Have you lost your groove?

Have you lost your groove?

Patellofemoral Pain Syndrome


Patellofemoral Pain Syndrome sounds pretty scary. In fact, it is one of the most common knee complaints – up to 25% of the population will suffer from it at onetime or another. Sometimes called Runners Knee, and even Theatre Knee, you don’t need to be a runner or a theatre-goer to suffer from it.



What is it?

As we bend our knee, the kneecap glides up and down the ‘femoral groove’, which is an indentation on the femur (thigh bone). This movement creates pressure between the kneecap and the groove. If your kneecap jumps out of this track, or misaligns, it rubs against the femur and the pressure is increased even further.


Misalignment can be caused by trauma, muscle imbalance or biomechanical problems.


Patellofemoral Pain Syndrome (PPS) often occurs in adolescence as the long bones of the thigh grow faster that the muscles, causing the muscles to tighten and pull the kneecap out of alignment.




The most common causes of PPS are muscular imbalance and biomechanical:


Muscular Imbalance – weakness in your Vastus Medialis Oblique (VMO) muscle, which pulls your kneecap up and inwards creates an imbalance with the Vastus Lateralis, which pulls up and outwards

Biomechanical – poor foot posture and poor control of hip and buttock muscles


Trauma such as a direct fall on the knee can also cause PPS.


Sports that require running and jumping can exacerbate this condition – netball, tennis, volleyball and basketball to name just a few.





Generally with PPS there will be a gradual onset of pain, starting with pain on weight bearing activity, like jumping or squatting, and developing through pain on walking until there is even pain when resting.


The pain can be sharp and sudden or dull and continuous. You may feel or hear grinding or popping and there may be swelling.


And if you were wondering where the term “Theatre Knee” came from here it is. It can be painful to sit with the knee bent for extended periods – as you do at the theatre.




As with many conditions, the first port of call is to reduce pain and inflammation – so back to the RICER (link) principles that we mentioned in an earlier blog. Light massage and chiropractic treatment including taping and dry needling will help with the pain an inflammation, as will anti-inflammatories.


Once the pain and inflammation has settled, a structured approach to Rehabilitation is required. It is likely this will include both a Chiropractor and a Podiatrist. The aim will be to normalize the movement of your kneecap within the femoral groove.


Your chiropractor will assess the strength and balance of your hip, thigh and quad muscles and develop a treatment plan that includes:

  1. Exercises that stretch the thigh, hamstring and calf muscles to reduce tension on the joint
  2. Exercises to strengthen and balance the muscles, particularly the quads
  3. Specific exercises that address speed, power and agility depending upon the needs of your activities or sports


Your Podiatrist will review your foot posture and gait to determine whether orthotics are required. Shoe selection will also be considered, based on your foot posture and activities.


Return to sporting activities should begin slowly, with low impact sports like swimming and cycling. Your Chiropractor will let you know when you can return to your normal sports.



If you are suffering from knee pain, contact our clinic on 9639 7337 to make an appointment for an assessment. The sooner you get treatment, the sooner you will be back in the groove!


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