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Child Physiotherapy

PFPS (Anterior Knee Pain)

What is (PFPS) Anterior Knee Pain?


Patella Femoral Pain Syndrome or Anterior knee pain is a common injury affecting the Patella and the structures at the front of the knee. There are many structures that can give rise to pain such as the patella (knee cap) the joint, fat pad, bursa and the tendon. It can sometimes be known as a runner’s knee because it is common with joggers and is also seen with people who play sports that involve running, jumping or squats. It is seen most frequently in the young, particularly women who are engaged in frequent sports activity. However, it can affect anyone regardless of age occupation and activity levels.

What does it feel like?

  • Pain at the front of the knee

  • Stiffness or Pain at rest or with periods of immobility.

  • Knee pain with stairs, especially down. 

  • Pain is worse following activity, particularly sports participation

  • Swelling may be present in and around the joint.

  • The sensation of clicking or grinding in the joint, sometimes audible

  • May feel the knee will give way or doesn't feel stable

What causes (PFPS) Anterior Knee Pain ?

There are many potential causes and contributing factors for Anterior Knee pain but chronic overloading is the most common. For example, with too much activity, sport or other recreational tasks we can then cause irritation to the joint or the fat pad. Biomechanical factors can contribute as these may create increased stress on parts of the joint or structures creating increased load. For example, increased foot pronation, poor single-leg stability, muscular imbalances of the hip (weak gluteal muscles)  muscle tightness, poor landing mechanics can all impact. Internal factors such as Joint hypermobility can also contribute. If the knee cap is very mobile then this can glide more in the joint that can then causes increased load on a specific part creating changes and then pain.  

Common Training Errors:

  • Too much volume too soon

  • Increased jumping/plyometric training

  • Increased hill running

  • Lack of variation in training- New sports or activities.

  • Walking up and Downhill often,

  • Sitting down for long periods and lack of mobility

What Treatments can I do? 

If you have Anterior knee pain these injuries can be treated successfully by a Physiotherapist. This will involve a course of specific rehabilitation for the level of irritation you have and what structure/s are involved. There may be other modalities involved to help such as Soft tissue massage, Taping, Acupuncture, Compex Muscle Stim that can help reduce your pain and help your rehabilitation plan. Due to exercises like squats and stairs being irritable and provocative in some, our experts can aid by giving you a very bespoke programme depending on the causative factors and goals.

Treatments for PFPS/AKP can include some of these below.

1. Manual Therapy- Soft tissue release, Massage, Joint mobilisations

2. Stretching- quadriceps, hip flexors, calves, hamstrings, 

3. Strengthening- hip and lower limb being specific on the weakness/dysfunction

4. Electrotherapy- Muscle Stimulation to help improve muscle patterning/activation

5. Taping to support and offload irritable structures such as PFJ, Tendon or fat pad

6. Orthotics if the causative factor is foot biomechanical dysfunction

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