PFPS: Sounds like a Governmental Form…

PFPS is an acronym in the sports medicine world for Patellofemoral Pain Sysdrome. This is more a category of injury than an actual diagnosis which can make it very frustrating to all us endurance athletes. Just like other injuries named for those that sterotypically get them; golfer’s elbow, nursemaid thumb, boxers fracture and others. They are not the only ones that will get the injury. Runner’s Knee can befall anyone that repetitively overuses their knees: runners, cyclists, basketball players, hikers, bodybuilders, crossfitters, skiers, and more.

Your kneecap (patella) works like a pulley up against a groove in the front, bottom end of your thigh bone (femur). Each time you bend your knee the patella slides through the groove and when you straighten it it slides back up. As the patella is connected on each end with a tendon (quad tendon on the top and patellar tendon on the bottom) they help hold the knee cap in place up against the groove as it moves. Both surfaces are covered in super slick cartilage (hyaline cartilage). This cartilage has very little friction, so they slide easily when used in normal conditions. As we age, change our nutrition or use our knees differently it will effect the cartilage. If the friction becomes too much for the surfaces under normal conditions it can become inflammed. So, basically when we make the kneecap slide up and down more than it is used to the cartilage and surrounding tissues will become inflamed.

In addition, if you recall that I said the patella is held down on each end by tendons this also creates another issue, pressure. As the knee bends the tendons gets stretched thus driving the patella deeper into the groove. Think of what happens when you try bending your knee with tight pants on. . .you feel an increase of pressure don’t you?

So now lets combine the two to explain how traditional runner’s knee works (PFPS). It is basically an overuse syndrome. Meaning that you overused your body part. One last time . . . YOU USED YOUR BODY PART TOO MUCH. When you run or cycle or hike so much that the friction and pressure from using your knees exceeds what your cartilage can handle it will create damage! This damage causes inflammation. Inflammation causes pain! Depending on how much damage occurs is what determines how long and how much healing can take place.

The number one cause of PFPS is overtraining.  Increasing milage, speed, intensity, resistance or any combination of those faster than your body can accommodate for will create the situation just described above. We have all done it. We will all do it again.

The issue gets complicated. There are many problems that people will call runner’s knee. Just study the picture above. Finding the cause aside from overtraining is difficult at times without help of specialist (like a physical therapist!) that has helped those with overuse injuries. Without knowing the cause it may take people years to figure out their issue. Some just deal with it. Some keep dealing with till it gets so painful they have surgery (which creates many other problems). Anyway, the answer is often not easy to figure out.

Some quick tips:

  • STOP or REDUCE your activity immediately.  Just “working through it” is often the worst choice and can make things worse.
  • EVALUATE your training and activity to see how much you have increased and where.
  • SEEK PROFESSIONAL HELP if your symptoms don’t decrease quickly or you can’t keep them away.  In this day and age of Google, you will have hundreds of answers and opinions about PFPS or any other injury in a matter of seconds.  The hard part is that everyone is different and many of those answers could make you worse!
  • FIND EXPERIENCED HELP when looking for advice.  Some that has actually helped someone with overuse issues.  You can’t always assume the running store attendant knows anything about anatomy, physiology, kinematics, injury process, healing, etc.  They are however, usually a very good resource on training routines and can help you determine if you increased too much.  Just make sure they are a true expert.  Typically if so they will hold running clinics, support races, have educational items and more.  Department stores do not count.
  •  RESEARCH is not a bad thing, but again, just use reputable sources and don’t believe quick fixes.  Our body needs TIME to heal.  Here is one example of additional info I found from Runners World 

As usual, Please use this blog and ask any questions you would like. I would love to discuss this more depth with you. If I can help you PREVENT or CORRECT your injury so you can PREVAIL. It would be my pleasure.