Patellofemoral Joint Pain (PFJP) is a common complaint in adolescents. The pain tends to be focused at the front of the knee and is often associated with a loss of mobility, strength and function. This may impact on the ability to take part in sports, and if severe may limit walking, climbing stairs and sitting.
My approach to the assessment and treatment of this condition includes the following:
Start with asking about the client’s symptoms which may include pain around the front of the knee, which worsens when climbing stairs and running. They will likely be aggravated by positions of increased knee flexion and it can arise without any specific event or injury.
This is important to carry out during assessment to identify the specific area of sensitivity which is often around the kneecap. It can help to rule out any other diagnoses such as Osgood-Schlatters or a patellar tendinopathy (below the knee cap).
Identify which group the client belongs to:
The active group – plays a lot of sport 5 -7 days per week, doing more than their body can handle and overloading their tissues
The inactive group – doesn’t take part in sports or activities, they are not challenging their bodies. They develop a low exercise tolerance so small activity can cause an overload of tissues, resulting in PFJP
It is vital that the client modifies their activity levels. Reducing the length and frequency of trainings to a level that is pain free, for a short period of time.
Starting with exercises for hip strength and control, then once this has been regained, progressing to more knee specific exercises. Ensure no pain is experienced when carrying out exercises, especially when starting to progress through them. Exercise adherence can be a challenge, so it is important that the client understands why they are carrying them out. Keeping the exercises simple and using an exercise diary to track progression can also be useful.
Orthotics (corrective and supportive devices in the shoes) and taping can also have good effect and we prescribe these at the clinic when necessary.
It is important to set both short term and long term goals for these clients, with the end aim to be to returning to sport and training with a pain free knee.
Along with the adolescents, it is important to educate the parents so they are on-board with modifying activity and sports. They are an important part of ensuring good adherence to exercises and management.
For more information or to book an appointment with me, please contact the clinic on 01 2834303.
By Katie Farrell
Physio Edge 039 Patellofemoral Pain in Adolescents with Michael Rathleff
Brukner P. Brukner & Khan's clinical sports medicine. North Ryde: McGraw-Hill; 2012.