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Patellofemoral Pain Syndrome - "Runner's Knee" Pain Relief

What is Patellofemoral Pain Syndrome?

Patellofemoral pain syndrome is pain in the front of the knee, at the insertion of the quadriceps muscles (mainly the Rectus femoris). It frequently occurs in teenagers, manual laborers, and athletes. The syndrome is commonly referred to as runner’s knee. One in four runners will experience patellofemoral pain syndrome at some point in time.

What Causes Patellofemoral Pain Syndrome?

Patellofemoral pain syndrome may be caused by several different factors and originally the cause of the pain was thought to be the lateral displacement of the kneecap due to a lack of strength of the vastus medialis (medial quadriceps muscle). We know now that the pain is caused by a faulty control of the hip and/or lack of proper foot motion. When we run, we spend time on one foot (single leg stance) for a fraction of a second before pushing off and landing on the other foot. Essentially, running is a series of single leg squat jumps, occurring quickly and repetitively, which is why control of your hip is such in important factor.

Treatment of Patellofemoral Pain Syndrome

Treating a patient for patellofemoral pain syndrome should always start with a functional exam evaluating the hip and the foot. In a study done in the Journal of Orthopedic Sports Physical Therapy in 2003, they found that when comparing patellofemoral pain syndrome patients to asymptomatic patients there was 26% less hip abductor strength and 36% less hip external rotator strength, demonstrating how important proper strength and motor control of the hip plays.

The human body is a kinetic chain. What happens at one joint will have an effect at another joint. Lack of ankle dorsiflexion or range of motion in the big toe when running can lead to an early bending in the knee, which in turn can disrupt the whole efficiency of the gait cycle. Your knee can only do what your hip can control and what your foot will allow. Below is a list of a typical treatment approach to patellofemoral pain syndrome.

  • Myofascial release to the rectus femoris

  • Joint mobilization of the foot and ankle

  • Hip strengthening exercises

  • Rehabilitation and stabilization training

The Behm Muscle & Joint Clinic Approach

At Behm Muscle & Joint Clinic, we are full body Active Release Technique (ART) providers. ART is the gold standard in soft tissue treatments and is a movement-based treatment for soft-tissue injuries that helps to break up scar tissue and restore normal function. This therapy combined with rehabilitation techniques to stabilize the hip and Chiropractic adjustments to the foot have helped others suffering with patellofemoral pain syndrome. New Patients are always welcome at Behm Muscle & Joint Clinic. Our Bellevue, Nebraska Chiropractic and Rehabilitation clinic provides the most up to date and evidence-based modalities to treat your muscle, nerve and joint pain. If you are suffering from patellofemoral pain syndrome do not hesitate to give us a call or schedule a consultation online.

Content written by Dr. Adam Behm, DC, CCSP®

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