Patellofemoral knee pain

January 11, 2014

Ben Train asked The Guru for the following Physiotherapy Advice:

I was diagnosed a couple of months ago with Patellofemoral pain syndrome in both of my knees. I have just returned to exercise after a couple of months off and my knees are very painful again. Is there any exercises or rehab you would recommend?

January 11, 2014

Hi Ben
Without a specific rehab you’re not going anywhere fast….or slow!

PFJ pain is super common, (normally) brilliantly looked after by physios and shouldn’t present as a long term problem as long as the reason why you’ve got it is addressed.

Basics first, is that you need to control your kneecap as it slides and moves over the front of your femur. This is either done by the bottom (pelvis/hip) down, the feet up or a bit of both. But control is the key word. You can tape your kneecap to feel better. You can roll on your ITB and mobilise your kneecap to feel better. You can wear the correct footwear to feel better.

BUT if you have no control of the kneecap, then you can’t improve in the long term. The control aspect in not just about a little muscle that steers your kneecap called VMO, but it’s about the entire leg from foot to hip. Your certainly don’t need to get stronger either.

Glut (especially medius) exercise are really important it control the amount your thigh rolls in (and consequentially you kneecap rolls out). This muscle is influenced by your spine posture, hip and foot positions.

As the pain has returned it’s most likely you don’t have enough control for what you want to do. They more exercise you do, the more control you’ll need. I think it worth going back to see your physio and get some specific rehab exercises to help with your kneecap alignment and control.

Guru Responded

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