The patella is a bone that connects the tendon of your quadriceps (anterior thigh muscle) across the knee joint and attaches to the tibia via your patellar tendon. The patella rests in the trochlear groove at the end of your femur. The patella slides within this groove as you bend and straighten your knee. Cartilage underneath the patella is responsible for smooth, frictionless movement. Repeated abrasion on any of the surfaces of the patella and femur stresses the soft tissues of the patellofemoral joint. Typically, the pain is caused by a weakening of the articular cartilage and swelling within the joint. PFP rarely occurs directly at the knee cap; rather, it refers out around the kneecap, more often medially, and can be felt as pain, an ache, or tightness. 

Patellofemoral Pain Syndrome is most often linked with:

• Overuse. Repeated stress on the knee joint without proper rest to allow recovery or tissue adaptation can lead to irritation under the kneecap.
• Muscle imbalances or weakness. For proper alignment, the body must maintain a straight line from the hips to the feet. However, if the muscles around the hip and knee are weak or imbalanced, this can cause misalignment, leading to stress on the kneecap.
• Muscular Tightness. The muscular structures that cause movement in the knee and hip must be flexible. If any muscle or muscle group is tighter than the rest, patellar tracking is affected, and instability can occur.
• Lower Leg Alignment. The quadriceps alignment between the hip and the knee, known as the Q angle, is thought to affect patellar tracking. Patients with a larger than normal Q angle (greater than 20 degrees) may be more susceptible to PFP because the patella tends to track more laterally.
• Foot Alignment. Individuals with flat feet or excessive pronation have an internal rotation of the lower leg with movement that is associated with proximal hip weakness and altered tracking of the patella.
• Injury. Direct Trauma, dislocation, or impact to the kneecap can result in PFPS syndrome.
• Surgery. Past knee surgery can increase the risk of patellofemoral pain syndrome due to swelling, weakness, or changes in the knee joint’s biomechanics.

Physical therapy is a first-line treatment recommended for patellofemoral pain. Knee pain is a common condition in our Bend, OR, physical therapy practice due to the athletic nature of our community. Once the underlying cause of knee pain is identified, your physical therapist will develop an individualized treatment plan based on your specific condition and needs. Physical therapy can help reduce pain, improve knee function and mobility, and prevent future injuries.

Physical therapy treatment for patellofemoral pain syndrome may include:

• Education/Activity modification
• Range of motion exercises
• Muscle strengthening
• Body mechanics training
• Manual therapy
• Taping or bracing
• Progressive Load Management
• Orthotic Prescription

Physical therapy can be a preventative measure for individuals at a higher risk of developing PFPS. The risk of developing this condition can be reduced by engaging in proactive strengthening and stretching exercises, wearing appropriate footwear, and gradually increasing physical activity. Our physical therapy treatments, which are one hour long and involve consistent one-on-one care with a physical therapist, are particularly effective in reducing rehabilitation times.

Patellofemoral pain syndrome (PFPS) is a condition that can negatively impact your movement, ability to enjoy sports, and overall quality of life. If you are experiencing knee pain, it is recommended that you schedule an appointment with a physical therapist as soon as possible. Early evaluation and treatment can improve mobility and strength, leading to a faster recovery with fewer required physical therapy visits. In Oregon, a referral is unnecessary for a physical therapy evaluation, and if further care is needed, we can work with you to obtain any necessary referrals for future appointments. 

At Alpine, we have a team of highly skilled physical therapists with diverse backgrounds and specialties. If you seek patellofemoral treatment in Bend, OR, we are here to help you recover and regain your quality of life.