Why does my knee hurt?


By Dr. Leonard J. Somarriba and Tom Horvath PTA

The school year is ramping up, fall is here, and seasons are beginning for our favorite sports. But with a new season comes a gentle reminder to be careful not to overdo it while we’re working hard to be the best athletes we can be. A common injury among athletes, runner’s knee, can start by feeling like a minor issue, but without proper care, can progress into a season-ending problem. If you are experiencing pain in the front of your knee you may have runner’s knee.

Runner’s knee, also known as patellofemoral pain syndrome (PFPS), is an overuse injury that mainly involves a feeling of pain in the area around or underneath the knee cap (patella) that can be caused by weakness, tightness, or imbalances among different leg structures. Typically, the patella glides smoothly along its path on the thigh bone (femur), but PFPS can arise when those mechanics are altered due to various reasons.

While not everyone is likely to experience this condition, some of us are more at risk than others. These factors, including muscle strength deficits or a lack of flexibility, can change how the patella moves with the entire knee, resulting in a progressively worsening case of PFPS.

Risk factors include:

  • Weakness in the quadriceps muscles, located at the front of the thigh.
    • Tightness of the iliotibial band (IT band), a connective tissue structure on the outer thigh
    • Tightness of the hamstring muscles along the back of the thigh, or of the calf muscles, as this increases the pressure between the patella and its track along the femur
    • Malalignment of the patella as the knee flexes and extends (bends and straightens)
    • Foot posture: High arches or being “flat-footed,”
    • Limited neurodynamics (nerve mobility) along the thigh

So what can you do once you realize PFPS might impact your season? Some things to consider are whether you are overworking yourself at practice. Resting is important but often not enough to make a full recovery. It’s important to consider how you’re walking or running during the day. Altered mechanics during these movements can stress the knee in ways that can result in the onset of pain. Your doctor of physical therapy can identify and address PFPS and the underlying causes. Physical therapy can resolve the soft tissue restrictions and muscle imbalances that precipitate this condition so that you can return to full participation sooner rather than later.

How can physical therapy help?

    • Strength and endurance exercises
    • Stretching of tight structures
    • Neuromuscular training
    • Improving neurodynamics
    • Proprioceptive training (position-sense)
    • Taping techniques
    • Pain modulation

PFPS does not have to be a season or activity ending condition. However, it is not often resolved by waiting until it gets better or ignoring it. In fact, delaying proper management can make it worse and prolong the healing process. If you are struggling with knee pain, be proactive and call your doctor of physical therapy to begin treatment today. The doctors of physical therapy at ProFysio are experts in managing sports injuries like PFPS and they can help you get back to the activities you love.

Visit ProFysioNJ.com for more information on how ProFysio Physical Therapy can help you live pain free.