Patellofemoral pain syndrome (PFPS), often referred to as “runner’s knee,” is a common condition characterized by pain in the front of the knee, usually around the kneecap (patella). This guide outlines the key exercises and treatments to help manage and recover from PFPS.
Initial Treatment and Pain Management
Before diving into exercises, it is crucial to manage the pain and inflammation.
RICE Method: Rest, Ice, Compression, and Elevation are essential in the initial stages. Avoid activities that exacerbate the pain, apply ice for 20 minutes several times a day, use compression bandages to prevent swelling, and elevate the knee above heart level[5].
Medication: Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen can help reduce pain and inflammation[2][5].
Phase I: Pain Control and Basic Mobility
In the initial phase, the focus is on controlling pain, reducing edema, and restoring normal range of motion (ROM).
Quad Sets: Place a small towel roll under your knee and straighten your knee by tightening your thigh muscles. Press the back of your knee into the towel and hold for 5-10 seconds. Repeat 10-20 times, 3-4 times a day[4].
Straight Leg Raises: Lie on your back with the affected leg straight and the other leg bent. Tighten your thigh muscles, then lift your leg no higher than the other knee. Keep your knee fully straight while lifting and lowering your leg. Repeat 10-20 times, 3-4 times a day[4].
Heel Slides: Slowly slide your heel towards your buttocks while keeping your knee straight, then return to the starting position. This helps maintain ROM[1].
Hip Exercises: Perform exercises targeting hip flexion, extension, abduction, and adduction to improve overall lower limb stability[1].
Phase II: Strengthening and Proprioception
As pain subsides, the focus shifts to increasing strength, proprioception, and flexibility.
Closed Chain Strengthening: Exercises like leg press, terminal knee extensions (TKEs), set-ups, wall sits, and hamstring curls are beneficial. Use abductor and adductor machines to target these muscle groups[1].
Proprioceptive Exercises: These exercises help improve your sense of body position and movement. Examples include single-leg squats and balance boards[1].
Lower Extremity Stretches: Stretch the quadriceps, hamstrings, glutes, abductors, adductors, iliotibial band (ITB), and piriformis muscles. For example, stand with the leg you want to stretch crossed behind the other and lean your hips towards the wall until you feel a stretch on the side of your hip. Hold for 30-60 seconds, 3-4 times a day[4].
Phase III: Return to Normal Activities
In this final phase, the goal is to return to normal activities of daily living (ADLs) and sports without pain or limitation.
Sports-Specific Exercises: Engage in exercises that mimic your specific sport or activity to ensure a smooth transition back to full participation[1].
Cardio Progression: Gradually increase cardiovascular activities to improve overall fitness and endurance[1].
Core Strengthening: Strengthening the abdominal and lower back muscles can help stabilize the knee and improve overall lower limb function[5].
Additional Tips and Considerations
Physical Therapy: Working with a physiotherapist can be highly beneficial. They will assess your knee and create a personalized exercise program to help strengthen your knee and leg muscles[2][5].
Orthotics: Shoe inserts can help align and stabilize your foot and ankle, reducing stress on the lower leg[5].
Surgery: In rare cases where other treatments fail, surgery may be an option for severe, persistent pain[2][5].
Most Important Facts About Patellofemoral Pain Syndrome Exercises
Pain Management: Initial treatment involves the RICE method and NSAIDs to control pain and inflammation[2][5].
Phase-Based Rehabilitation: Rehabilitation is divided into phases focusing on pain control, strengthening, proprioception, and return to normal activities[1].
Key Exercises: Include quad sets, straight leg raises, heel slides, hip exercises, closed chain strengthening, proprioceptive exercises, and lower extremity stretches[1][4].
Physical Therapy: A physiotherapist can provide a tailored exercise program and is crucial for recovery[2][5].
Recovery Time: Most people recover within four to six weeks with consistent adherence to the exercise program[2].
Surgical Intervention: Rarely needed, but an option for severe cases that do not respond to nonsurgical treatments[2][5].
By following these guidelines and consulting with healthcare professionals, individuals with patellofemoral pain syndrome can effectively manage their symptoms and return to their normal activities.
