Patellofemoral Pain Syndrome

Patellofemoral Pain Syndrome (PFPS) is a broad umbrella term for pain in the front of the knee arising from the knee cap. Patients often have pain with squatting, prolonged sitting and with stairs. Clinicians must be able to exclude causes of knee pain that are a result of injury inside the deeper knee capsule.

Physical therapy treatment may include:

• Exercise therapy with exercises to combine both the hips and knees. Hip exercises will focus mostly on back and side of the hip muscles. The combination of hip and knee exercises has been shown to result in better outcomes than exclusively performing knee-targeted exercises.
• Manual therapy to reduce pain and range of motion limitations. These treatments should address impairments found in the hips, ankles, feet and spine in addition to range of motion impairments noted in the knee.
• Patellar mobilizations to increase the ability and knee cap movement.
• Lower-limb stretching.
• Patella (knee cap) taping to reduce pain.
• Foot orthoses for patients with greater than normal pronation.
• Running gait retraining.

Research recommends not using orthotics, braces, sleeves or straps for PFPS and also recommends against ultrasound, cryotherapy, phonophoresis, iontophoresis, electrical stimulation and therapeutic laser for the treatment of patients with PFPS.

References:

1. Willy, Richard W. et al. “Patellofemoral Pain.” Journal of Orthopaedic & Sports Physical Therapy, Vol. 49, No. 9, 2019, pp. CPG1-CPG95. Journal of Orthopaedic & Sports Physical Therapy (JOSPT), https://doi.org/10.2519/jospt.2019.0302.

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