Common Conditions

Knee Pain

Symptoms, Common Causes and Treatments

Understanding Knee Pain: Patellofemoral Pain Syndrome (PFPS)

Knee pain is a common issue that many people face, and one of the most prevalent conditions contributing to it is Patellofemoral Pain Syndrome (PFPS), also known as runner’s knee. This term describes diffuse pain arising from the patellofemoral joint or the surrounding soft tissues. It affects about one in four people annually and can significantly impact daily activities and quality of life.

What is Patellofemoral Pain Syndrome?

PFPS is characterized by pain in the front of the knee and around the patella, or kneecap. The pain often worsens with activities that load the patellofemoral joint, such as squatting, kneeling, walking up and down stairs, and running. Conversely, the pain typically improves with rest and activities that don't stress the knee, like sitting or lying down.

Symptoms of PFPS

The hallmark of PFPS is a dull, aching pain in the front of the knee. Common symptoms include:

Pain when walking up or down stairs
Discomfort during activities requiring kneeling or squatting
Pain after sitting with bent knees for long periods
Pain associated with changes in activity level, intensity, playing surface, or equipment
Popping or crackling sounds in the knee when climbing stairs or standing up after sitting

Causes of PFPS

The exact cause of PFPS is usually multifactorial, involving several contributing factors. However, excessive overload and alignment or orientation of the patellar are the main causes of PFPS.

Overuse

Overuse on knee occurs as the load exceeds its capacity and it can manifest in various forms such as a sudden spike in load e.g. training intensity and frequency, exposure to a new activity or sport, or a change in footwear or playing surface i.e. from turf to concrete. Improper sports training techniques or equipment can also cause similar issues.

Patellar Malalignment

The patella (kneecap) travels along the trochlear groove as the knee bends and straightens. Malalignment of the kneecap relative to the groove can cause uneven load distribution within the joint, resulting in pain and discomfort especially when we squat.

Other contributing factors

Muscular Imbalances or Weaknesses

Biomechanical factors in the lower limbs can also contribute to pain around the patellar region. For example, alignment issues of the hip and ankle joints such as genu varum or valgus can create excessive pressure on the patellofemoral joint. Furthermore, weakness or tightness of muscles around the region like the quadriceps, hip abductors or adductors can also lead to patellofemoral joint pain via imbalances of forces acting upon the patella.

Risk Factors

While anyone can develop PFPS, certain groups are more susceptible:

Athletes or physically active individuals, especially those who run, jump, or squat frequently
Women and people assigned female at birth
Teenagers and young adults aged 20 to 40
People who perform physical labour

Managing and Treating PFPS

Management of PFPS is usually multi-faceted and largely depends on the underlying cause. At Mobilize, we take pride in identifying the root cause of the problem with specific treatment given accordingly.

Professional Treatments

Manual Therapy: joint mobilizations on patellofemoral and tibiofemoral joints, as well as soft tissue therapy on surrounding muscles in order to restore joint mobility
Acupuncture for pain modulation: dry needling techniques targeting trigger points of muscles surrounding the patella can help reduce muscle tightness, which results in improved pain and mobility
Electrophysical modalities: commonly used modalities such as shockwave therapy, interferential therapy and high energy inductive therapy all assist with pain relief for acute pain around the patella
Exercise therapy: specific strengthening exercises targeting weak or tight muscles would be prescribed upon thorough assessment to address the cause of the pain. Quadriceps, gluteal and hamstrings muscles are often the cause of the problem.
Biomechanical assessment: underlying issues with certain movement patterns such as walking, squatting or running can also lead to patellofemoral knee pain. Therefore, assessment and movement adjustments would be conducted if necessary.

Self-Care and Home Treatment:

Adjusting exercise routines to reduce knee stress
Switching to low-impact activities
Implementing activity modifications until the pain subsides

Recovery

Most cases of PFPS improve with simple home treatments and activity modifications. By making the necessary changes to your exercise routine and reducing pressure on your knees, you can effectively manage and alleviate the pain associated with PFPS.

If you're experiencing knee pain or suspect you have PFPS, our team is here to help. We offer personalised treatment plans to address your specific needs and help you get back to your active lifestyle. Contact us today to schedule an appointment

Testimonials & Reviews

After suffering years of chronic knee issues after ACL reconstructive surgery I was recommended to this clinic and the results were amazing. The centre does not only focus on pain relief but with an extremely holistic approach, assesses the root cause of pain and focuses on return to sports and performance once the pain diminishes. Most physiotherapy centres in Hong Kong do not even offer this level of attention to detail and service and would highly recommend to anyone having chronic pains or want to have proper post orthopaedic surgery rehabilitation!

Arnold Woo

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I had never been a believer in physio therapy in the past or that my experience with multiple chain medical physiotherapy center had brought me nothing but temporary improvements. Until I had came across mobilize physiotherapy where they take the extra mile to examine your situation and tailor a physiotherapy session. The physiotherapists at Mobilize not only identifies the root cause and provide massages for pain relievers but also to provide take home exercises for improvements. I was never rush out the door for the next session and they ensure that I had receive the right treatment before the session ends.
I would highly recommend this physiotherapy center.

Edmond Chan

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I came to them with chronic neck and knee issues, and they didn't just provide massage therapy. They took the time to thoroughly evaluate the source of my problems and develop a comprehensive treatment plan.
Through a combination of targeted hands-on therapy, customized strengthening exercises, and patient education, they helped me regain mobility and address the root causes of my pain. I learned the correct ways to strengthen the muscles and improve my posture to prevent future issues.
The staff is incredibly knowledgeable, taking the time to explain everything and ensure I understood how to continue my progress at home. Thanks to their expertise and dedication, I'm now pain-free and able to return to my regular activities without any limitations.

Arthur Liu

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Very professional therapy that doesn't only focus on passive treatment but also targets training of weak spots to improve overall performance and physiological sustainability.

Felix Lo

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Will was very professional. He was very thorough with the assessment and suggested different exercises for me to improve my condition. Recommended 👍🏾

Keith So

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I can't recommend my physio partner enough! They are always patient and provide valuable guidance to help me relieve chronic pain and improve my performance in jiu-jitsu. Their expertise has been invaluable to me. Highly recommended!

Felix Kung

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