What is patellofemoral pain?
Patellofemoral pain is pain around or behind the kneecap. The kneecap glides in a groove at the end of the thigh bone every time you bend and straighten the knee. When that joint is loaded beyond what it can currently handle, the area becomes sore.
It is one of the most frequent causes of knee pain in active adults. It is not a sign that the kneecap is broken or that the knee is wearing out.
What does it feel like in everyday Ipoh life?
The pain is a dull ache at the front of the knee that flares with bending under load. Climbing the terrace-house stairs, squatting to the squat toilet, and getting up from a low seat are the common triggers.
Sitting for a long time with the knees bent, for example through a film or a long kopitiam catch-up, can make the knee stiff and sore when you stand. Walking down the steep parts of Bukit Kledang or Gunung Lang tends to hurt more than walking up.
Runners returning to the track after a break, futsal and badminton players, and cyclists who ride with the saddle set too low can all feel it.
Who is it most likely to affect?
It is most common in active people, especially those who have recently increased their running, hiking or sport. It is also seen in people who have been inactive and then started a new exercise routine, and in teenagers going through a growth spurt.
Weak hip and thigh muscles, a change in footwear, or a sudden jump in training can all play a part. The pattern is very treatable with the right plan.
What does a physiotherapist check first?
We ask when it started, what changed in your activity, and which movements bring it on. Then we look at how you squat, step down, run or walk.
We check:
- where the pain sits around the kneecap.
- how the kneecap moves and how the knee bends.
- strength in the thigh, buttock and hip, and control when you step down from a stool.
- flexibility in the thigh and calf.
- your footwear and the training you do each week.
If anything points to a different problem, such as a meniscus tear or a tendon problem below the kneecap, we say so and adjust.
What helps?
The main treatment is exercise that strengthens the hip and thigh, combined with sensible changes to how much load the knee takes. Most people do not need to stop activity altogether.
A plan may include:
- strengthening for the thigh, buttock and hip.
- practice for stair and step-down control.
- reducing or reshaping the activities that provoke the pain, then building back up.
- stretching for tight thigh and calf muscles.
- taping or a knee support for a short period if you find it helps during activity.
- footwear advice for walking, hiking and running.
Recovery varies between people. We set goals with you, and review them at every visit.
What can I do this week?
Keep moving, but spread the load.
- Break up long sitting: stretch the leg out and walk for a minute every half hour.
- On hikes, take shorter steps downhill and use the handrail or a stick.
- Replace deep squats with a shallower range until the knee settles.
- Walk or cycle on flat ground, in the cooler morning or evening hours.
- Do gentle sit-to-stand from a sturdy chair, a few times, three times a day.
Stop an exercise if it makes the pain sharp for more than a few hours afterwards.
When should I see a doctor first?
Go to the emergency department if the knee swells quickly after an injury, looks out of shape, or cannot bear weight. Go too if the kneecap has slipped out and stays out of place.
See a doctor if the knee locks or gives way, if it is red and hot with a fever, or if the pain wakes you at night. Hospital Raja Permaisuri Bainun, Fatimah Hospital and Pantai Hospital Ipoh can assess these.
How do home sessions in Ipoh work?
A physiotherapist visits your house, examines the knee and watches how you climb your own stairs and sit down. We treat on the spot and teach the hip and thigh exercises that suit you.
Visits across Ipoh are available now, and our Canning Garden centre near Fatimah Hospital is opening soon. Prices are quoted on WhatsApp after a short description.
Read how home physiotherapy works, and the wider page on knee pain. If you hike, see hiking Bukit Kledang with knee pain.