Patellofemoral Pain Syndrome

One of the exciting things for the Pivotal Motion Family lately is the opening of the brand spanking new Reading Cinemas at Newmarket Village! It has certainly made the shopping village more vibrant. However, to us, we can’t help but think one thing: the return of the nasty ‘Moviegoers’ Knee’.

This is such a pain (quite literally) for us physios to treat as it’s so common. In this blog I aim to briefly educate you guys on the knee condition and how to manage it better.

What is Moviegoers’ Knee?

This is the layman’s term for a condition called Patellofemoral Pain Syndrome (Anterior Knee Pain), This is usually caused by irritation of the structures between the knee cap (patella) and the lower end of the femur (thigh bone).

The patella sits in a nice groove between the condyles (bony prominences) of the femur where it joins the knee.

When the knee cap is poorly aligned, there can be grinding or rubbing of the under-surface of the knee cap and femoral condyles. This causes irritation and eventually pain.

The most common maltracking of the knee cap occurs laterally (outward, away from our body’s midline), occuring progressively with time.

The unwanted ‘tug of war’

In Moviegoer’s Knee, the knee cap experiences a tug of war between the inner leg structures trying to pull the knee cap inwards (the VMO muscle – Vastus Medialis Oblique) and the outer leg structures (the VL – Vastus Lateralis and the ITB – iliotibial band).

The outer structures tend to get too tight while the inner structures are too weak, resulting in the patella being pulled outward. Irritation occurs between the patella under-surface and the lateral femoral condyle as the knee moves during everyday movement.

Signs and Symptoms

• Discomfort or Pain with prolonged sitting (hence the term ‘moviegoer’s knee’)
• Pain ascending/descending stairs, particularly descending
• Pain with squatting
• Occasional swelling
• Occasional clicking

How physiotherapy manages Moviegoer’s Knee?

Physiotherapy is definitely the first point of call for treating this condition. Timely physiotherapy will corrected moviegoer’s knee and prevent future episodes.

Our Physios can use any or all of the following to treat this condition:

• Manual therapy – This includes deep tissue massage and patella mobilisations to loosen the lateral structures
• Adjuncts – cupping and dry needling of the lateral structures (ITB & VL) is another way to loosen these structures. Physiotherapists will temporarily strap to realign the knee cap andgive immediate, short-term relief from pain
• Prescription (and performance) of home/gym based exercise programme aimed at VMO and gluteal strengthening with initial activation exercises and progression to functional exercises. Strengthening the VMO leads to stronger inward pull of the knee cap, while gluteal strengthening improves the biomechanics of the femur when squatting. This means that no inward (valgus) drop of the knee occurs. Prescribing foam roller exercises also helps with loosening the lateral structures.
• Education and advice – This includes advice on improving posture as this influences how the knee cap tracks

For more information, particularly if you feel you are experiencing this issue, come and see the physio Brisbane trusts at Pivotal Motion. Book an exercise physiology appointment online or call us on 07 3352 5116.