Patellofemoral Pain Syndrome (PFPS), also known as “runner’s knee” or “jumper’s knee,” is a common issue not only to physically active individuals, but also to those less active. Characterised by pain at the front of the knee and around the patella (knee cap), PFPS affects people from all walks of life, particularly young adults and females who are active in sports. 

The pain and stiffness associated with PFPS can significantly hinder everyday life, making it more than an inconvenience. The syndrome is often triggered by factors like misalignment of the kneecap or the rigorous demands of sports and training. This means proper knee care and preventive practices are a must. 

Fortunately, many find relief through treatment. Adjusting activity levels and booking an appointment with a professional physiotherapist can alleviate symptoms. At Benchmark Physio, we understand the nuances of PFPS and are dedicated to helping our clients navigate this condition with expert care and comprehensive support.

What Is Patellofemoral Pain Syndrome?

Patellofemoral Pain Syndrome (PFPS) is the name of a condition that describes pain in the front of the knee and around the kneecap, or patella. It’s often referred to as “runner’s knee”. 

The primary symptom of PFPS is a persistent pain that typically intensifies with activities such as running, jumping, climbing stairs, or prolonged sitting with bent knees. This pain is primarily due to the stress and friction between the kneecap and the lower part of the thigh bone, which can result from poor alignment of the kneecap, muscular imbalances, or overuse. 

Causes

PFPS can be caused by a variety of factors.

Overuse

Engaging in sports that involve repetitive running or jumping can place significant stress on the knee joint. This repeated strain often leads to irritation beneath the kneecap, manifesting as the pain characteristic of PFPS. Athletes participating in high-impact sports are particularly susceptible to developing this condition due to the constant pressure exerted on their knee joints.

Muscle Imbalances or Weaknesses

PFPS may also stem from imbalances or weaknesses in the muscles surrounding the hip and knee. These muscular discrepancies can fail to keep the kneecap properly aligned, leading to maltracking and increased stress on the knee joint. For instance, if the knee moves inward during activities like squatting, it can trigger or exacerbate patellofemoral pain.

Injury

Direct trauma to the kneecap, such as dislocation or fracture, is a common precursor to PFPS. Such injuries can alter the mechanics of the kneecap, making it more prone to misalignment and pain. Even after the initial injury has healed, the resulting structural changes can continue to affect kneecap movement and cause persistent pain.

Surgery

Surgical interventions on the knee, especially those involving the patellar tendon, such as anterior cruciate ligament (ACL) repair, can increase the likelihood of developing PFPS. The use of one’s own patellar tendon as a graft in knee surgery can alter the dynamics of knee function and contribute to patellofemoral stress and discomfort.

How to Prevent PFPS

Preventing Patellofemoral Pain Syndrome involves taking steps to reduce stress on your knees, ensuring they remain healthy and functional during all types of activities. Here are some practical strategies you can implement to minimise the risk of developing PFPS:

Maintain a Healthy Body Weight

Extra body weight can increase the load and stress on your knee joints during daily activities and exercise. Maintaining a healthy weight reduces this strain, thereby lowering the risk of knee pain.

Warm-Up Properly Before Physical Activity

Engaging in a thorough warm-up routine before any physical activity prepares your muscles and joints, including the knees, for the stresses of exercise. This can include light jogging or dynamic stretches that mimic the movements of the upcoming activity.

Stretch Regularly

Incorporating stretching into your routine both before and after physical activities can improve flexibility and reduce tension in the muscles supporting your knees. Focus on stretches that target the quadriceps, hamstrings, and calves, as tightness in these areas can contribute to kneecap misalignment and pain.

Increase Activity Levels Gradually

Whether you’re starting a new sport or intensifying your exercise regimen, it’s important to increase your activity levels gradually. Sudden increases in intensity or duration can overwhelm the knees, leading to injury and PFPS. Follow a progressive plan that allows your body to adapt safely.

Choose Appropriate Footwear

Wearing shoes that provide adequate support and are suitable for your specific activities can significantly impact knee health. Proper footwear helps maintain correct leg alignment and distributes forces exerted on the knee joint more evenly.

Adopt Proper Running Techniques

When running, try to lean slightly forward and keep your knees bent. This posture helps distribute the impact of each step more evenly and reduces the stress on your knees, which can prevent PFPS.

By integrating these preventive measures into your daily and athletic routines, you can significantly reduce the risk of developing Patellofemoral Pain Syndrome. 

3 Exercises for Patellofemoral Pain Syndrome

Clamshells

The clamshell helps strengthen your gluteus medius. This muscle helps stabilise your hips and knees and is a common weak point when it comes to experiencing PFPS. 

How to Do Them

Clamshells
How To Do Clamshells
  1. Lie on your side with your knees bent at a 90-degree angle and your feet stacked on top of each other. Place one arm under your head for extra stability, the other arm can sit on the top of your hip or wherever feels comfortable. 
  2. Slowly lift your top knee up towards the ceiling, keeping the feet together, until you feel the muscles. Hold this position for 5-10 seconds before slowly returning the knee to its starting point. 
  3. Repeat this exercise 10-15 times for each leg. 

Aim to complete a full set of these 2-4 times per day for good results. 

Mini Squats

Mini squats strengthen your glutes, quads, and even your hamstrings. They are an exercise that can work all the important muscles in your legs without putting too much stress on your knee, avoiding exacerbating your pain. 

How to Do Them

Mini Squats
How To Do Mini Squats
  1. Begin by standing with your feet hip-width apart, looking straight ahead, feet pointing forward
  2. Keep your back straight, core tight, and chin up throughout the entire exercise
  3. Lower yourself down as low as you can before the pain becomes too great, ensuring that your knees are not moving past 90 degrees 
  4. Push through your heels to lift yourself back up to starting position

Repeat 10-15 reps of this exercise 2-4 times a day, aiming to deepen your squat over time. 

Seated Knee Extension

This exercise provides a gentle stretch to the knee, without overloading it with weight. It’s a great exercise for when the pain is severe and you can’t manage some of the harder exercises. 

How to Do Them:

Seated Knee Extension
How To Do Seated Knee Extension
  1. Place two chairs opposite each other, facing one another. 
  2. Sit in one chair and place one foot onto the chair opposite, with the knee bent. It might take a couple of tries to get the distance right. 
  3. Gently straighten the leg as far as you can before it becomes too painful. Hold for 10 seconds and repeat 4-5 times, then swap legs. 

Repeat this 2-4 times for each leg. If you want more exercises for knee pain, check out our blog on the topic

Say Goodbye to Patellofemoral Pain Syndrome

If you live in the Sydney area and are suffering from PFPS, contact Benchmark Physio today. We are experts in helping individuals overcome knee pain and we know what works and what doesn’t. We won’t just give you the age-old prescription of pain medication and rest – we want to make sure we treat the cause of the problem and help you get fit and healthy again.