Have you experienced pain in the front of your knee with walking, running, squatting, going up and down stairs, or other activities? Pain in the front (anterior) knee is often diagnosed as Patellofemoral Pain Syndrome. Patellofemoral pain (PFP) can occur across the life span, from young children to older adults, however it is found to be most common between 12 and 19 years of age and 50 - 59 years of age. There are varying reports of prevalence, but idiopathic (no known cause) PFP is most commonly noted as having a prevalence of about 25% of the population. This pain is typically described as a nagging ache or a sharp twinge.

Treatment for PFP can vary depending upon your individual goals and preferences, but recently updated guidelines were released for evidence based care of PFP that looked at 271 of the best research articles in order to determine the best advice and guidelines for management of PFP. The following is a list of recommendations made (and a bit of our own advice as well!)

1) The best treatment is a combined program of hip and knee strengthening exercises. The addition of hip strengthening showed better outcomes than knee strengthening alone. The hip joint often drives what is happening at the knee, therefore if we can build strength and stability there, we can improve control in our knee joint. We strongly encourage you to have an individualized assessment in order to determine the best exercise progression to address any deficits in strength at the hip and knee joints!

2) Off-the-shelf shoe inserts might be helpful to manage pain for the first 6 weeks when combined with exercises such as squats. Take note of a couple of things about the previous sentence - first, they note that off-the-shelf shoe inserts can be helpful. This means you likely don’t need to invest in expensive, custom orthotics for PFP! Also note that they determined these inserts were only helpful for the first 6 weeks. You should also be building strength in your foot so that you don’t need support from an insert or orthotic long term. Finally, shoe inserts should not be the only treatment. These inserts need to be combined with exercise (such as squatting - YES, SQUATTING for knee pain!!) for the best results.

3) Taping the painful kneecap, in combination with exercises, may help some people manage kneecap pain and get back to their normal activities in the first 4 weeks of therapy. Again, note that they are recommending taping be combined with exercises. It is a technique that can help with pain management short term but in order to get long term relief, exercise is key!

If pain in your kneecap is preventing you from squatting, running, walking, or any other daily activity, it’s time to have an individualized assessment to determine the best plan of care for YOU to get back to the things you love. Questions? Contact us! info@absolutekineticspt.com.

References:

Willy, R., Hoglund, L., Barton, C., Bolgla, L., Scalzitti, D., Logerstedt, D., Lynch, A., Snyder-Mackler, L., McDonough, C. (2019). Patellofemoral Pain: Clinical Practice Guidelines Linked to the International Classification of Functioning, Disability and Health From the Academy of Orthopaedic Physical Therapy of the American Physical Therapy Association. J Orthop Sports Phys Ther. 2019;49(9):CPG1-CPG95. Doi:10.2519/jospt.2019.0302.

Blog post written by Dr. Alexis Hutchison, PT, DPT, OCS