How to solve Patellofemoral pain.

By August 14, 2017Rehabilitation

Patellofemoral pain (PFP) or Runner’s knee is one of the most common forms of knee pain people seek medical help for. It’s characterised by pain under the knee cap (patella). This typically occurs when the knee is bent and loaded.

You certainly don’t have to be a runner to suffer with this issue.  

How to solve Patellofemoral pain

A recent study found that 40 – 62% of individuals who suffer with PFP report unfavourable outcomes 1 year on from treatment using conventional physiotherapy.

So if you suffer from PFP, you have around a 50% chance of getting better using standard treatment protocols. 

This is clearly unacceptable. It illustrates the fact a one size fits all approach doesn’t work for many people with PFP.

A more targeted approach.

In an effort to improve those statistics researchers have begun to experiment with more targeted approaches. 

A paper just published in the BMC has shown strengthening hip abductor muscles (in individuals where they were found to be weak) produced positive changes in 62% of participants who were suffering from PFP. 

Whilst that’s an improvement, it still has the potential to leave 38% with knee pain. Not great if that’s you.

Whenever researchers set out to test the influence of strengthening a particular set of muscles, by design other muscles are neglected. 

What if, in the case of the study above, the 38% of people who didn’t improve had weakness elsewhere?

We know that a lack of ankle dorsiflexion can affect how the knee moves. It’s also possible that the knee can be affected by weakness in the adductors (muscles on the inside of the thigh). Or weakness in the muscles of the trunk.  

Even presuming that the problem lies on the side that’s causing pain can be misleading. Adverse motion on one side of the body can certainly influence how the other side moves. 

Targeted and individualised.

We know that muscle weakness greatly contributes to these issues. What we need therefore isn’t a protocol that will work for some of the people some of the time. We require a method of assessing each individual and finding where their particular weaknesses are. 

Muscle Activation Techniques is the only process that I’m aware of which enables practitioners to do just that. 

By comparing motion on one side of your body to the other and looking for major asymmetries, it’s possible to drill down to the precise weaknesses that are leading you to move in a way that causes pain. 

We have around 650 muscles. By the time you wind up with a sore knee it’s not just a handful of muscles that are responsible. In my experience it’s likely to be a few more than that. 

Protocols don’t work.

A protocol will never work for everybody because the reasons we end up with the same injury can be very different. 

Our muscular systems are too complicated for cookie cutter solutions. No amount of research will ever find the magic group of muscles for PFP or any other injury because they simply don’t exist.