weight.Wearing appropriate shoes for your activities.Stretching and warming up before activity.Increasing athletic training intensity gradually.Avoiding activities that hurt your knee in the past.
How does physical therapy help with patellofemoral?
Coordination training. Based on your activity level, your physical therapist may help retrain your hip and knee movement patterns to reduce your knee pain. This type of training is effective for athletes, in particular, and may focus on movements like: Stair climbing.
Can patellofemoral pain syndrome be cured?
This is a book-length tutorial covering every aspect of patellofemoral pain: the nature of the beast (etiology), diagnosis and related conditions, prognosis and worst case scenarios, and more than two dozen reviews of PFPS treatment options. It concludes with plenty of specific advice, but there are no miracle cures.
Can you play sports with patellofemoral pain syndrome?
Athletes with patellofemoral pain syndrome usually participate in running or jumping sports such as basketball, volleyball, track, or cross-country, and the pain often comes on when there has been a recent increase in training intensity or volume.
How do you prevent knee injuries?
Prevention TipsAlways take time to warm up before physical activity and cool down afterwards.Keep your leg muscles strong with regular exercise.Avoid any sudden changes in the intensity of your workout. ... Replace worn out shoes regularly. ... Wear knee guards, as needed.
How do you treat a knee injury?
Self-care measures for an injured knee include:Rest. Take a break from your normal activities to reduce repetitive strain on your knee, give the injury time to heal and help prevent further damage. ... Ice. Ice reduces both pain and inflammation. ... Heat. ... Compression. ... Elevation.
Does a knee brace help with patellofemoral pain syndrome?
There are a variety of knee braces, arch supports, knee sleeves, knee straps, and kinetic tape on the market that help treat patellofemoral pain syndrome. Wearing a knee brace is a great way to stabilize your kneecap, alleviate patellofemoral pain, and protect against movements that might cause more damage.
What is patellofemoral joint pain?
Overview. Patellofemoral (puh-tel-o-FEM-uh-rul) pain syndrome is pain at the front of your knee, around your kneecap (patella). Sometimes called "runner's knee," it's more common in people who participate in sports that involve running and jumping.
Where is pain in patellofemoral?
Symptoms. The most common symptom of PFPS is a dull, aching pain in the front of the knee. This pain—which usually begins gradually and is frequently activity-related—may be present in one or both knees.
Can I still exercise with patellofemoral syndrome?
If you want to keep exercising, try swimming or another low-impact activity. You may want to try the AlterG Anti-Gravity Treadmill. The AlterG can reduce your body weight by up to 80%, reducing the load on your knees. As your knees feel better, you can slowly go back to your normal sports.
How to treat patellofemoral pain?
One of the most effective techniques for treating Patellofemoral Pain Syndrome is eccentric training. Ecce ntric training refers to performing exercise with a slow, controlled motion while returning to the starting position. One of the most effective ways to train eccentrically is with the BTE Eccentron.
Is patellofemoral pain a common condition?
In conclusion, Patellofemoral Pain Syndrome is a common condition with a complex background and many treatment options. Using exercise to treat PFPS is becoming common practice, but specific parameters for optimal treatment are still being developed. For more information about treating and preventing knee pain, check out these other resources from TherapySpark:
What is the aim of patellofemoral pain syndrome exercises?
Aim of Patellofemoral pain syndrome exercises. The aim of Patellofemoral pain syndrome exercises is to correct tracking of the patella as the knee bends. Most commonly the patella tracks outwards (laterally) so the muscles on the inside of the thigh need strengthening.
What exercises are used to relieve patellofemoral pain?
Stretching exercises for Patellofemoral pain. The tight structures of the knee such as the lateral retinaculum need to be stretched and mobilized.
How to strengthen the vastus medialis muscle?
Place your hand on your vastus medialis muscle (just above and to the inside of the knee cap). This is so you can feel it contracting. It is essential you learn to isolate the vastus medialis muscle (VMO) and feel it working for strengthening to be effective. Turning the foot outwards may increase the load on the VMO.
How to get the Gluteus Medius muscle?
Lay on your side with the knees bent to 90 degrees and feet in line with your spine. Lift the top knee away from the bottom knee. Make sure you keep the lower back and pelvis still and don’t rock backwards. You should start to feel the Gluteus Medius muscle at the back, top of the hip working. Start with 2 sets of 10 repetitions and gradually increase to 3 sets of 15-20.
How to strengthen VMO?
Contact the muscles, hold for 3 to 5 seconds, relax and repeat 10 times. Your foot should lift up off the floor as your knee straightens. This exercises should be performed 3 to 5 times a day if pain allows. More on VMO strengthening.
How to get rid of a swollen vastus medialis?
This exercise should be started as soon as pain will allow. Tape the knee if necessary to avoid pain. Stand one foot in front of the other, the injured knee forwards. Bend the front knee enough to feel the vastus medialis is working. Aim to keep the knee pointing forwards – don’t let it fall inwards.
What exercise is best for knee pain?
Isometric quadriceps. This exercise is more suitable if you have pain and are unable to perform standing exercises. Sit on the floor with a foam roller or rolled-up towel under the knee so that it is slightly bent. Place your hand on your vastus medialis muscle (just above and to the inside of the knee cap).
What muscles are used to treat PFP?
7 Exercises to treat PFP should target the muscles of the hip, knee (quadriceps and hamstrings), trunk, and the iliotibial tract ( Figure 5 ). Figure 5 Exercise for hip abductors.
What is the role of muscular imbalances in PFP?
1 Many previous studies have focused on dysfunction of vastus medialis muscle and vastus lateralis muscle in PFP patients because these muscles attach directly to the patella. 31 – 33 These studies have shown that an imbalance in the activation of m. vastus medialis obliquus and m. vastus lateral is correlates with lateral patellar tracking in PFP patients. 31 – 33
What is nonsurgical treatment for PFP?
Nonsurgical therapy is the treatment of choice for PFPS in young patients. 7 Kettunen et al 64 performed a prospective, randomized trial to compare the outcome of arthroscopy combined with a home exercise program versus a home exercise program alone in patients with PFPS. Patients included in their study were between 18 and 40 years old and had persistent (>6 months) symptoms of PFP during jumping, running, squatting, or while going up or downstairs. 64 Exclusion criteria were OA, patellar instability, osteochondritis dissecans, and jumper’s knee. 64 The following procedures were performed arthroscopically: resection of the medial plicae, debridement of chondral lesions, partial synovectomy, and lateral release. 64 Fifty-six patients were included in the study and were randomized either to the arthroscopy plus exercise or to the exercise-only group. 64 The mean postintervention improvements in the Kujala knee score and VAS scale score for ascending and descending stairs were greater in the arthroscopy group than in the exercise-only group; 64 however, these differences were not statistically significant. 64 The health care costs for patients in the arthroscopy group were significantly higher than the costs for patients in the control group. The results of this study must be considered with caution because only 56 patients were included and thus the study might be underpowered. 64 With a larger patient population, the observed differences in the clinical scores probably would have been significant. 64 More criticism of this study includes the heterogeneity of the arthroscopic procedures that were actually performed (11 patients had no arthroscopic treatment, 11 patients underwent cartilage shaving, 5 patients underwent plica resection, 1 lateral release, and 2 partial meniscectomies). Only one patient had a grade IV cartilage defect, and all grade III cartilage defects were treated with debridement; thus, the results of this study are not valid for patients with severe cartilage defects. Severe cartilage defects may indicate that cartilage resurfacing procedures such as matrix-augmented chondrogenesis (AMIC) or autologous chondrocyte implantation (ACI) are required. The results of this prospective, randomized trial suggest that arthroscopy might not be the best first-line treatment for patients with PFPS. However, it is likely that a subgroup of patients exists who would benefit from arthroscopic surgery. This subgroup could include patients with structural joint damage such as grade III or IV cartilage defects or with lateral subluxation of the patella. In a previous study, Kettunen et al 65 showed that among patients with PFPS, those with severe lesions of the patellar cartilage or femoral trochlea subjectively reported more symptoms and functional limitations at follow-up than those with no lesions or with small cartilage lesions of the patella or femoral trochlea.
What is PFP pain?
Patellofemoral pain (PFP) is the accepted term for localized pain of the anterior aspect of the knee. 1, 2 The prevalence of PFP is high; 1, 2 it affects 11–17% of patients who present to general practitioners. 1, 2 PFP is typically associated with activities that load the patella, such as ascending or descending stairs, jumping, running, and squatting. 1 – 4 Other symptoms often associated with PFP are crepitus and mild/moderate joint effusion. 1
What is PFP in sports?
Abstract: Patellofemoral pain (PFP) is a frequent cause of anterior knee pain in athletes, which affects patients with and without structural patellofemoral joint (PFJ) damage. Most younger patients do not have any structural changes to the PFJ, such as an increased Q angle and a cartilage damage.
What is the best treatment for PFP?
Most authors agree that exercise therapy is the treatment of choice for patients with PFP. 2, 74 Exercise has been the most well-studied form of PFPS therapy and should aim to correct the dynamic valgus malalignment that occurs in many patients. 7 Five recently published systematic reviews concluded that exercise had a positive effect on pain and function in patients with PFP. 75 – 79 The most effective intervention programs included exercises targeting the hip external rotator and abductor muscles and knee extensor muscles. However, positive results have also been described for exercises that target only muscles acting on the knee and hip. 75 – 79 One study showed a positive effect of trunk stabilization exercises, which targeted core muscles such as the rectus abdominis. The results of previous studies suggest that, if knee and hip exercises are recommended, then the patient should begin with the more proximal exercises because they have greater benefit and may cause fewer adverse effects. 2, 74
Where does pain originate from PFP?
Most likely the pain develops in the insertions of the extensor muscles or within the subchondral bone. 7 In an experimental arthroscopy performed using local skin anesthesia, a patient experienced strong pain when the probe touched their retinacula, Hoffas fat pad, or peripatellar synovium. 62 Several neurotransmitters, including substance P, neurofilament protein, S-100 protein, and neural growth factor, have been found within these structures. 63, 64 These findings suggest that retinacular innervation may play a key role in the development of anterior knee pain. However, there is also evidence that the pain may also originate in the subchondral bone; a PET CT study demonstrated increased metabolic bone activity in patients with PFP. 65