How I recovered from Patellofemoral Pain Syndrome (PFPS) or Runner’s Knee Injury ?

SUMIT SHARMA
7 min readOct 3, 2020
Patellofemoral Pain Syndrome (PFPS) or Runner’s Knee Injury

Patellofemoral Pain Syndrome (PFPS) is a common injury pain in which a person experiences pain in front portion of the knee and around the kneecap, known as patella. Sometimes called “runner’s knee,” it’s more common in people who participate in sports that involve running, squatting and jumping. The knee pain often increases when you run, walk up or down stairs, sit for long periods, or squat. Simple treatments and sometimes physical therapy is needed to ease patellofemoral pain. Knee pain isn’t something to joke about as it might make difficult for us to do the simplest of all activities, like exercises, regular walking and climbing stairs, so let’s try to understand more about it in detail.

Patellofemoral Pain Syndrome

My Personal Story — How I developed the pain and recovered back

I love working out and have been working out since I was 15. In September of 2020, I developed some knee issues as I was on strength training and started lifting more heavy and heavy weights specially for lunges and squatting. In the beginning the knee pain was very light when it started to develop, as I was experiencing it only while doing the legs workout. Then later after few days gradually it developed to a very sever pain with high intensity.

While the exact cause was unclear, Then I decided to appear for the medical checking to make sure what was happening and the results were : Blood tests were fine, no deficiencies in vitamins, we eat really healthy so no cholesterol or any other deficiency. The MRI’s showed nothing more than everything was alright. Later after meeting with an experienced physiotherapist who basically diagnosed me with PFPS.

From the next day, I stopped doing legs workout, also I was not in the condition to do. Then I adopted some home remedies for the treatment as suggested by physiotherapist also added some stretching exercises to my routine for fast recovery.

Recovery from PFPS injury was a very bad journey and based on my experience I am sharing here all the remedies, exercises and injury prevention measures which I adopted to recover myself from PFPS.

Also during my treatment and recovery phase what I understand that there can be a lot of variation in what causes Patellofemoral Pain Syndrome (PFPS) from one person to the next.

A Look Inside Your Knee —

In PFPS we probably feel pain towards the front of the kneecap or around the entire kneecap, pain from Patellofemoral Pain Syndrome (PFPS) actually originates behind the kneecap where patella and femur make contact. What are they, to understand this lets have a look inside our knee —

Patellofemoral Pain Syndrome originates behind the kneecap where patella and femur make contact

Repeated contact, usually due to overuse, of the patella and femur causes deterioration and softening of the protective cartilage around the kneecap, a condition called chondromalacia patellae and is typically responsible for patellofemoral pain. Ouch! To visualize it more clearly lets have a front and side view of the knee —

Front and Side View of Knee — Patellofemoral Pain Syndrome (PFPS)

Friction from the repetitive contact often causes inflammation, swelling, and pain around the kneecap. The pain at the front of the knee is likely Patellofemoral Pain Syndrome (PFPS)from loss of cartilage in kneecap.

Causes of Patellofemoral Pain Syndrome (PFPS) ?

There are one or more of the following factors which can lead to patellofemoral pain :

Causes of Patellofemoral Pain Syndrome (PFPS)
  1. Overuse and Overloading —
    Continuous vigorous physical exercises which involves the repetitive bending and straightening of the knee puts strain and stress on the knee, and a constant bending motion, especially on the weighted leg, may lead to the disorder because of the increased pressure points between the patella and femur when the knee is bent. Also, Running or jumping sports puts repetitive stress on your knee joint, which can cause irritation under the kneecap.
    Similarly, a sudden change in the routine of physical activities can cause patellofemoral pain syndrome. For instance, if you increase the number of days you exercise in a week, it can put more pressure on your knee.
  2. Patellar Misalignment —
    The patella may be pushed out on one side of the groove when you bent the knee, i.e., abnormal tracking of the knee. This is abnormal, and it may cause increased pressure between the back of the patella and the trochlea. This will, in turn, irritate the soft tissues.
    The quadriceps alignment between the hip and the knee (the Q angle) is thought to affect patellar tracking. Patients with a larger than normal Q angle (greater than 20 degrees) may be more susceptible to patellofemoral pain because the patella has a tendency to track more laterally (to the outside).
  3. Muscular Imbalances or Weakness —
    A weakness or strength imbalance of the quadriceps muscles may alter the tracking of the patella. Inward movement of the knee during a squat has been found to be associated with patellofemoral pain.
  4. Other Factors —
    Apart from these, there are some other factors which includes Muscular Tightness where Tight muscles and tendon may also affect patellar tracking. Flat Feet — Patients with little or no arch in the foot are also likely candidates for patellofemoral pain. Also decrease in patellar mobility considered as one factor of patellofemoral pain.

Signs and Symptoms of Patellofemoral Pain Syndrome (PFPS) ?

People having patellofemoral pain syndrome usually experience a dull but aching pain at the front of the knee. The pain begins typically gradually and occurs in both knees. However, common symptoms are —
— Pain during activities and exercises that require repeatedly bending the knee, e.g., climbing stairs, running, squatting, jumping, etc.
— Knee pain when standing up from sitting position, especially if you sit down for a long time with your knee bent.
— Feeling pain when you change the intensity of an activity or exercise equipment.
— A slight swelling may exist and symptoms may be present in one or both knees.

Treatment for Patellofemoral Pain Syndrome (PFPS) ?

Patellofemoral Pain Syndrome (PFPS) can usually be effectively treated with a non-operative treatment. It can take six weeks or more to show improvement once treatment begins; this is often the same length of time the pain has been present.

Treatment for Patellofemoral Pain Syndrome (PFPS)

The following options for the treatment of patellofemoral pain syndrome (PFPS) that do not require any surgery include —
Reduce Overloading and Overuse :- Because patellofemoral syndrome often results from overuse and overactivity, resting the affected joint can often help treat the underlying problem. Alternating activities to avoid overuse like If we do high-impact activities, such as running or playing a sport, try doing a low-impact activity the next day, such as swimming or riding a bicycle.
Practice the RICE method (Rest, Ice, Compression, and Elevation) :- Wrap the knee in an elastic bandage or use a pull-on bandage with the kneecap cut out. These can help to stabilize and support the joint. Wear special shoe inserts, known as orthotics, to support and stabilize your foot and ankle.
Specific Strength Building Exercises :- Specific exercises that are meant to strengthen and straighten your quadriceps and hamstrings should be added to daily routine. These exercises will help to improve endurance, mobility, and strength of other parts of the body, such as the lower back and abdomen. Get a sports massage to reduce the incidence of too-tight muscles causing pain.

Exercises for Patellofemoral Pain Syndrome (PFPS) ?

  1. Stretching Exercises —
    — Quad Exercise
    — Calf Stretch Exercise
    — Hamstring Stretch Exercise
    — Iliotibial Band and Buttock Stretch Exercise
Stretching Exercises for Patellofemoral Pain Syndrome (PFPS)

2. Strengthening Exercises —
— Straight Leg Raise Exercise
— Wall Slide Exercise
— Hip Abduction Exercise
— Hip Adduction Exercise
— Hip Flexion Exercise
— External Hip Rotation

Strengthening Exercises for Patellofemoral Pain Syndrome (PFPS)

3. Yoga Poses/Asanas —
— Balasana (The child’s pose)
— Utkatasana (The supported chair pose)
— Setu Bandha Sarvangasana ( The bridge pose)
— Veerasana
— Padahastasana (The standing forward bend)
— Vrikashana (The tree pose)
— Sukhasan (The easy pose)
— Tadasana
— Reclined raises of the leg.
— Trikonasana (The triangular pose)
— Utthita Trikonasana (The extended triangle pose)

Yoga Poses/Asanas for Patellofemoral Pain Syndrome (PFPS)

Exercises to Avoid for Patellofemoral Pain Syndrome (PFPS) ?

Exercises to Avoid for Patellofemoral Pain Syndrome (PFPS)

These exercises should be avoided if you have patellofemoral pain as they can do more harm than good for your knees!
Remember : Exercise should never cause pain, possibly discomfort but never pain.
— Deep squats
— Leg Extension Machine
— Lunges

Conclusions —

Taking care of your knee is very important, especially if you are a sportsperson. Some form of activities will, without a doubt, cause wear and tear when you do them in higher intensity that it is supposed to be. In turn, this will make you feel uncomfortable or, in worse cases, causes knee pain.

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SUMIT SHARMA

Software Development Engineer, Stock Market Analyst, Fitness Coach, Video Editor, Freelancer