What’s Going On?
Patello femoral syndrome (PFS) commonly affects runners or those who integrate running into their training regime. It is caused by the patella (knee cap) not tracking properly over the femur (thigh bone). The patella normally rides in a groove on the femur. The patella is really a fulcrum – it gives leverage to the big muscles on the front of the thigh, the quadriceps. With PFS, you get an imbalance in these muscles – usually the lateral or outside muscles over-powers the inner medial muscle – and this pulls the patella out of its normal groove. When the patella doesn’t track properly in its groove, it causes pain under the patella. Foot posture may contribute by allowing the knee to internally rotate.
What To Look For????
- Pain whilst running or after running
- Pain under or around the knee cap
- Pain is often worse after activity that involves knee bending – running, stairs, squats, down thrust on cycling, etc.
- Feeling of instability and/or pain whilst descending stairs and ascending stairs
What To Do About It??
- Stop the aggravating activity. Fitness can be maintained with activities that don’t cause pain.
- Strapping to support and better track the patella across the femur
- Suitable orthoses to control contributing biomechanical factors
- Appropriate footwear for both foot type and activity
- Undertake a stretching and strengthening program aimed at having quads fore at the same time and the same amount
- Use ice over the knee when pain is severe
Advice from your podiatrist coupled with assistance from a physiotherapist will guide you through this debilitating problem.