Whether you’re a casual walker, an avid runner, a gym-goer or a busy parent getting up and down off the floor hundreds of times a day, knee pain can quickly stop you in your tracks and make life very uncomfortable. Due to the impact that knee pain can have on life and work, it’s one of the top problems we see and treat at our clinic. Specifically, there’s one type of knee pain at the front of the kneecap that we see very often: patellofemoral pain syndrome.
One thing that we are frequently asked by our clients who are eager to make a hasty recovery is what they can be doing at home daily to help relieve their pain and help them get better faster. So today, our physiotherapists share the ins and outs of patellofemoral pain syndrome paired with three simple things you can do today to start helping your knee pain at home.
What Is Patellofemoral Pain Syndrome?
Patellofemoral pain syndrome is the most common cause of pain at the front of the knee and is often referred to as runner’s knee. There can be many causes of this knee pain, one of which is thought to be from the patella(kneecap) failing to glide smoothly up and down a groove on the top of the femur (thigh bone) as the knee bends and straightens - hence the name patello-femoral pain.. Other causes include overusing and overloading the knee joint, anatomical abnormalities of the knee like the bone shape, muscle weakness, balance or dysfunction - or a combination of these factors.
It can be difficult to pinpoint the exact location of the pain within the knee joint but is often described as being at the front of the knee or behind the kneecap. If you have patellofemoral pain, you may find that your knee pain intensifies when you’re bending your knee (like during squatting), when you’ve been sitting for long periods, when you run or jump, or when you walk down a flight of stairs. This can make completing everyday tasks and participating in physical activity difficult and painful.
Treating Patellofemoral Knee Pain
Effectively treating knee pain goes far beyond what’s happening solely within the knee joint. During our assessment, we find that we get a lot of answers and insight into the cause of your pain - and how to best treat it - from thoroughly assessing the entire kinetic chain of movement from your foot up to your hip. This lets us understand where the deficits are present that affect how your knee is moving and being loaded by the body.
Based on your assessment results, which includes looking at everything from the strength and flexibility of your glutes to your foot posture and the size of your kneecap, we’ll present you with treatment options and create a treatment plan for you that will best help meet your goals. As part of your treatment plan, we’ll introduce some at-home care for your knee to help with your recovery and help prevent your knee pain from recurring in the future. Here are three ways we may recommend you do this at home.
1. Foam Rolling
Foam rolling is widely used to help improve the range of motion through muscles and joints while improving pain and muscle soreness. In the case of knee pain, you want to look at the quads and your hip mobility as a direct link to knee pain. Roll over your glutes, hip flexors and quads, taking turns rotating the hips in and out on your quads to get the outer and inner thigh.
Foam rollers are great because they give you plenty of control over the intensity of the movement. Foam rolling may feel tender but should never feel excruciating - if the pain is too much, reduce how much bodyweight you are placing on the roller. If you don’t have a foam roller, we can recommend the best one for you and show you how to use it effectively at your appointment.
2. Hip Flexor Stretch
Your hip flexors are a group of muscles at the front of the hip. As many common causes of knee pain are linked to muscle imbalances or weaknesses in the hips that force your knee out of alignment, it’s vital to work on improving the range of motion and flexibility of your hip flexors.
There are many ways you can stretch your hip flexors, including: Kneel on your right leg and bend your left leg out in front of you, with that foot flat on the floor - like you’re going to propose. You can put a folded towel under your right knee, or do this on carpet or a Pilates mat. Keeping your back straight, and your tailbone tucked in, slowly move your hips forward until you feel a stretch in the upper thigh of your right leg and hip. If you need to hold on to something to balance, you can do this next to a couch, or bench. Hold the stretch for at least 15 to 30 seconds then swap sides.
Tip 3: Hip Strengthening Exercises
Strengthening programs involving the hip have shown significant improvements in patellofemoral pain, function and strength in six weeks. This is because strengthening the hips helps support the proper balance of the muscles that attach to the knees. A review of the best strengthening protocols for patellofemoral pain has shown that combining hip and knee exercise to be superior to strengthening the knee muscles alone in terms of lessening pain and improving function, while having long-lasting benefits.
Here are three simple exercises that can get you started:
Supporting yourself with your hand against a wall or chair if needed, stand on your right leg with your left leg lifted out to the side slightly Move your left leg in small circles, about the size of an apple Draw 20 circles in each direction. Swap legs To make this exercise more difficult, increase the size of the circles and complete 2–3 sets
Kneel on your hands and knees with your knees directly below your hips and your hands directly below your shoulders Lift your right knee, keeping it bent 90 degrees as you gently kick it upward towards the roof. Think about touching the roof with the bottom of your foot Return to the starting position Complete 2–3 sets of 12–20 repetitions on each side
Side leg raises
Lie on your side with your legs stacked one on top of the other. You can rest your head in your hand Slowly raise your left leg about 45 degrees into the air, or as high as you can. Pause at the highest point, then return to the starting position. This movement should be slow and controlled on the way up, and on the way down Complete 2–3 sets of 12–15 repetitions on both sides During your appointment with your physio, they will create a custom strengthening program that best matches the results of your assessment. This will include stretching and strengthening other areas like the hamstrings, groin, glutes and core. Interestingly, some studies have shown that strengthening the hip together with the core resulted in patellofemoral pain resolving even earlier and producing greater overall gains in strength compared with focusing on strengthening the hip with the knee.
Get Your Answers: Visit Your Physio
While foam rolling, stretching, and strengthening can help with managing your knee pain, it’s not a standalone solution and doesn’t give you any insight into what’s happening with your body and what deficits are present that have likely led to your knee pain developing. Once you have these answers from a complete physio assessment, you can ensure that your treatment plan is geared for a full recovery and covers all bases - including helping prevent the pain from returning in the future.
If you have knee pain, we’re here to help. For any questions or to book your appointment with our fantastic team, call us on +852 2801.4801 or book your appointment online.