Do you have pain in your knee on squatting or climbing stairs?
Does your knee get sore when you sit for long periods?
Are you concerned about the pain evoked or the amount of noise your knee makes every time you sit down or stand up?
You may be suffering from patellofemoral pain, which is pain at the patellofemoral joint of the knee. The patellofemoral joint is the joint formed where your patella or kneecap sits in the little notch at the base of your thigh bone at the front of your knee.
Patellofemoral pain is pain usually located around the front of the knee, under or around the knee cap. Patellofemoral pain is usually evoked by loading the knee in a flexed or bent position as happens when sitting, moving from sitting to standing or vice versa, going up or down stairs and even running.
Patellofemoral pain can be due to several factors. There may be an overuse or overload on the patellofemoral joint itself. This could be due to an increase in bending/lifting with a move of house or an increase in stairs with switch to a two-storey house, it could be due to overload on the joint due to a new job leading to high heels being worn more often or it could be that you have increased your training volume as you get ready for that 10km running event in a few months. Alternatively there may be no increase in load or use but there may be some weaknesses in the muscles about the hip or knee causing increased stress on the patellofemoral joint. Alternatively some movement coordination problems may cause increased stress at the patellofemoral joint. For example your knee may be turning inwards every time you go up or down a step. These poor biomechanics can place undue stress on the patellofemoral joint. Finally there may be some stiffness at the patellofemoral joint or increased movement at the patellofemoral joint or lower down in the foot that can be causing increased load on the patellofemoral joint.
As you can see determining the causes of your knee pain can be quite involved and therefore a comprehensive physio assessment is imperative. Your physio will look at the local structures around the area, assess the mobility of the joints, flexibility of the surrounding soft tissues and muscles, strength of the relevant muscles and look at the movement and recruitment patterns around the area when you’re moving. This will assist in deciding which of the above factors are impacting and contributing to the pain you are feeling. Once we know what areas to target- whether it’s joint stiffness, muscle tightness, movement coordination and strength, a detailed plan can be drawn up to ensure your pain goes away and stays away.
Treatment for patellofemoral pain may involve some hands-on treatment or manual therapy, but this will only be effective in conjunction with specific exercises and appropriate load management. In some cases taping and foot orthoses may also be helpful.
One other area to discuss when considering patellofemoral pain is the creaking and clunking that can occur around this area. Often people are very concerned and anxious about what these noises mean. They might believe their knee joint is bone-on-bone and that their knee joint is a total mess, unable to withstand any more stress and that they just need surgery asap. They may believe if they push their knee further when it is making so much noise, they may do further damage. These beliefs lead to a fear-avoidance pattern, where they are too scared to move and therefore, they get weaker and stiffer and tighter and less fit which only exacerbates the problem. Over time the knee needs less and less stress to cause symptoms and pain increases.
If this is how you’re feeling about your knee, you need our help to get you over this hurdle and barrier to your recovery. You need a trained professional who can help you safely exercise your joint without fear of making things worse. Someone to guide you in the performance of your exercises. Someone to guide you in the dosage of your exercises and someone to help you to decide whether the pain you may be feeling when you exercise or after you exercise is okay or not.
Your physio can do all of these things and on top of that if the exercises are too appropriate for you your physio can either give you amazing feedback to correct your exercises or they can alter your program so that you avoid flaring up your issue. This guidance and expert knowledge will allow you to move forward, reduce your pain and regain the confidence to move once again. This will allow you to get back to being your true self, without the stress and worry your knee used to give you.
If you are ready to deal with your knee pain, give us a call on 3200 8541 for your comprehensive one-hour initial examination to determine what factors are coming into play for you and to get you back on the path to living your fullest life.
