Newsletter Autumn 2006

Patellofemoral Syndrome (Runner's Knee)

What is runner's knee?
Patello-Femoral Syndrome refers to pain behind or around the knee cap (patella). The condition is characterized by the kneecap rubbing against the thighbone (femur) when moving. The patella is embedded in the common tendon of the quadriceps muscles and forms part of the knee joint by articulating with the femur. There is a groove at the bottom of the femur that allows the patella to move through it as a pulley when the quads are in action. However, should the pull of the quadriceps be unequal, the patella will deviate to one side, rubbing painfully along the patellar groove.

What causes runner's knee?
Runner's knee may be caused by a structural defect, or a certain way of walking or running. Other causes may include the following:

• a kneecap that is located too high in the knee joint.
• weak thigh muscles.
• tight hamstrings.
• Walking or running with the feet rolling in, while the thigh muscles pull the kneecap outward. This is the most common cause in running.
• Biomechanical abnormalities such as over pronation of the feet can also result in incongruity between the direction the patella is pulled by the quadriceps muscle and the shape of the patellofemoral groove through which it travels.

• The following are the most common symptoms of runner's knee. However, each individual may experience symptoms differently. Symptoms may include:
• pain in and around the kneecap that may be felt with activity ( running ), or even after prolonged sitting with the knees bent, occasionally resulting in stiffness and soreness at the front of the knee.
• rubbing, grinding, or clicking sound of the kneecap that can be heard at times when the knee is bent and straightened.
• It is usually aggravated by hill running. The symptoms may quieten down during running, only to recur at the end of a run or later on in the day.

• Stretching exercises for the tight lateral structures of the thigh.
• strengthening exercises of the medial quadriceps and gluteal muscles will help.
• Custom made orthotics specifically designed for you needs. The orthtoics will correct or stabilise the foot in the appropriate manor in order to affect your general gait. They will improve patellar tracking by affecting the foot and the knee biomechanics.