Patellofemoral pain syndrome, often referred to as “runner’s knee”, is one of the most common causes of knee pain. PFPS is a common injury seen in adolescent athletes, particularly females. It is caused by an imbalance of forces placed through the patella, or kneecap. The amount of stress placed on the patellofemoral joint varies during certain activities, ranging from about ⅓ to ½ of body weight during walking, 3 times body weight with stair climbing, 5 to 6 times body weight with running, and up to 7 times body weight with squatting. As you can imagine, there is a good amount of running and squatting involved in cheer and this places athletes at an increased risk of developing PFPS.
Risk Factors for Developing PFPS
Any of these factors alone could cause an athlete to develop PFPS, however if multiple of these factors are at play, that further increases the likelihood of the athlete developing PFPS. The good news is that many of these factors are preventable and/or fixable.
Symptoms of PFPS
Treatment of PFPS
Physical therapy is a key component in recovering from PFPS. A physical therapist will evaluate you to help determine what the cause or causes are and then develop an individualized program to address these factors. Some of the common treatment activities include:
Prevention of PFPS
While PFPS is usually easily resolved with physical therapy, there is a high chance that it can recur, or come back, unless changes to your training are made.
An overuse injury is a type of muscle or bone injury, such as tendinopathy (tendinitis) or a stress fracture, that is caused by repetitive trauma.
There are different causes of overuse injuries, but they tend to originate from 2 different sources:
Overuse injuries are more common in athletes as they get older as well as with athletes that specialize in one sport year round. This is part of the reason why it is important for athletes to participate in multiple sports, so different muscles can be used and develop equally with other muscles.
Ways to help prevent overuse injuries from occurring:
If you believe you or your athlete have sustained an overuse injury, it is important to manage and treat it early as it can persist and turn into chronic pain, which tends to take longer to recover from. More mild overuse injuries such as a tendinitis can usually be treated with just physical therapy, more serious injuries such as a stress fracture usually require treatment from a physician.
What is a Muscle Strain?
Often called a muscle pull, a strain is any damage to a muscle or a tendon. Before I talk about what to do if you experience a muscle strain, it is important to understand the different types, or levels, of these injuries.
Grade I: A grade I strain, often called a mild muscle strain, occurs when the fibers of the muscle or tendon are overstretched. There may or may not be a few small tears in this type of strain. You will likely experience mild pain with some mild swelling in this type of injury. This is the most common type of muscle strain seen.
Grade II: Also referred to as a moderate muscle strain, these are slightly more serious than grade I in that the muscle is even more overstretched and some of the fibers are torn, though there is not a complete tear of the muscle or tendon. Likely symptoms include more pain and swelling, along with bruising and some difficulty moving that part of the body.
Grade III: A severe muscle strain is one in which most of the fibers are completely torn, or in some cases the muscle is completely torn or ruptured. Movement is usually very difficult and you will see even more pain, swelling, and bruising than Grade II strains.
More severe muscle strains, including Grade III’s and even some bad Grade II’s should be seen by a medical professional to determine the best treatment options.
Grade I injuries are much more common and respond better to more conservative treatment options.
So I Have a Muscle Strain, What Do I Do?
The most important first step following a mild muscle strain is to rest. If the muscle is damaged, doing activities or exercises that use that muscle will only damage it even more.
Using ice and compression can also aid in managing the pain and swelling that may be present.
If there is swelling around the area, elevating the limb will help to decrease some of that swelling.
Build back up slowly. Once you are ready to return to your sport or activity, don’t just jump right back in where you left off. This increases the chance of a re-injury. Start off slow and gradually work your way back up to the level you were at prior to injury. If you start to feel any pain, take a step back.
Grade I injuries tend to heal rather quickly if these steps are taken, often times in as little as 1-2 weeks. If you are experiencing pain that lasts longer than this, it is a good idea to see a medical professional for a proper evaluation and diagnosis.
How Can Physical Therapy Help?
A physical therapist can do the following:
While there are many benefits of exercise or a hard practice, often times athletes may experience some discomfort. When this occurs, it is important for the athlete to be able to distinguish between soreness and pain. Perhaps you have heard the term delayed onset muscle soreness, but what does this mean? Muscular soreness is a healthy and expected response to exercise. While pain is an unhealthy and abnormal response. Experiencing pain following a hard practice or workout may be indicative of an injury.
So, how Do You Tell the Difference?
This chart below highlights some key differences between the two:
If you’ve been involved in sports or activities, you may have heard the term DOMS before. This stands for Delayed Onset Muscle Soreness and is a normal response to an increase in difficulty of activity. This is the result of small, safe damage to muscle fibers, and usually peaks about 24-72 hours after activity. Movement may initially be uncomfortable, but you may find that moving and stretching gently will help decrease the soreness. During the short time period you experience muscle soreness, you may consider performing alternative exercise activities in order to give your sore muscles time to recover while continuing to strengthen other muscles.
In contrast to muscle soreness, you may experience pain during or after exercise or a practice. This may be a sharp pain and likely involves your muscles or joints. This pain may linger for awhile, even after a rest period. If you find this to be the case, it could be indicative of an injury, opposed to soreness. It is important to note that pushing through a pain could lead to even further injury, so being able to recognize these symptoms is imperative. If you feel the pain is extreme or is not improving within 7-10 days or so, consider consulting a medical professional for further assessment and treatment.
A good way to combat both of these side effects of exercise is to gradually increase the difficulty whenever possible. This will allow the body to adapt more slowly and decrease the risk of muscle soreness and injury.
Disclaimer: The information contained on this website is compiled from a variety of professional sources as well as the author's own experiences. The information should NOT be used in place of a visit to your healthcare provider or used to disregard any advice provided by your healthcare provider.