"Runner's Knee"

Patella femoral joint pain (PFJP) commonly known as Runner's Knee

​The PFJ is the joint at the front of the knee connecting the patella (knee cap) and the femur (thigh bone). Pain can emanate from many structures, most commonly the bony surfaces and associated tendons.

Risk factors

• Activities that frequently aggravate symptoms include running (particularly longer runs, downhill running or running on cambered surfaces)
• walking (particularly up and down stairs or hills)
• Muscular tightness/weakness (particularly quads, hamstrings, TFL core and glutes).
• Excessive or inappropriate training load (mileage, intensity)
• Abnormal biomechanics or poor running technique.
• Recent changes or inappropriate footwear or surfaces                                                                                                              

 Signs and symptoms
Patients with PFJ pain experience pain on the anterior aspect (front) of the knee. Patients usually experience an ache that may increase to a sharper pain with activity. Pain is typically experienced during activities that bend or straighten the knee repetitively particularly whilst weight bearing, such as running or squatting in the gym. Pain may be worse first thing in the morning or following activity (once the body has cooled down). This may be associated with knee stiffness and can sometimes cause the patient to limp.

​Clinical signs
Patients with PFJP typically experience pain when firmly touching the distal aspect of the patella and the patellar tendon and also mobilising the patella. In more severe cases, swelling may be present at the anterior aspect of the knee along with an associated grinding sound when bending or straightening the knee. Occasionally, patients may also experience episodes of the knee giving way or collapsing due to pain.

Investigations
A thorough subjective and objective examination from a physiotherapist is sufficient to diagnose PFJP. Investigations such as an ultrasound or MRI may be used to assist with diagnosis.

Management options
Physiotherapy treatment for PFJ is vital to speed up the recovery process, ensure an optimal outcome and reduce the likelihood of recurrence. Treatment options include:

• soft tissue massage (particularly to the quads)
• mobilisation of the patella
• dry needling
• electrotherapy
• ice or heat treatment
• progressive exercises to improve flexibility, strength and balance
• activity modification advice
• biomechanical correction (see our biomechanics page)
• anti-inflammatory advice
• Clinical Pilates and core stability exercises
• footwear advice

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Here are some exercises you can try to improve balance, strength and control.  Aim to keep hips, knees and knees aligned with minimal wobble!  If these do not help then give us a call for an in-depth assessment!

​Central Bath Physiotherapy