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health watch: caitlin r. mouille

Knee pain slowing you down? Have you had to stop running because of pain in the front of your knee? If so you are not alone. You could be experiencing Patellofemoral Pain Syndrome (PFPS) or more commonly known as “runner’s knee.” PFPS represents 16-25 percent of all running injuries and is the most common overuse injury in young athletes. Patellofemoral pain is caused when the athlete places too much stress on the front of the knee joint. This can usually occur due to overuse, trauma, faulty technique, muscle dysfunction and tight quadriceps (the muscle on the front of the thigh). Achy or sharp pain can be felt “around” or “underneath” the knee cap when running, bending the knee, squatting, jumping, up/ down stairs, changing direction or sitting with the knee bent.


›› Muscle Imbalance: The quadriceps muscles are working overtime, while the back hip muscles (gluteus muscles) are weak. This imbalance places too much stress on the front of the knee. There is increased workload for the front of the thigh and the back hip muscles aren’t helping control movements. ›› Tightness: Increased tightness of the quadriceps muscle leading to decreased flexibility which compresses the patellofemoral joint. ›› Faulty Technique: It’s common for the knee to rotate or “cave in” while running, jumping or changing direction. This usually occurs because of decreased strength in the ankle or hip. These muscles aren’t able to help support the movements of the knee, thus leading to an increase of stress on the joint.



October 17, 2013

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(Forces on the patella range from half a person’s body weight when walking, to three times body weight walking up stairs and up to seven times body weight while squatting). ›› Overuse: The training program has progressed too quickly. This can lead to the above causes or lead to fatigue due to a lack of rest and recovery.


>> P.R.I.C.E (protect, ice, compression, elevation) to decrease pain and inflammation. ›› If you are over training: If running is causing pain, alternative activities such as swimming or bicycling. ›› If you have a muscle Imbalance: Strengthen those weak muscles! Strengthen your hips abductors, gluteus muscles, hamstrings and calves. ›› If you are tight: Stretch the quadriceps muscle on the front of your knee by pulling your heel towards your buttocks. You can perform this by lying on your stomach to reduce twisting of the knee or arching of the back. ›› Rehabilitation: Physical therapy has been found to be the treatment of choice for PFPS. The physical therapist will give you exercises to help with strengthening and stretching. ✪ Caitlin R. Mouille is a Doctor of Physical Therapy for the Sports Medicine Center for Young Athletes, a division of Children’s Hospital Oakland.

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BA Issue 74, Oct. 17, 2013  
BA Issue 74, Oct. 17, 2013  

Bay Area Issue 74, October 17, 2013