Patellofemoral Pain

Description

Patellofemoral Pain Syndrome (PFPS) is one of the most common sports medicine injuries at the knee joint. Patellofemoral pain is highly common in active adults, specifically runners. As early as 1976, NISMAT’s founder, Dr. James Nicholas, recognized the importance of hip strength in this injury condition. Subsequent research studies have identified limitations in hip strength and weakness in patients with PFPS. Several other factors, including lower extremity static alignment, muscular imbalance, decreased flexibility, patellar mobility, running mechanics, and changes in activity can contribute to patellofemoral pain.

Exercises

Kneeling Hip Flexor/TFL Stretch

Begin in a half kneeling position with hands on hips.  Shift weight forward and bend front knee until you feel a stretch in the front of back leg. Bring opposite arm straight overhead and lean your trunk to the side.  Hold, then return to starting position.

Hold for 90 seconds, perform 3 reps, 1 time per day.

Prone Quad Stretch

While lying down on your stomach place a strap around your foot. Gently pull on the strap to increase the bend in your knee until you feel a stretch in the front of your thigh. Hold this position, making sure your thigh remains on the table or surface.

Hold for 90 seconds, perform 3 reps, 1 time per day.

Seated Hip Flexion

Start sitting with a weight around your foot. Lift your knee up, hold, then lower down slowly.  Maintain upright sitting posture at all times.

Perform 3 sets, 15 reps, 1 time per day

Single-Leg Eccentric Squat

Start standing on one foot in front of a chair. Stay balanced as you slowly lower into the chair. Plant both feet to stand up and repeat.

Perform 2 sets, 15 reps, 1 time per day

Step Up Plus

Begin standing with a stair in front of you, hands on hips. Step one foot up onto the stair and drive your opposite knee forward to hip height and hold. Step backwards with your lead foot to return to your starting position and repeat.

Perform 2 sets, 15 reps, 1 time per day

Other instructions

Stretching should be performed for 4-6 minutes per muscle group. This can be broken down into 60-90 second intervals but should not be shorter than 60 seconds per repetition.

References

  • Mullaney, M. J., & Fukunaga, T. (2016). CURRENT CONCEPTS AND TREATMENT OF PATELLOFEMORAL COMPRESSIVE ISSUES. International Journal of Sports Physical Therapy, 11(6), 891–902. Cite Download
  • Tyler, T. F., Nicholas, S. J., Mullaney, M. J., & McHugh, M. P. (2006). The role of hip muscle function in the treatment of patellofemoral pain syndrome. The American Journal of Sports Medicine, 34(4), 630–636. https://doi.org/10.1177/0363546505281808 Cite Download
  • Mellinger S, Neurohr GA. Evidence based treatment options for common knee injuries in runners. Ann Transl Med. 2019;7(Suppl 7):S249. doi:10.21037/atm.2019.04.08