Patella
Patella Femoral Joint Pain
Patella femoral joint pain (PFJ Pain) or anterior knee pain is usually described as pain around or under the knee cap, most commonly when the knee bends or in activities such as climbing stairs and squatting. This can be caused (associated with )by a weakness or shortening of muscles around the hip and knee.
Self Management
This condition is usually managed conservatively NOT with surgery.Self Management of your symptoms and compliance with exercises is extremely important in improving pain. You should:
- Stop activities that aggravate your pain wherever possible
- Wear good, supportive footwear with a good shock absorber in the heel ie. a running trainer
- Complete the exercises prescribed my your physiotherapist at least 3 times a day (unless told differently)
The following exercises are given as a guide only. Only do the exercises your physiotherapist recommends. Do not progress the exercises until you are advised to do so.
Quadricep Exercises
Static Quads at 600
Sit in a chair facing a wall with feet on the floor and toes touching the wall, contract your thigh muscle by pushing your heel into the floor and tightening your thigh. Imagine you are trying to push the wall away. Hold each contraction for 10 seconds, repeat 10 times
Static Quads
With your leg out straight, contract your thigh muscles, imagine pushing the back of your knee into the surface underneath. Hold each contraction for 10 seconds, repeat 10 times
Straight Leg Raises
Sitting up, keep the affected knee straight and lift about 30cm’s off the bed. Once improved you can do this with a weight. Hold for 10 seconds, repeat 10 times
Single Knee Dips
Standing on your affected leg with your arms supported. Slowly squat down so that your knee bends and your knee-cap goes straight over your second toe. Repeat 10 times
Glut Exercises
Glut Clam
Lie on your non-affected side with your hips and knees slightly bent and your ankles together. Keep your pelvis upright throughout the exercise, being careful not to allow it to move. Open your knees keeping your ankles together. Hold for 5 seconds, repeat 10 times.
Hip Abduction
Lay on unaffected side with leg extended. Point your toe to the ceiling ( this will end up being hip flex not abd) ensuring your heel, your hip and your shoulders are in line. Slowly raise the extended leg upwards and hold for up to 10 seconds. Repeat 10 times.
Hip Extension (I do bridge exs)
Lay on front, bend the affected knee to 90°, lift your leg as high as you can without moving your pelvis. Hold each lift for 10 seconds, repeat 10 times.
Core Exercices
Trans Abs
Lie on back with knee’s bent and pointing to ceiling. Find your transverse abdominals by finding the bone prominence if your hip bones and moving your fingers 2 inches in. Imagine you are trying to hold in a wee, you should feel the muscle underneath your fingers contract slightly. Try and hold this contraction for 10 seconds, repeat 3 times.
Heel Slides
Start by gaining a trans ab contraction, keep this contraction and slowly slide one of you heels along the bed until your leg is almost straight and then bend it back to the starting position. Repeat with the other leg, repeat 10 times. Ensure you keep your trans abs engaged throughout the exercise.
Standing Exercises
Weight Transference (progress to single leg stance and step through)
Stand with feet hip width apart and toes pointing forwards. Transfer your weight from one leg to the other keeping body upright and still. Keep your core and bottom tight. Repeat for 1 minute.
Hip Abduction on step
Stand on a bottom step sideways so you are holding onto the bannister. Have the foot of your affected side on the edge of the step so your other leg is hanging off the edge. Ensure your hip bones are in line. Keep both legs straight, core and bottom tight. Take the non-affected leg out away from your body and back in. Repeat until your standing leg fatigues.
Lock/Unlock
In the same position as hip abduction on step. Start with you affected leg straight, so it is ‘locked out’, slowly unlock the knee so it is slightly bent then take back into a locked position. This should be a smooth, controlled movement. Repeat 10 times.
Stretches
Quads Stretch
In lying: Sit on the edge of a step or bed. Hug your non affected leg to your chest, roll backwards into lying. Let your affected leg hang over the edge, you should feel a stretch in your thigh. Hold for 30 seconds. Repeat 3 times.
In standing: hook the ankle of your affected side behind you. Lunge forwards until you feel a stretch in the thigh of your affected side. Hold for 30 seconds. Repeat 3 times.