Knee cap pain, often called Patellofemoral pain, is very common in the active population and can be around, behind or above the Knee cap.

It affects a lot of people with knee cap pain making up 8-33% of all knee injuries, which even though this is a large range, is still a lot either way! It can be tricky to treat as there is a number of different causes behind and treatment approaches.(1)

It can be tricky to treat as there is a number of different causes behind and treatment approaches but through utilizing current best practice treatment and research, these are the top tips that will help anyone with knee cap pain.

1. Exercise therapy

The first goal for most people if to reduce pain and that is what exercise has been shown to do in the short, medium and long term. It also improves function with a bit of perseverance so is well worth doing!

The aim here is to do exercises the work the hip and knee together and NOT the knee in isolation. The hip does a lot to control the knee and help stabilize the lower limb so make sure the hip is involved. If your knee is quite sore, start easy with sitting and lying exercises such as clamshells, side-planks and knee extensions.

As you get better, get upright and standing with some weight-bearing exercises such as wall squats, one leg squats and step-ups etc

2. Foot orthosis

Orthotics are recommended to help relieve pain by guiding better joint motion. Just remember that these help in the short to medium term so working on the other tips in the meantime mean you get a great long-term outcome.

3. Physiotherapy (Physical Therapy)

Yup, go see a professional in real life as there are a number of things that, when combined, really help, including:

• Patella taping to help guide the knee cap and retrain movement
• Specific exercise prescription

Note: Patellofemoral, knee and lumbar mobilisations and electrophysical agents were not recommended.

4. Retrain movement

Stand in front of a long mirror and do a one leg squat. This is a great test to see how your lower limb is moving so keep an eye out for:

• Your opposite hip dropping
• How much your knee rolls in towards the center line
• And how much your foot collapses in (pronates)

This way you can see what is going and work to re-train your movement. Find the problem, find what is hard and work at it.

5. Combined interventions

The best way to beat knee cap pain is to persevere with as many of the above 4 tips as you can for as long as is needed (up to 12 months). Stick to your exercises and go see a physio if specific exercises, individual to you are needed.

References:

2016 Patellofemoral pain consensus statement

The “Best Practice Guide to Conservative Management of Patellofemoral Pain”

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