Patellofemoral Pain Syndrome – the 411
So, you’ve been to the doc and they’ve told you that you have patellofemoral pain syndrome (PFPS). What exactly does that mean? Does it go away? Can I do anything about it? Let’s unpack all these questions and more.
What is Patellofemoral Pain Syndrome?
At a basic level, the name sounds much more intimidating than it is. Patellofemoral simply means kneecap (patella) and femur (thigh bone). This describes the location of where the pain is at.
Syndrome is a catch-all term. It’s a phrase that doctors use when describing a cluster of different ways people can present. In truth, individuals who have PFPS have it for a variety of reasons and their symptoms present in a variety of ways. This is why it’s a syndrome. The symptoms that are the most common are having pain around your kneecap when you use your leg (think running, stairs, squats, walking, etc.).
Because individuals who have patellofemoral pain syndrome have it due to a variety of reasons, there isn’t one clear-cut way to resolve symptoms. When we work with individuals who have PFPS, we address the specific deficits or limitations that they present with. However, there are common themes among these deficits. These common limitations include hip (glute) weakness, hip flexor tightness, quadriceps weakness, calf tightness.
Addressing Deficits with Patellofemoral Pain Syndrome
Hip (Glute) Weakness
The hip muscles control where the knee goes. Think about a baseball bat – your hands are at one end and the other end contacts the ball (well, hopefully the bat hits the ball when you swing). Your hands are what determines where the other end of the bat ends up.
It’s the same way with your hips and your knees. The strength (or lack of strength) at your hips, determines where your knee ends up. If your hips lack strength, you can’t control your knee as well. When you can’t control your knee, extra motion occurs. This extra motion often – but not always – leads to discomfort.
There are a number of different exercises you can use to develop glute strength, but this is one of our favorite exercises to start clients off with. When it’s done correctly, it’s more challenging than it seems.
Hip Flexor Tightness
When your hip flexors are tight, they pull on your kneecap more. More pulling on your kneecap can cause it to move in a way that causes irritation. This irritation can lead to patellofemoral pain syndrome. A rear-foot elevated split squat (yes, that’s a mouthful) helps strengthen and lengthen your hip flexor at the same time, making it an excellent choice to resolve tight hip flexors.
The reason quadriceps weakness contributes to patellofemoral pain syndrome is very similar to how hip weakness contributes. When things aren’t strong enough to allow for proper mechanics, extra motion occurs. This motion sometimes isn’t visible on a macro level despite occurring on a micro level, which can make it tricky to identify. When quadriceps weakness is on board, the Spanish Squat is one of our favorite exercises to strengthen the quad.
Just like tight hip flexors affect the motion at the kneecap, so do tight calves. While this exercise may not look like your typical calf stretch, it’s more effective than using a strap to stretch or leaning your foot against a wall. It’s more effective because you are putting your body weight through your calf. This puts more tension on the muscle than you can generate by leaning against an object or pulling with a band.
Patellofemoral Pain Syndrome in a Nutshell
There you have it. PFPS is essentially pain around your kneecap. It happens for a variety of different reasons but the most common are glute weakness, hip flexor tightness, quadriceps weakness, and calf tightness. The overwhelming majority of individuals who have patellofemoral pain syndrome are able to completely eliminate their symptoms. So, if you’ve been struggling with PFPS, reach out. Relief is possible and very achievable.