Patello-femoral pain syndrome (PFPS) or ‘runners knee’ is an overuse syndrome affecting the patello-femoral joint (the joint between the knee cap and the knee joint itself). PFPS is reported to be the most common musculoskeletal overuse injury in active individuals. Current research reports a prevalence of 19-30% in female runners and 13-25% of male runners (Mellinger & Neurohr, 2019). PFPS is often described as a vague dull pain around the front aspect of the knee cap which is often exacerbated when the front of the knee is loaded i.e downhill running, squatting or prolonged sitting (Mellinger & Neurohr, 2019). The symptoms experienced by those with the condition are most likely the result of aggravation to the cartilage on the undersurface of the patella.

Runners presenting with PFPS often report a recent and rapid increase in training loads. This may be the result of increased km’s, changes in your running environment (increased stairs/hills) or changes to running speed etc. In addition to changes in running load the following can attribute to the development of PFPS in a runner:

  • Muscular imbalances/insufficiencies (particularly around the hip and knee)
  • Muscular/joint tightness
  • Altered running biomechanics
  • Poor/decreased motor control (particularly around the core, hip and knee)
  • Lower extremity malalignment (Mellinger & Neurohr, 2019)

Treatment of PFPS initially involves modifying/altering current training loads to allow adequate recovery of the effected joint. Cross training can be an appropriate way to maintain cardiovascular fitness while the knee is symptomatic. During the acute phase of the condition the following can be used to assist symptomatic reduction;

  • Ice
  • Soft tissue therapy
  • Joint mobilisation
  • Taping (Jayaseelan, D. et al. 2018)

Once the knee has adequately settled, treatment should be focused on addressing the underlying causes specific to the runner. A strength and running assessment can help identify muscular imbalances and altered running mechanics which may be causing the runner knee pain (Mellinger & Neurohr, 2019). A targeted and specific strength program is essential to improve running biomechanics and reduce forces placed on the front of the knee. In conjunction with load management and gait specific re-training individualized to the runner, patella-femoral pain can be well managed.

Written by Jack Penny – Physiotherapist (B. PHTY)

If you are suffering from patello-femoral pain or any other musculo-skeletal complaint, then the staff at Northside Sports Physiotherapy can guide you to recovery and get you back on the trails.

Call your nearest practice to book in an appointment:
Hornsby – 9476 1666
Wahroonga – 9489 4588
Lindfield – 9489 4588

Mellinger, S., & Neurohr, G. (2019). Evidence based treatment options for common knee injuries in runners. Annals Of Translational Medicine, 7(S7), S249-S249. doi: 10.21037/atm.2019.04.08
Jayaseelan, D., Scalzitti, D., Palmer, G., Immerman, A., & Courtney, C. (2018). The effects of joint mobilization on individuals with patellofemoral pain: a systematic review. Clinical Rehabilitation, 32(6), 722-733. doi: 10.1177/0269215517753971