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Patellofemoral pain (knee cap pain)

What is Patellofemoral Pain?

The patellofemoral joint is part of the knee joint, where the kneecap (patella) sits within its groove (trochlea) on the front of the thigh bone (femur). Patellofemoral pain (PFP) is a condition where the pain is felt on the front of the knee, either around or behind the patella. This pain is felt with activities including squatting, running, jumping and going up or downstairs. This condition can affect people at any age.

What causes patellofemoral pain?

Patellofemoral pain can be caused by the following:

  • Change in knee loading
  • Due to an injury or surgery
  • There may be no particular trigger or injury that causes the pain

People may have contributing factors to the condition such as:

  • Patellar instability –  If you have sustained dislocations to the patella it can lead to pain and ongoing instability. This will need to be managed correctly.
  • Patellofemoral osteoarthritis
  • Variations in bony anatomy
  • Weakness in the hip/buttock (gluteal) muscles – Poor alignment of the leg and knee, or excessive tightness of other thigh muscles can cause stress on the joint.
  • Weakness of the front of thigh (quadriceps) muscles – Caused by the patella not gliding centrally within its groove, leading to areas of increased pressure or friction within the joint.

How do I know if I have patellofemoral pain?

You may have patellofemoral pain if you experience pain around or behind the patella, or pain that is made worse by at least one activity involving a bent knee and body weight on the leg. Scans are not used to diagnose this condition. Symptoms include:

  • Front of knee pain whilst sitting etc.
  • Grinding sensations when bending knee
  • Mild knee swelling
  • Tenderness when touching the back of your knee

How can physiotherapy help with patellofemoral pain?

It is vital that you receive an accurate diagnosis so that your physiotherapist can give you the best treatment plan for your condition. Treatments for patellofemoral pain include:

  • Education – Your physiotherapist can give you information so that you understand your condition, this will ensure you   to have realistic expectations of rehabilitation, to manage their activity appropriately, and to actively participate in their treatment
  • Individually tailored treatment – This type of treatment will take into consideration the individual person and contributing factors which then a plan will be created including exercise, education, taping and moulded shoe inserts.
  • Exercise – Different types of exercises will be used to help strengthen surrounding muscles.
  • Taping/Bracing – This can help immediately reduce pain in the patella.
  • Shoe inserts (foot orthoses) – This may reduce pain in the short-term
  • Manual therapy –Massage or dry needling

What can I do at home?

It is important that you understand your condition to properly manage your symptoms and activity levels. Once you have been diagnosed with PFP there are a few important things to consider in terms of home management. It is vital that you slowly introduce activities to ensure that you do not cause flare-ups. Short term, you should reduce activities that cause you pain this will allow your condition to settle. Prescribed exercises should be completed as often as your physiotherapist has requested.  You may be asked to tape your patella, your physiotherapist can show you how to do this.

How long will my recovery be?

It has been proven that this condition is not something that will disappear on its own, where people may have on and off periods of pain for years. Furthermore, to ensure you receive the best possible recovery it is important to understand your condition, your individual contributing factors and what you can do as well as listen to the guidance of your physiotherapist. It is possible that an ongoing exercise program can help build and maintain muscle strength, and good movement coordination.

If you would like to find out more please call us or book an appointment here.

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Reference: Australian Physiotherapy Association 2019, Your Body, viewed 19 November 2019, < https://australian.physio/>.