Three Tips to Avoid Patellofemoral Pain

Have you ever gone up a few flights of stairs quickly and felt a little soreness in the front of your knee?  Or have you crouched down to pick something up from the ground and felt a sharp twinge under your knee cap when you got up?  Chances are that you have at least once.

Patellofemoral dysfunction is the most common cause for knee pain in the United States.  It develops secondary to tracking issues of the knee cap.  In normal gait, the patella should glide up and down in a groove that lies at the end of the femur (thigh bone).  If for some reason the patella isn’t gliding down the middle of the groove, it will lead to pain in the front of the knee.

Thankfully, along with being the most common ailment of the knee, it also happens to be one of the easiest knee dysfunctions to fix if you know what to do.  Here are three simple tips to help you avoid patellofemoral knee pain:

  1. Take a look at your shoes – Believe it or not, if you foot isn’t properly supported it can lead to improper positioning of the knee in the gait cycle.  When shoes have improper medial (arch) support, it can lead to increased stress at the knee allowing the knees to drift inward.  This slight inward drift can be enough to lead to abnormal tracking.  Go to your local running store and have a professional fit you for your next pair of running or walking shoes.  It is worth it!
  2. Work on your hips in single limb positions – The second way to help fix improper tracking mechanics is to work at the hip.  The proximal muscles at your hip also help to control against the inward drift of the knee.  If certain muscles are weak (glut medius in particular) it can lead to improper tracking of the patella and possible patellofemoral disorders.  Some research has found that one of the best ways to work on lateral hip strength is in single limb, balance exercises.  Try doing single limb deadlifts at the mirror with your knee facing straight ahead or work on the TRX while balancing on one leg.
  3. Train your leg muscles at speed – You can have the strongest leg muscles in the world, but if you don’t train your muscles at speed, they won’t be any help at all when doing more challenging activities such as running.  Jogging is a complex and quick task.  Your muscles need to be able to contract quickly in order to control the impact of you landing on a single leg while running.  If you haven’t been training your leg muscles at speed, they may not be able to contract quickly enough in order to dissipate the forces from landing on the ground, and will send large compressive forces up into the knee. Train with squat jumps and then work up to single limb jumps in order to get ready for running.

These are just a few ideas to get you started.  If you want to work on protecting your knees further, I suggest that you seek out one of the trainers at the club to give you more specific ideas of exercises that you can try in order to strengthen the muscles around your knees.  If you continue to have problems with knee pain, go to your doctor and they might be able to recommend where to go next so that you don’t miss a step!

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Diana grew up in a small suburb north of Boston. She received her clinical doctorate degree in Physical Therapy at Boston University in 2006. Diana started practicing as a physical therapist at Massachusetts General Hospital. While at MGH, she developed a specialty in the evaluation and treatment of complex lumbopelvic dysfunction. Diana is currently practicing at Spaulding Rehabilitation Hospital in Boston where she is the Orthopedic Clinical Supervisor of the Spine program. She is presently a Boston resident and her interests outside physical therapy include cooking, walking on the Esplanade, and international travel.

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