Pain arising from the knee cap can be frustrating for the athlete. For the approximate 2.5 million runners who are diagnosed with it over a given year worldwide it is a significant trouble. More than 75% of them will have recurrent problems with it, and end up with chronic pain .
Up to now, the majority of treatment has aimed at short term successes, while long term solutions have been harder to come by . New research into the longterm management of PFPS shows that the gold standard treatment principles include:
1. Act Locally
PFPS is associated with force loads through the patella. These loads are higher in women than men, and higher in those with weaker vastus medialis oblique muscles. It is thought that this muscle has the greatest effect on motion of the patella and the femur. Recent studies suggest that it is VMO’s control of thigh motion rather than the knee cap that is the reason for its value in minimising pain .
For the injured person that means we should work hard on strengthening the vastus medialis muscle with a load bearing, slow, controlled strength and conditioning program from your QSMC physiotherapist or Aspire Fitness & Rehabilitation Exercise Physiologist. You will be given key cues to ensure that you maintain an ideal position of your thigh bone during these exercises.
2. Footwear Matters
People with increased mid foot mobility (dropped arch / flat foot) are at a higher risk of PFPS. Foot orthoses prescribed to treat people with PFPS are known to produce positive clinical outcomes .
The podiatrists at QSMC believe that it all begins with good quality footwear. Up to a point, you get what you pay for with brands like Asics, Brooks, and New Balance leading the way in running shoes for the last decade. In recent times, Nike has made a resurgence in technical running shoes as well.
Independent of the choice of brand, choosing a shoe that provides an adequate amount of motion control, especially in and around the arch has been shown to minimise risk of PFPS.
QSMC podiatrists Nathan Eadie and Nick Sprenger may also advise some people to get orthotics where clinically indicated.
3. Core Stability
Evidence suggests that people with PFPS may be weaker around their hip and core . This leads the ‘at risk’ runner to an increased amount of hip ‘internal rotation’ and ‘adduction’ when their foot strikes the ground . At QSMC, our clinicians will ensure that you have the right kind of therapeutic exercise program to activate and strengthen the muscles around your hip, trunk, and upper thigh in order to minimise the leg ‘turn in’ during running and other sporting activity.
With these three simple thoughts in mind, you can minimise the chances of getting PFPS and maximise the recovery process for those with symptoms. If you are already suffering PFPS, or for a general preventative checkup, contact QSMC for the latest in assessment and treatment protocols to get your knees back on track.
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