Welcome back everyone to another week here at ARC Therapy’s blog section. For this week, we are going to be talking about a very common issue present among those who go for daily walks, to your weekend warriors, and your younger athletes. We will be covering patellofemoral pain, or that pain you may feel around or under your knee cap; how to accurately diagnose it, and effectively treat it. As always, we will provide videos at the end of the post to help explain and demonstrate some home exercises you can utilize to treat your pain. And of course, this information is intended for general ideas and not specific to individual needs. For a more specific evaluation and treatment, please come by and see us here in the clinic (YES, WE ARE OPEN), or consult another physical therapist in your area.
Patellofemoral pain can present with pain along the front of your knee near your knee cap. You may experience pain around the knee cap, or in some instances, even under your knee cap. Your physical therapist will help diagnose your condition by placing your symptoms into 4 different subgroups: overuse, muscle performance deficit, movement coordination deficits, and mobility deficits. A proper diagnosis is usually made during examination if you present with pain around the knee cap, pain with squatting, stairs, or prolonged sitting, and after ruling out all other possible pathologies. We will briefly talk about each to give a background understanding of which category you may fall into which will help guide the treatment.
The overuse subgroup are those individuals that may develop knee pain due to a sudden increase in activity levels. The increase in activities may be too quick for the body to respond and adapt; therefore, leading to tissue inflammation and break down. These patients tend to do better with pain relieving modalities and activity modification. The muscular performance deficit group tends to be those who develop knee pain because of some hip deficits which cause abnormal tracking of the patella with movement. As you bend and straighten your knee, the patella will slide and glide up and down like a train on a track. In this instance, you may have a muscle that is acting as too tight or weak that may cause the patella to get off track. These patients generally do well with resistive hip and knee exercise. The movement coordination deficit group characterizes those individuals who may not demonstrate hip or knee weakness; however, when tasked to perform a dynamic movement such as a squat, they lack the coordination to perform the movement with proper mechanics. This is usually indicated during the exam when we ask you to perform a squat, we will notice your knees may turn inward, causing an awkward angle on the knee and associated pain. These folks tend to respond well with neuromuscular re-education and gait training exercises to retrain proper movement patterns. The last subgroup is those with mobility deficits of the patellofemoral joint. These folks will present with a stiff knee cap and generally do well with certain mobilizations to help stretch the joint. We will discuss some strengthening and stretching exercises and provide some video demonstrations on our blog and YouTube channel for your review at any time.
Research has shown non weight bearing versus weight bearing exercise are no different in short- or long-term outcomes. We will discuss resisted hip and knee strengthening exercises both in weight bearing and non-weight bearing positions in the videos posted below. We will also briefly discuss recommendations for foot orthoses that can help reduce excessive foot pronation which can reduce knee pain.
Thanks again for tuning in, we hope this information and exercises provided help in some capacity; and of course, for a more specific and detailed evaluation/exercise program, come see us down at the clinic. Check back in soon for our next post! Be safe and well!