Dealing With Patellofemoral Pain Syndrome

Patellofemoral Pain Syndrome

Did your New Year’s Resolutions include running, but not pain? Unfortunately, running can come with patellofemoral pain, commonly known as runner’s knee. This condition can worsen by overtraining, running in poor shoes, and not cross-training to build up other muscles in the legs. Here’s what you should know about runner’s knee and how to keep your exercise pain-free.

What Is Patellofemoral Pain Syndrome (PFPS)?

The patella (kneecap) is the bone in the front of the knee joint that connects to the lower part of the thigh. Patellofemoral pain syndrome, also known as runner’s knee, commonly causes dull pain in the front of the knee around the patella. In a healthy knee, the patella slides up and down the end of the femur (thigh bone) in a natural groove. Knee movement is supported by quadriceps (thigh muscles), ligaments, and cartilage. Patellofemoral pain syndrome happens when the patella and the femur create friction because they aren’t moving smoothly along that groove. Runner’s knee is most often caused by a defect or pre-existing condition that upsets the smooth mechanism of the knee joint, but there are other causes as well.

While running and jumping are everyday activities associated with patellofemoral pain syndrome, you don’t have to participate in these activities to have knee pain. In other words, you don’t have to be a runner to have runner’s knee.

Patellofemoral Pain Causes

Other than an underlying condition or defect in the knee structure, patellofemoral knee pain can be triggered by:

  1. Excessive training and overuse
  2. An injury or trauma to the knee or the supporting tissue around it
  3. Misalignment of the patella
  4. Weak hip or thigh muscles
  5. Walking or running in a nontraditional way, like being “pigeon-toed” or “knock-kneed.”
  6. Tight tendons and ligaments
  7. Poor foot support

How Is Patellofemoral Pain Syndrome Diagnosed?

The symptoms of patellofemoral pain syndrome mimic many knee-related conditions, so a diagnosis is best left to your doctor. Your physician will take a medical history and do a physical exam. Your doctor may also check for damage to the bones with an x-ray of the area.

Symptoms of Patellofemoral Pain Syndrome

You will need to tell your doctor about the activities you participate in, especially those that cause a dull ache in the anterior (front) of your knee. Other common symptoms of runner’s knee include:

  1. Dull pain around the kneecap when active or after sitting for long periods with your knees bent.
  2. The kneecap is tender or painful when touched.
  3. A clicking or grinding sound when the knee is engaged.
  4. The pain increases when walking on a slant.

Treatment for Patellofemoral Pain Syndrome

Mild and moderate PFPS is an easily treatable condition. The first step is the R.I.C.E. method (always follow the treatment prescribed by your doctor!)

  1. Rest and protect your knee from further injury by stopping any activity that causes pain and keeping weight off the knee.
  2. Ice your knee. Cold reduces swelling and pain. Do not place ice directly on your skin. Instead, place a towel between you and the ice pack. Ice the affected area for between 10 and 15 minutes multiple times a day.
  3. Compression (wrapping the injured knee) can help reduce pain and swelling while supporting the patella and surrounding areas as you heal. Wrap your knee lightly, above and below the kneecap, leaving the kneecap itself uncovered. Make sure you don’t wrap too tightly, or you will reduce circulation to the injury. Do not wrap your knee in a way that causes more pain.
  4. Elevate your leg. While you rest and ice, keep your knee propped up on pillows or something similar. You can reduce swelling by keeping the knee at or above the level of your heart.
  5. Medications

    You may also be prescribed nonsteroidal anti-inflammatory drugs (NSAIDs) to help reduce pain and swelling. Aleve (naproxen) and Advil (ibuprofen) are examples of these over-the-counter medications. Your doctor will likely recommend simple stretching and strengthening exercises to help heal the area. Remember to follow your doctor’s medicinal and movement instructions carefully.

    Additional Treatment

    If your chronic runner’s knee doesn’t improve after using the R.I.C.E. method, your doctor may prescribe additional treatments. Usually, your doctor will want a better idea of the damage done to soft tissue, so they may require an MRI of the area. An MRI (magnetic resonance imaging) is an imaging method that gets a clearer picture of the soft tissue of the knee. Depending on the diagnosis, your runner’s knee may require special orthotics like arch supports, physical therapy, or possibly surgery.

    Can I Prevent or Avoid Runner’s Knee?

    Assuming there are no underlying medical conditions or defects to the knee structure, there are ways to help prevent and avoid knee pain and patellofemoral pain syndrome.

    Strengthen Supporting Muscles

    Cross-train to strengthen your legs, hips, and core. The outer hip muscles keep your knee from caving backward. A strong body will help keep your body aligned and your knees supported.

    Less Weight

    Maintain a healthy weight. Less pressure on the knees keeps the structures aligned and in balance.

    Get Better Shoes

    It’s said that anything that comes between you and the ground is worth the money, and it is especially true for athletic shoes. You can help avoid runner’s knee by getting shoes with proper arch supports that are comfortable, fit well, and provide ample shock absorption.

    Warm-Up and Stretch

    Flexibility is just as important as strength in preventing injuries. Gentle stretching exercises help train your muscles and prepare you for intense activity.

    Increase Intensity Slowly

    Don’t return to activities that once caused PFPS, and gradually increase the intensity of your workout instead of suddenly changing your routine with new squats or jumps.

    Patellofemoral pain syndrome may be unpleasant, but it is usually only a minor inconvenience if treated right away. If you feel any debilitating pain in your knee, it is best to see a doctor. At MOSH, we have knee specialists that can help you get back to your active lifestyle. Contact us today for an appointment.