Knee pain

Patellofemoral Pain Syndrome

If you are having pain in the front of your knee, it may be coming from your knee cap. If you are having pain coming from this area, we call it patellofemoral pain syndrome!

Patella is the proper name for your knee cap.  Femur is your thigh bone.  Your knee cap sits in a groove on top of your femur.  If your knee cap does not track through this groove properly it can cause pain.

             Anatomy of the knee

                            

This pain tends to be worse while sitting, going up or down stairs, squatting, bending, and after exercising. 

The type of pain is typically described in a vague manner and it is often hard to pinpoint the exact location. It is often described as "surrounding the knee cap" and it may feel like it moves around. Less commonly, it can be sharp and focal.

Your knee is densely innervated with pain receptors and there can be a number of structures responsible for your knee pain. Poor biomechanics (the way you move) and poor quad strength are often the main contributors to irritating knee structures.

The goal of this blog is to discuss some biomechanical reasons why you may be having knee pain and show you taping techniques that can reduce your pain while you exercise.  A structured physical therapy program can help improve your biomechanics and provide you specific exercises to increase your quad strength. Taping can be extremely beneficial during this time by decreasing your pain, which will help you to continue working on your physical therapy exercises.

 I utilize the step down test to both evaluate your biomechanics and to determine if patellofemoral taping will help you.  Here is how the test is completed:

Stand with one leg on a 6-8 inch block, place your hands on your hips and lower your body down until your opposite foot touches the ground.

Do not transfer weight to the leg touching the ground. Repeat this 10 times.

During this process, I look at the quality of your movement. Does your knee cave in towards the arch of your foot? Do your knees go over top of your toes? Does your hip drop? 

These are all bio mechanical factors that can be the reason you are having pain.  With proper treatment they can be fixed!

                                                                                  Poor mechanics before and after treatment

If there is pain during the step down, McConnell Taping (also called Leukotape) can be helpful to reduce or eliminate pain (see below).  There are several theories as to why this may help.  Compression of the joint may help to facilitate smoother motion, ensuring the patella stays inside of the groove. It may also serve as external feedback for your brain, allowing you to fire muscles in a different pattern that help to control the movement of the knee cap.  This process is called proprioception or your body’s ability to know where it is in space.

After taping the knee I re-assess the step down test to see if there is any change in pain.  If the pain is gone, I use the medial (pull the tape toward the inside of your knee) taping technique.  If there is still pain, I look to see if using a different technique that pulls the knee cap superior (up) will be more effective (see below).

Once again, I re-assess the step down test.  If there is less pain with this technique, it should be used while exercising to reduce pain. 

Both improving quad strength and the way your body moves (biomechanics) can help eliminate the problem. McConnell tape is extremely effective in reducing your pain while you work to improve your quad strength. This reduction in pain will allow you to increase your activity so you and your physical therapist can work on strength and bio-mechanical deficits so you can fully resolve the pain.

Click here for full uninterrupted video on patellofemoral pain and McConnell Taping!