Runner’s knee can also be known as patellofemoral pain and is a common condition affecting many athletes including runners, skiers, soccer players, etc. Common symptoms associated with Runner’s knee or patellofemoral pain include a dull achy feeling around the knee cap. Pain can occur when walking up or down stairs, squatting, kneeling, or sitting with the knee bent for a long time due to the increased forces at the knee joint when the knee is bent.
Initially after your injury, a common phrase that physical therapists use is RICE. RICE stands for rest, ice, compression, and elevation. The first thing to do after injury would be to rest from the activity that is causing your knee pain until you see a physical therapist. Icing is also beneficial to reduce any inflammation or swelling along with the pain you may be experiencing. Compression sleeves or braces may be used to promote the movement of excess fluid out of the knee joint. Lastly, elevating the knee above the level of the heart promotes the movement of any excess fluid away from the knee joint and towards the center of your body.
When it comes to patellofemoral pain, one may think that because they have knee pain, the knee is the cause of that pain. The pain may be coming from the knee joint itself or the true cause of the knee pain may be coming from another body part. For example, an injury to tissues in the back, hip, or ankle may have been injured initially, and then causes knee pain with or without pain at the site of actual injury. The etiology of patellofemoral pain is still not 100% determined, however; it is thought that this syndrome can be caused by overuse and overload, problems with how the joints are functioning, and muscular dysfunction.
Focusing on just the issues with how the joints are functioning as a potential cause of patellofemoral pain, it will be important to keep in mind that every patient is different and someone may not present with the same symptoms as another patient. Therefore, it will be important to consult your physical therapist to have an evaluation done so they can determine the cause of your knee pain and tailor an exercise program to you as an individual patient. When it comes to knee pain, there may problems at other joints above or below the knee joint. Issues below the knee joint may include problems with the ankle such as excessive ankle pronation, which is when your foot rolls inward after taking a step. Issues occurring at sites above the knee joint, like the hip, may also be causing knee pain. Both of these examples show that problems involving how the hip, ankle, or knee joint itself function may be causing the actual knee pain.
This blog will focus mainly on issues at the hip that may be causing knee pain. Hip muscle strength, muscle recruitment, and muscle endurance may be the cause of patellofemoral pain. In addition, someone who has increased hip internal rotation range of motion, which is when the thigh rolls inward, may have knee pain due to increased forces on the knee cap. When it comes to hip musculature, the hip moves in multiple directions and each movement is controlled by a different muscle. When these muscles are weak, they can cause altered forces through the knee joint and therefore cause your pain. Physical therapists are experts at designing strengthening programs to address each patients’ individual needs. For more information on physical therapy services visit www.totalperformancept.com.
Other issues with hip musculature include abnormal muscle recruitment. Muscle recruitment can be explained as a certain pattern or sequence in which different muscles activate. Proper muscle recruitment is necessary to maintain the normal load and forces through each joint in the lower extremity and physical therapists can teach patients proper technique and exercises that correct the recruitment of lower extremity musculature if this is one of the causes of your knee pain.
In addition to strengthening and retraining proper muscle recruitment, your therapist may also be performing certain exercises or modalities to reduce your pain. Examples of some modalities would be the use of ultrasound, which can warm up the injured tissues as well as promote tissue healing. Another modality would be the use of TENS or transcutaneous electrical nerve stimulation, which can help reduce pain. Your therapist will work to reduce pain and improve your function to allow you to return to your daily recreational and/or work activities if your pain has been limiting your participation in these activities.
In conclusion, if you are experiencing knee pain and think that it may be patellofemoral pain, consult Total Performance Physical Therapy to schedule an initial evaluation.
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