According to the American Academy of Family Physicians, patellofemoral pain syndrome or PFPS, also known as runner's knee or jumper's knee, is pain behind the kneecap or patella caused by physical and biochemical changes in the patellofemoral joint or the articulation of the kneecap and the femur or thigh bone. PFPS can also be brought on by prolonged sitting.
Physical Therapies
Physical therapy modalities can help treat PFPS. According to Dr. Michael Carnes, a chiropractic physician and the author of "Quick Reference Conservative Care Conditions Manual," passive physical therapy modalities, including ice, ultrasound and electrotherapy, may be used to reduce pain and speed healing during the acute or initial phase of PFPS. Along with resting for one to two weeks and avoiding any activities that make the knee pain worse, Carnes recommends icing the involved area for 15 to 20 minutes, three times per day.
Ultrasound, which involves the use of ultrasonic waves for therapeutic purposes, may also be an effective physical therapy modality in the acute phase of PFPS. A health care provider performing ultrasound for PFPS will be especially careful to avoid contacting bone during the treatment, as ultrasound may irritate certain parts of the bone. Electrotherapy--the use of electrical energy as a therapeutic treatment--may be effective for acute stage PFPS when performed multiple times per week for several weeks.
Manual Therapies
The Sports Injury Bulletin states that manual therapies are an important adjunct therapy in the treatment of PFPS. According to Carnes, manual therapies for PFPS should be performed in the post-acute phase of the condition and could include massage therapy techniques such as cross-fiber friction massage to the infrapatellar tendon--the thick band of tissue that joins a person kneecap to the tibia, or shin bone; myofascial release to the tissues surrounding the knee joint; and trigger point therapy to the quadriceps, hamstrings and iliotibial band muscles. Instrument-assisted soft tissue mobilization or the use of beveled-edged tools to reduce scar tissues and myofascial adhesions in the tissue surrounding the kneecap may help treat PFPS. Carnes states that manipulation and mobilization of the kneecap, knee, foot, pelvis and spine are also manual therapies that can be used to treat PFPS.
Exercises
According to the Nicholas Institute of Sports Medicine and Athletic Trauma, a sports medicine research facility and clinic, conservative treatment of PFPS involving stretching and strengthening exercises can help relieve symptoms. The principle goal of a rehabilitation program for PFPS is to restore full, dynamic knee joint range of motion, power and stability. Excessive tightness above or below a person's kneecap can place undue stress around and under the kneecap by limiting normal joint range of motion. Stretches to reduce PFPS-related symptoms target the thigh and lower leg muscles that cross the knee joint, including the hamstrings, quadriceps, iliotibial band and gastrocnemius and soleus muscles. Strengthening the lower extremity musculature can help reduce pressure on the kneecap. Effective lower extremity exercises to decrease PFPS-related symptoms include straight leg raises, hip abduction and adduction exercises and hip flexion exercises.
