Physical therapy session focusing on knee muscle activation and exercise.

Do you experience knee pain in the front of your knee but don’t know why? You may be experiencing what’s called patellofemoral pain syndrome. This condition is multifactorial but can be treated with appropriately prescribed exercise.

In PTFP, the patella may be the main issue whereby it is not in the correct position it should be, leading to pain being felt in the kneecap region. The patella itself may be tilted, shifted or hypermobile. A potential reason for this can be due to a muscle imbalance between two quadriceps muscles sitting either side of the patella – the vastus medialis and vastus lateralis. Other muscles that are correlated to this pain are located in the hip. If weakness is evident in the external rotators and abductors of the hip, it results in internal rotation of the femur and also the tibia causing a malalignment of the patella between the lower and upper leg.

How do we help this situation? Strengthen the weak muscles that cause an imbalance at the knee. Exercises can include box squats, straight leg raises, leg press, leg extension, clams, standing hip abductions, fire hydrants, bridges, side step ups, and terminal knee extension just to name a few.

Quality of these movements is very important to achieve maximal muscular contraction of the targeted muscle. An Exercise physiologist can pay close attention to exercise performance and ensure these are done correctly. Some people may require ‘beginner’ type exercises for PTFP which takes quality time to ensure the exercises are chosen correctly as to stress the muscles appropriately. When successfully achieved, such exercises can be progressed as to cause further adaptation of the targeted muscles in the hips and quads.

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