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Battling Patellofemoral Pain: A Physio's Perspective to Diagnosis and Treatment.






Today I want to dive into a topic that many active individuals might be familiar with but often dread, Patellofemoral Pain Syndrome, or PFPS for short. If you've ever experienced that nagging ache around your kneecap during or after physical activity, you might just be well acquainted with this condition.


Definition & Diagnosis:


So, what exactly is PFPS? Well, in simple terms, it's like a grumpy neighbour living around your kneecap. It's characterised by pain and discomfort in the front of the knee, especially around the area where the kneecap (patella) meets the thigh bone (femur). Whether you're a seasoned athlete, a fitness enthusiast, or just someone who enjoys the occasional stroll, PFPS can put a damper on your activities.


Now, let's talk about the important stuff: how do you diagnose this culprit? Cue the physiotherapist! Us wizards of the body have a keen eye for spotting PFPS and devising a game plan to tackle it head-on. During your visit, we'll likely start by asking about your symptoms and when they tend to flare up. Then comes the fun part – the physical examination.


One of the hallmark tests for PFPS is called the "patellar grind test." No, it's not as intense as it sounds! Your physio will gently press on your kneecap while you gently contract your quadriceps muscles. If this elicits some discomfort or that familiar ache, it could be a sign that PFPS is crashing your knee party (1).


But wait, there's a lot more! Your physio might also check your lower limb alignment, muscle strength, flexibility & complete other special tests to get the full picture.



Now, onto the good stuff – treatment options:


1. Exercise Prescription: Your physio will likely whip up a personalised exercise program aimed at strengthening the muscles around your knee, especially your quadriceps and hips. These exercises can help improve stability and reduce stress on the patellofemoral joint (2).


2. Manual Therapy: Hands-on techniques like massage, joint mobilisations, and stretching can work wonders in easing tight muscles and improving joint mobility (3).


3. Activity Modification: It might be time to give your knee a breather from activities that aggravate your symptoms. Your physio can help you tweak your routine to minimise pain while still staying active.


4. Education and Self-Management: Knowledge is power! Your physio will arm you with tips and tricks to manage your symptoms and prevent future flare-ups. From proper warm-ups to ergonomic tweaks, a little know-how can go a long way (4).



Remember, tackling PFPS is like embarking on a journey – it takes time, patience, and a dash of determination. With the guidance of your trusty physiotherapist and a sprinkle of self-care, you'll be well on your way to kicking PFPS to the curb and reclaiming your knee's happiness.


Our Barnet, Cockfosters & Enfield Physio's have tons of experience in dealing with all types of knee pain. Have confidence that our specialist Physiotherapists will closely assess, diagnose & treat you in the correct & evidence-based way for all injuries. You can book an appointment here.



Blog By: Emre Oz (Musculoskeletal Physiotherapist at Crouch Physio).




References:


1. Crossley, K. M., Callaghan, M. J., & Linschoten, R. V. (2016). Patellofemoral pain. BMJ Clinical Evidence, 2016, 1111.


2. Van der Heijden, R.A., Lankhorst, N.E., Van Linschoten, R., Bierma-Zeinstra, S.M. and Van Middelkoop, M., 2016. Exercise for treating patellofemoral pain syndrome: an abridged version of Cochrane systematic review. Eur J Phys Rehabil Med, 52(1), pp.110-33.


3. Eckenrode, B.J., Kietrys, D.M. and Parrott, J.S., 2018. Effectiveness of manual therapy for pain and self-reported function in individuals with patellofemoral pain: systematic review and meta-analysis. journal of orthopaedic & sports physical therapy, 48(5), pp.358-371.


4. De Oliveira Silva, D., Pazzinatto, M.F., Rathleff, M.S., Holden, S., Bell, E., Azevedo, F. and Barton, C., 2020. Patient education for patellofemoral pain: a systematic review. journal of orthopaedic & sports physical therapy, 50(7), pp.388-396.

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