You might have heard about Patellofemoral Pain Syndrome or runners knee. Patellofemoral pain syndrome (PFPS) is a common knee pathology causing knee pain in both athletes and non athletes. It can affect both men and women in any part of life.

PFPS is a collective term used for the pain associated with the patellofemoral joint and surrounding soft tissues. PFPS is a chronic condition that occurs because of overloading of the knee front and behind the knee cap. The symptoms get worse with activities like squatting, sitting, running, climbing stairs, jumping, and running. 

If you are also suffering from PFPS, then don’t need to worry because, in this article, we will discuss patellofemoral pain syndrome exercises that will help you ease your pain. 

However, before this, let’s have a look at the causes associated with patellofemoral pain syndrome.

CAUSES OF PATELLOFEMORAL PAIN SYNDROME:

 PFPS usually occurs without a knee injury. However, sometimes knee injury such as falling onto the knee also results in patellofemoral syndrome. In those cases where PFPS occurs without injury, it is always hard to find the exact cause. 

Multiple factors such as starting a new activity, enhancing the intensity or frequency of the activity that you are already doing, or starting training after a period of break can cause PFPS. Other factors that can contribute to PFPS are: 

• Tight Muscles.
• Poor Foot Stability.
• Improper hip control
• Tight Iliotibial Band.
• Quadriceps Dysfunction.

All these factors disturb the biomechanics of the knee and result in abnormal patella movement that enhances the pressure on the patellofemoral joint and results in pain.

SYMPTOMS RELATED TO PATELLOFEMORAL SYNDROME:

The core symptom of PFPS is pain that can be felt anywhere around the kneecap or even at the knee back. PFPS can affect one or both legs. Other symptoms related to PFPS are: 

• Clicking or clucking sound in the knee.
• Mild to moderate swelling.
• Pain when sitting in constant posture for a longer duration.
• Pain in squatting or climbing position.

TREATMENT FOR PATELLOFEMORAL SYNDROME:

After the complete examination, your doctor or physiotherapist will identify the problem that you might have in your particular muscle group, then he will recommend you an Exercise program. 

However, before the exercise program, he will prescribe you pain killers like ibuprofen or paracetamol to reduce pain. He will also recommend ice or hot packs to decrease the swelling around your knee. 

Sometimes patients are also referred to an orthotist for orthotic shoes if their feet are the contributing factor in PFPS. Following all this initial treatment, a complete exercise program is prescribed to the patient that is around about eight weeks or sometimes more to strengthen that muscle group that causes PFPS.

Having necessary information about PFPS and treatments that are used to lower pain and swelling. 

Let’s have a look at patellofemoral Pain Syndrome Exercises and stretches that you can follow at home. 

PATELLOFEMORAL PAIN SYNDROME EXERCISES:

Patellofemoral pain syndrome exercises are the best source for strengthening muscles around your knee. These exercises also aid in releasing the pressure around your knee. Doing these exercises with consistency can correct your knee alignment and muscle balance surrounding the knee. 

We have divided these exercises into four phases. Each phase consists of two weeks that means that it is a step-by-step guide that can help you to strengthen your muscles. 

PHASE: 1 (FIRST TWO WEEKS)

Here are the exercises that you can follow during the first phase of the exercise program if you have PFPS.

SIDE-LYING HIP ABDUCTION:

• Lie down on the exercise mat in a sideline position in a way that your legs should be extended, and your hip should be in a parallel manner. 
• Bend your lower arm beneath your head. In this way, the entire weight of your head will rest on your forearm.
• Let your feet relax in a natural position, right angle to your legs.
• Expire/exhale while lifting your upper leg slightly above your hip joint; when you feel that your hip and back are getting tense, pause and hold this position for two seconds.
• Inhale and descend your leg to its initial position. Keeping it erect and place it directly over the other leg
• Do this exercise twice daily for 10-15 times.
• After the first week, you can wear an elastic band on your thighs to add some progression. You can also increase the hold duration of peak position to 10 secs.  

SUPINELINE BRIDGING

• Lie down with your face in an upward direction with your knees bent to give V shape, arms on your side, and feet placed flat on the ground.
• Lift your butts off the ground and contract your glutei. 
• Slowly descend your hips to their initial position.
• Do this exercise twice daily for 15 times.
• In the second week of doing this exercise, you can add progression by holding yourself for 10 seconds in the peak position, or you can also perform this exercise with one leg raised and one leg flat on the ground to balance yourself. 

STEP-UPS:

• Find a bench, chain, block, or stool so that, when you position your leg on it, your knees should be tilted to 90 degrees.
• Position your entire right foot onto the bench or block then, lift yourself through your right foot, and stand on the bench with your legs.
• Move your left leg first while stepping down and return to the starting position.
• Do this exercise twice daily for10-15 times.
• To add some change, you can increase the height of the chair or stool you are using in this activity.

PHASE: 2 (3^RD AND 4^TH WEEK)

After completing the first two weeks of the exercise program, now it’s time to add some new exercises to your routine. These new exercises are discussed below:

  SQUATS:

• Stand erect with feet hip-distance apart
• Tighten up your abdominal muscles
• Descend to attain a position like you are standing on an imaginary chair.
• Straighten your legs to get the initial position.
• Do this exercise twice daily for 10-15 times.
• You can add progression by wearing elastic bands on your legs, or you can hold the squat position for 10 secs to add advancement to the exercise.

STEP DOWN:

• Begin by standing with one foot on the step or box, one foot off the floor.
• Steadily descend the unaffected leg down off the side of the step. Touch your heel slightly to the floor.
• Restore the original position
• Do the same activity with the opposite foot
• Do it twice daily for 10-15 times every day. You can add progression by enhancing the step height.

MULTIDIRECTIONAL HIP STRENGTHENING:

• Tie the one end of the elastic band around your ankle and the other end with some pillar. 
• Progress the leg in the forward direction and then try to kick
• Now progress the limb to the left side at the angle of 45 degrees from the forward direction, and kick again. Repeat the same action, this time towards the right side. 
• Now do the same activity with the opposite leg.
• You can add progression in this activity by increasing the band strength.

PHASE: 3 (5^th AND 6^th WEEK) 

Following are the exercises that you can do in the third phase of your exercise program. 

SINGLE LEG SQUAT

• Stand straight on your right leg, raise your left leg and keep it erect and slightly in front of your torso. You can also bend your knee. However, it should be raised in front of you.
• Put your arms on your side or in front of you to balance yourself.
• Now descend yourself, just like you do in a squatting position. Hold for 2-4 seconds and then return to your starting position.
• Do this exercise twice daily for 10-15 times. Following improvement, you can increase the hold duration from 2-4 secs to 10 secs.

STEP DOWN WITH ELASTIC BAND:

• Do the same step-down exercise as described above. However, wear an elastic band on your shin bone (lower leg bone) below the knee joint.
• Do it twice daily for 10-15 times. Add progression by adding increasing the band strength.

ABDOMINAL PLANKS:

• Lie on the floor with your face downward and your forearms and toes on the ground. Your forearm should be at the right angle to your shoulder.
• Hold your abdominal muscles, pulling your navel towards your backbone, and lift yourself in an upward direction. Keep your torso erect and firm; and your body in a straight line with no tilting or dangling. This is called neutral spine position. 
• Keep this position for 10 secs and then return to the floor.
• Do this activity once a day ten times.

PHASE: 4 (7^TH AND 8^TH WEEK)

In the last phase of your exercise program, most of the exercises are the same. We have just made some advancements in them.

ONE-LEG SQUAT WITH ELASTIC BAND:

• Perform the one-leg squat as described earlier. However, wear an elastic band on your thighs.
• Do this exercise twice daily for 10-15 times.

STEP DOWN WITH ELASTIC BAND:

• Do the same exercise as described in phase three.

ABDOMINAL PLANKS WITH ONE LEG:

• Perform this exercise in the same way as you have done in phase three. However, instead of lifting yourself on your toes and forearms, balance yourself on a single toe and both forearms and; lift your other leg in an upward direction.  
• Do this activity once daily for 5-10 times.

PATELLOFEMORAL PAIN SYNDROME STRETCHES;

Besides patellofemoral pain syndrome exercises, you can also incorporate some patellofemoral stretches in your routine to completely erase the symptoms of PFPS. These stretches are described below:

QUADRICEPS STRETCH:

• Lie on the floor on your right side. Place your right hand beneath your head for support. 
• Hold your left foot with your left hand, your right leg should be extended.
• Pull your left foot to feel stretch in the quadriceps 
• Hold it for 15-30 secs.
• Repeat this activity with the second leg.

ILIOTIBIAL BAND STRETCH:

• Tilt sideways against the wall
• Stand on the leg that is affected and, your limb should be close to the wall
• Allow your affected hip to drop to the side of your body and against the wall.
• Keep this stretch for 15-30 secs
• Do it 2-4 times

STRAIGHT LEG RAISE:

• Lie in supine line position (lying on back) with your legs erect in your front.
• Tilt the knee on your undamaged side and position the foot flat on the ground.
• Squeeze the thigh muscle of the other leg and raise it about 8 inches off the ground.
• Hold the thigh muscle tight throughout.
• Noe gradually descends your leg back to the floor. 
• Repeat this exercise thrice daily for ten times.

Considering the above written text, we are pretty much confident that these patellofemoral exercises are can help you in the best way to ease your symptoms.

Still, if you want to seek personal suggestions and consultation regarding patellofemoral exercises, I can put a corrective program together to suit your bodies needs or try a class with me. We both will work together to ease your patellafemoral symptoms.        

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