Patellofemoral Joint Pain – What you need to know

The first thing you should know is it isn’t just for runners.

It is a generic term used for people that have knee pain, more commonly seen in runners. Typically it is diagnosed as patellofemoral joint pain (PFJP).

The patellofemoral joint is the joint between the back of the kneecap (patella) and the front of the thigh bone (femur).

Pain in this area can be caused by a number of structures. It is a very common injury that we commonly see present in non-traumatic knee pain in physiotherapy patients.

What does PFJP feel like?

It is commonly, but not limited to, pain at the front of the knee or around/behind the knee cap. It is usually increased with stair use, kneeling, squats or lunges, and running or jumping.

Why might I get this problem?

There are so many factors that may contribute to PFJP and sometimes it may be a combination or a number of those factors. Your cause of this pain may be predisposed, mechanical, adaptive or environmental. It is likely to develop due to an increase or change in how much activity you are doing or also known as load.

More specifically…

For runners, this may be due to ‘overload’. Overload or overuse may be a direct result of an increase in training volume or speed, a change in footwear or terrain, engaging in more stairs/hills or including more jumping/skipping into your workouts. Other factors may include a direct impact to the kneecap causing an inflammation, swelling and therefore pain. Pain may also appear due to the way your body moves or your genetic makeup.

Muscles around the hip and knee allow your patella to track smoothly in the joint, if there are imbalances in these muscles, weakness or tightness, your patella may not stay in the right position. If there is a malalignment of the patella over time this can cause wear under the surface of the kneecap. The way you run, squat, or position your body may also affect the way you use your knee.

PFJP vs Patellar Tendonitis

PFJP can commonly be misdiagnosed or mistaken for other knee related injuries. It may sometimes be mistaken for patella tendinitis (tendinopathy).

There are a few main specific indicators that can help to differentiate between PFJP and patella tendinitis.

Patella tendinitis, otherwise known as ‘Jumper’s Knee’, may also present due to an increase in load, and particularly in a period of increased activity after a relative rest period. Patella tendinopathy presents with pain directly on the mid portion of the patella tendon.

The patella tendon forms at the top of the knee where your quadricep muscles come together. It then lies on top of your patella, encompassing it, and attaches at the top of your tibia, or shin bone.

Its role is to act like a spring when we run, jump and land. When it is unable to store load correctly it becomes inflamed. When it is inflamed it will typically present as a sharp pain during high activity or aching after exercise. It will feel stiff and sore in the morning and with periods of rest, typically it improves with movement due to increased blood flow which allows the tendon to function more effectively.

What can you do about PFJP?

A thorough assessment with one of our Physiotherapists will allow us to narrow down your source and work out the cause of your pain.

Treatment involves physiotherapy manual techniques, taping and education. It is likely you will need to incorporate a range of stretches and strengthening exercises to assist in managing your pain.

There are a few simple things you can be doing before you have your assessment to kick-start your treatment.

Releasing your iliotibial band and gluteal muscles may assist to maintain optimal length and therefore overall alignment. To kick-start your treatment today, learn how to release your iliotibial band and gluteal muscles in the videos below.

Your Recovery Time From PFJP

It is likely you will make a full recovery from this injury. Recovery time varies from person to person however as physiotherapists we typically see this injury taking 6 weeks to make a full recovery. However, this doesn’t mean you won’t be staying active throughout this time and that is therefore why we suggest coming in to see us at Viva so we can put a structured plan in place.

With spring now upon us and exciting events like the Melbourne Marathon, it may be your time to get out there.

If knee pain is something that has stopped you or even scared you in the past please do not hesitate to make a time to see us at Viva!

Find out more about what help we can offer to you as a runner.