How your bum can make your knee sore!
By Sarah Forsyth Physiotherapist at GSSC
Patellofemoral joint pain (PFJP) is the most common running overuse injury. It is usually identified by pain around the kneecap (patella) at the front of your knee. Known to some people as runner’s knee it is a condition that can be managed with an appropriate rehab program. This should be commenced as early as possible, as the longer the duration and the greater severity of PFJP results in a poorer recovery prognosis.
PFJP is diagnosed by several indicators and tests including widespread general knee pain around the kneecap. It is commonly aggravated by bending the knee when running, stair use, jumping and squatting* and is often complemented by swelling and or creaking around the knee.
Exercise is the best treatment for PFJP. Who would have thought?! This has been shown to reduce pain and symptoms in the short-term term as well as improving function in the long-term **.
Rehab encompasses knee and hip motor control, and strength work in combination with ankle/foot mobility and strength. Strengthening the surrounding structures and muscles of the knee, addressing imbalances and correcting technique enables load to be taken off the knee joint and as a result decrease knee your knee pain.#
It is important during all forms of running and through all the strengthening exercises throughout rehab that the pelvis stays even across both sides and the opposite hip does not drop. Using a mirror may help provide feedback about hip, knee and ankle joint positions.
Overall, PFJP is often experienced due to a load too high for the knee joint to handle. Individuals often feel they need to treat only their knee and can over emphasise quads in the gym by performing exercises such as leg extension. However, this commonly will only exacerbate the knee pain as it can grind out the joint. Furthermore, without addressing any underlying issues that have caused the knee pain in areas such as the hip and foot, the condition is unlikely to resolve.
Some exercises are shown below for the management of PFJP:
- Calf raises –Double leg, single leg or smith machine single leg
- Knee to wall – You should be able to get approximately 10cm away from the wall, keeping your heel on the ground.
- Clam/ Crab walks
- Glute bridge – Double leg bridge, single leg bridge, double leg hip thrust, single leg hip thrust
- Correct Squat technique
- Step up
For more advice and treatment on PFJP and knee pain come and visit one of our physiotherapists at Glenferrie Sports and Spinal Clinic in Hawthorn. We will have you back on your feet running with a specific and targeted exercise program in combination with manual therapy.
#Barton, C., Lack, S., Hemmings, S., Tufail, S., & Morrissey, D. (2015). The ‘best practice guide to conservative management of patellofemoral pain’: Incorporating level 1 evidence with expert clinical reasoning. British Journal of Sports Medicine, 49, 923–934. doi:10.1136/bjsports-2014-093637
*Crossley, K., Stefanik, J., Selfe, J., Collins, N., Davis, I., Powers, C., . . . Callaghan, M. (2016). 2016 patellofemoral pain consensus statement from the 4th international patellofemoral pain research retreat, manchester. Part 1: Terminology, definitions, clinical examination, natural history, patellofemoral osteoarthritis and patient- reported outcome measures. British Journal of Sports Medicine, 50(14), 839-843. doi:10.1136/bjsports-2016-096384
**Crossley, K., Van Middelkoop, M., Callaghan, M., Collins, N., Rathleff, M., & Barton, C. (2016). 2016 patellofemoral pain consensus statement from the 4th international patellofemoral pain research retreat, manchester. Part 2: Recommended physical interventions (exercise, taping, bracing, foot orthoses and combined interventions). British Journal of Sports Medicine, 50(14), 844-852. doi:10.1136/ bjsports-2016-096268
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