Patellofemoral Pain Syndrome (PFPS) is the pain located at the front of the knee. Patellofemoral Pain Syndrome starts gradually and has symptoms that increase over the time. It is also known as anterior knee pain. Commonly the patellofemoral pain syndrome occurs if the patella does not move or ‘track’ in a correct manner when the knee is being flexed and extended. This mal-tracking of the patella causes damage to the surrounding tissues resulting in pain in that region. Individuals who are active in sports and in adolescent girls more commonly suffer from Patellofemoral Pain Syndrome. When bending and straightening the knee, there are several structures surrounding the joint which work together to run the patella in a straight line within the intercondylar groove (made by tibia and femur). Any type of tightness or weakness in the structures causes an imbalance resulting in the patella mal-tracking. Patellofemoral knee pain can also be caused due to a knee injury, if the quadriceps (especially VMO) become inhibited or are considerably weakened. Physical therapy and exercises play an important role in reducing the pain associated with patellofemoral pain syndrome, improving the range of motion of knees and strengthening the knee so as to avoid any future knee injuries.
Physical Therapy Management of Patellofemoral Pain Syndrome
Physical therapist provides exercises and rehabilitation program for your patellofemoral pain syndrome. The first aim of the physical therapy treatment is to relieve the patellofemoral pain. Physical therapist can use patella taping or bracing and electrotherapeutic modalities with gentle joint mobilization of patella to relieve the patellofemoral pain.
Once the pain is relieved, the therapist’s next treatment plan for patellofemoral pain syndrome is focused on strengthening or stretching exercises of the muscles.
Strengthening Exercises for Patellofemoral Pain Syndrome
Quad Set Strengthening Exercises for Patellofemoral Pain Syndrome
Sit on the floor extending the leg (having patellofemoral pain) straight and bend the other leg with foot kept flat on the floor (as shown in the image). Keep a small folded towel under the knee with patellofemoral pain. Next, tighten your thigh muscles of the extended leg by pressing the back of your knee on the folded towel. Hold this position for about 5 to 10 seconds or as long as you feel comfortable, and then rest for up to 10 seconds. Repeat this exercise for 10 to 20 times in one set and 2 to 3 times a day.
Straight Leg Raise Exercise for Patellofemoral Pain Syndrome
Lie down with your back on the floor with knees in a bent position, make sure that the soles of your feet rest flat on the floor. Then extend the leg having patellofemoral pain syndrome straight up about 1.5 ft to 2 ft above the ground as shown in the figure. Maintain 12 to 18 inches of distance between the heel and floor. Hold the position for 5 to 10 seconds and lower down your leg slowly. Repeat this exercise for 10 to 20 times in one set and 2 to 3 times a day.
Wall Slide Exercise with Ball for Patellofemoral Pain Syndrome
Stand against the wall with your back and feet. Keep your feet shoulder width apart and move a little forward from the wall to maintain some distance between feet and wall. Keep your body in upright position and place a ball between your knees (as shown in the image). Then, slowly descent while applying pressure against the ball with your knees until your knees are bent 30 degrees. Hold the position for 10 to 15 seconds or as long as you can. Repeat this exercise for 10 to 20 times in one set and 2 to 3 times a day.
Stretching Exercises for Patellofemoral Pain Syndrome
Calf Wall Stretch
To do this exercise for patellofemoral pain syndrome, stand in front of a wall and keep your hands on the wall (as shown in the image). Keep the affected leg behind the normal leg, with both feet pointed forward and keep the back knee straight with the heel pressed to the floor. Try stretching the calf by pushing the hips forward, while pressing your back heel to ground. Hold this stretch for 20 to 30 seconds or as much you feel comfortable. Repeat this stretching exercise for patellofemoral pain syndrome 3 to 5 times a day.
Hamstring Wall Stretch to Ease Patellofemoral Pain Syndrome
Lie down on your back in a doorway, with the buttock against the wall and your unaffected leg through the open door. Place the foot of the affected leg up the wall, then try to push the knee straight. You should feel a gentle stretch down the back of your leg. Hold the position for 30 to 45 seconds. While doing this stretch, don’t arch your back and bend your knee. Repeat this exercise for 3 to 5 times a day.
Quadriceps Stretch for Patelofemoral Pain Syndrome
While standing, hold on to a chair, counter, or wall to assist in balance. Bend your knee (having patellofemoral pain) back by grasping the front of your ankle or foot with one hand (as shown in the image). Pull your foot upward toward your buttocks until you feel a stretch in front of your hip or thigh muscles. While doing this exercise, your knee should be pointed directly to the floor. Hold this stretch position for 20 to 30 seconds or as long as you feel comfortable. Repeat this exercise for 3 to 5 times a day.