Injury of the Week # 3: Patellofemoral Pain Syndrome (PFPS)

Patellofemoral Pain Syndrome (PFPS)

What is it?

An overuse injury resulting in anterior knee pain (pain around the front of the knee) consisting of dull achy pain with physical activity.

When do you notice the pain?

PFPS commonly presents as achy pain around along the front of the knee with movement such as in a squat, walking down the stairs and running. It can also hurt when sitting for long periods of time.

Where does it hurt?

It hurts along the front of the knee and around the knee cap (patella).

How does it happen?

PFPS often results from poor patellar tracking (the knee cap not moving properly with movement), which can result from tight quads, IT Band, hamstrings and glutes. Also there is commonly an imbalance between the medial quad and lateral quad muscles (most often a weak VMO—medial quad muscle and a tight lateral quad muscle). Also poor arch support can play a role in onset of PFPS.

How can I help it go away?

A compression sleeve may help alleviate symptoms of PFPS during physical activity as well as proper footwear/arch support. But most importantly appropriate therapeutic exercises and stretches will help for long term management! Stay tuned

#kneepain #PFPS #patellofemoralpainsyndrome #kneebrace #athletictherapy #runnersknee #rehab #therapeuticex


Foam rolling the quads!

This is a fun one (you may question my definition of fun)!

I love using the foam roller, and the quads can become SO tight with the activities we do. Tight quads can put a lot of pressure on the knee and its important to keep the quads flexible to alleviate and prevent knee pain.

Foam rolling allows you to do a self-myofascial release. Myo=muscle & fascia=connective tissue, so myofascia = connective tissue around our muscles. Our fascia can become very tight and I like to foam roll first prior to stretching, to help release some of the fascial adhesions first.

You can foam roll the quads either both at a time (less intense) or foam roll one at a time (more intense). Try and roll the entire length of the quad (don’t get caught just doing a small section in the middle!) Aim for 10 passes of each quad. If it’s too painful, use a softer foam roller and do both legs at the same time to start. Foam rolling gets easier the more you do it, so practice makes perfect!


Monster Walk

With the mini (looped) band around your ankles and a soft bend in the knees, you will step side to side. Make sure there is tension in the band throughout the entire movement. If you start to feel the burn in your quads, you may be too much in a squat position and just stand up a little higher.

Working into the endurance phase for this exercise is key, especially if you are a runner or an endurance athlete. You want to work these glutes to fatigue to help you in your respective sports. As soon as your form breaks down, that is an indication to stop. But I recommend starting at 40 steps total and gradually increase to 100 if you can! (I try and go up by 20 steps per week). Find a space in your house and just go back and forth! You should (and will) feel a burn in the glutes.

Also make sure the band you use isn’t too hard, if there is a lot of resistance in the band you likely will be using other muscles (besides the glutes) to get moving. Less  resistance (at first) is better, feel free to increase the resistance as this exercise gets easier.

#gluteexercise #PFPS #prehabtues #runninginjury #therapeuticexercise #triathlon #womanstri #glutes #kneeinjury #kneepain #athletictherapy


Clam Shells

The glutes play a big role when it comes to knee pain: either tight, weak or BOTH! You want to make sure you can activate one glute at a time so that you can use the glutes properly in your daily activities (and that other structures aren’t taking this load instead).

Glute Activation: Try laying on your stomach and squeezing both glutes together. Then try squeezing one glute at a time. MAKE SURE the opposite glute isn’t firing when you do this. This can be very challenging! This is the first step to ensure you are properly firing your glutes and then progressing to more functional exercises.

Clam shells are a good exercise to start with if you are experiencing PFPS. Although clams aren’t the most functional exercise, this will bridge the gap between glute firing and more functional movements (monster walks, squats etc.)

Lay on your side with your knees bent. Roll the hips forward and place your hand on your top hip. Keep the ankles together and when you squeeze the top glute, raise the knee a few inches, lower back down and repeat. If your hips roll back during this movement you have gone too far with the knee. Less is more here! Eventually you should feel a burn in that top glute. The goal would be 3 sets of 20 reps. If your form breaks down prior to reaching 3 sets of 20, then stop where you are and gradually build up your endurance.


As is the theme of the week with PFPS: GLUTES!

Here are some good exercises to help strengthen the glutes and quads to help alleviate and prevent PFPS:

  1. Bridge: 2 or 1 leg: dig with the heel(s) and raise the glutes up. Keep your hips level. Start with 2 legs, once this gets easy progress to the 1 leg bridge. Hold 3-5 seconds, lower and repeat
  2. Squat: Make sure your squat is pain-free! If its sore, squat into a pain-free range of motion. Make sure you sit your butt back and can see your toes throughout the entire movement. Squeeze your glutes at the top of the movement.
  3. Side Step Up: Dig your heel into the step and straighten your leg and lower back down to ground. Your knee may want to cave inwards but don’t let this happen!
  4. Eccentric Step down: with one foot fully on the step, take your opposite leg and slowly lower it to the ground until you barely tap the ground with your toes and raise back up. This is a challenging quad exercise and again your knee may want to cave inwards but try and keep it straight!

As per my plantar fasciitis injury of the week, the squat is an effective exercise that I prescribe for a lot of lower body injuries! It is an exercise you should master!

This is a challenging circuit you implement into an existing workout or do this on its own! You can do 3 sets of 10-15 per exercise

If you are experiencing symptoms similar to patellofemoral pain syndrome, feel free to book in a virtual Athletic Therapy session!

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