What Is Runner’s Knee – Patellofemoral Pain Syndrome?
Patellofemoral pain syndrome (PFPS), often called runner’s knee, refers to pain under and around the knee cap. The pain of PFPS may occur in one or both knees, and it tends to worsen with activity, while descending stairs and after long periods of inactivity. Patellofemoral pain syndrome is often mistaken for chondromalacia, a condition which describes damage (typically softening) of the articular cartilage on the underside of the kneecap (patella). 
What Causes Patellofemoral Pain Syndrome?
While the exact cause of patellofemoral pain isn’t known, it’s believed that the way the patella tracks along the groove of the femur can lead to irritation of the cartilage on the underside of the patella. The patella can move up and down, side to side in the groove, as well as tilt and rotate. All this movement means that the patella can have contact with many of the articular surfaces of the knee depending upon a variety of factors such as muscle strength and balance, overuse, and incorrect tracking. It also means that the cause of the pain may be from a variety of different factors.
What Can You Do About Patellofemoral Pain Syndrome?
Rest is one of the first treatment steps to reduce the pain and severity of patellofemoral pain and runner’s knee. Reduce your mileage or turn to non-impact exercise, such as swimming, to keep your fitness level while allowing your knees to heal.
While many athletes can can manage their own rehab program, ideally you would want a physician or physical therapist to learn the latest treatment options and learn how to perform the exercises correctly. Depending upon your diagnosis, there may be additional strengthening and stretching exercises you will need to add to your routine.
Hip Strengthening for Patellofemoral Pain Syndrome
The latest information about patellofemoral pain syndrome points the focus on strengthening the hips to get the kneecap to track correctly. Research by the Department of Physical Therapy at Indiana University-Purdue University Indianapolis found significant reductions in kneecap pain when women runners were treated with a hip strengthening exercise program. Their study findings support the idea that kneecap motion is more influenced by the hip muscles than the quadriceps, as previously thought.
Previous research on patellofemoral pain syndrome has looked at the feet and the quadriceps as part of the problem. Some people have reported that using specific shoe insoles or strengthening the quads can reduce knee pain, and quad balance may still have a place in treatment.
Footwear and Patellofemoral Pain Syndrome
The footwear your choose, can also be an important factor in recovering from PPS. High quality shoes should be replaced every 300 to 500 miles for a runner. Shoe breakdown can result in more knee pain. Orthotics and arch supports may also be advised. Icing the knees after use, has also been shown to decrease the inflammation, and pain in the joints.
Patellofemoral pain can be hard to treat, and may take considerable time (up to six weeks) to fully recover. So ease back into an exercise routine and maintain quadriceps strength, wear appropriate footwear, and rest at any signs of overuse, and PPS is far less likely to sideline you in the future.
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