We use our legs all day to get us from point A to point B but we don’t really think about them unless we’re having some sort of issue.
Pain in the lower extremity can be quite a….. well, pain!
Today we are going to talk about the knee and patellofemoral pain.
First, a little knee anatomy review
The knee is comprised of several different joints including the tibiofemoral joint (joint between the two long bones in our leg), the patellofemoral joint (joint between the kneecap and femur), and the proximal tibiofibular joint (joint between the two long-ish bones in our lower leg).
Whoa, that’s a lot of joints that comprise the knee!
You can see now that several joints must work together for our knees to work properly and pain-free!
So let’s narrow it down for the purpose of the blog post and focus on a common source of knee pain.
Patellofemoral Pain
One common source of pain in the knee is patellofemoral pain often called patellofemoral pain syndrome.
With this condition, pain is often felt beneath or surrounding the patella (kneecap) and pain is most noticeable with sitting for prolonged periods, going down steps (usually more so than going up steps), squatting, running, and jumping.
So what are some things that contribute to this problem?
Typically pain occurs when the patella is not tracking properly along the femur. A slight shift of positioning could create a little friction and irritation between the undersurface of the patella and the femur.
The slightly altered tracking usually occurs as a result of a muscular imbalance either through weakness or a range of motion limitation. This could be caused directly from the knee or from further away, such as in the hip or ankle.
How can GOfit help?
Every person is unique and may have differing factors that have contributed to this pain.
So what do we look at to determine what may be contributing to this pain?
Well, we look a number of things. We look at the coordination of lower body movements and functional movement patterns (ie. we watch you walk, go up and down stairs, squat, run, etc…) to assess if there’s any undue stress placed on the knee.
We look at your posture. How is the knee positioned when you are standing?
We look at the mobility of all of the joints in the knee, aka how well do each of those joints in the knee glide in the directions that they are supposed to. Do they glide enough? Or a little too much?
… and then we move on to look at the mobility of the joints up and down the chain from the knee because they have an influence on how the knee is working!
We look at the strength and flexibility of the lower body musculature. Of course we also look at strength of the trunk musculature.
We assess for trigger points and areas that may be tender to touch such as the joint surface.
We rule out any areas that may be referring pain to the knee.
Out of all of these contributing factors is there one magic fix for this pain?
Of course not, you knew that answer!
Every person is unique which causes the factors above to be different for each person. Therefore there is not one basic stretch or exercise that “fits all.”
Truly to get to the bottom of your pain, you should see a physical therapist to tease out which factors are affecting you personally. This way you can have a tailored approach to reach your goal.
But, we can give you some helpful things to work on in the meantime:
Leg positioning: Work on keeping your knee in-line with your foot to keep it in a neutral position. This means avoiding letting your knee fall or rotate inwards. Try to focus on this especially with steps and squatting.
Hip Strengthening: Begin basic hip strengthening exercises such as bridges, hip abduction leg raises, side-steps with a band around your ankles
Lower Body Flexibility: Make sure the muscles in your lower body are as flexible as they need to be, especially your glutes and quads.
Let us know here what you have tried, what is working, what isn’t working, and if you have any questions.