Patellofemoral Pain Syndrome

Patellofemoral Pain Syndrome (PFPS) is a common cause of knee pain in both adolescents and adults.  It is especially prevalent in runners and is sometimes called “Runner’s knee”. PFPS is typically characterized by pain at the front of the knee.

Anatomy:
b.pfsmlThe patellofemoral joint is comprised of the patella (knee cap) and the femur (thigh bone). The patella sits in a groove on the femur. When the knee bends, the patella moves along this groove. This is referred to as “patellar tracking”. A combination of dynamic (quadricep muscles and ITB)  and static (articular capsule, medial and lateral retinacula, bony structure and ligaments) stabilizers control patellar tracking.

 

Symptoms:

  • Pain around or under the patella
  • Aggravated by activities such as squatting, going down stairs, kneeling, lunging, running and prolonged periods of sitting
  • Knee may feel stiff
  • May notice clicking or grinding with knee movement
  • Minimal swelling

Causes:
There are 3 primary contributing factors that increase the risk of PFPS.

1) Muscular imbalance

  • Quadricep muscle weakness can impair patellar tracking. When the inner quadricep muscle is weak and the outer quadricep muscles and ITB are tight, the patella is pulled towards the outside, impairing its tracking. Tight hamstrings and calves can also contribute to PFPS. Furthermore, weak gluteus muscles decreases pelvic stability and increase the force placed on the knee which increases risk of PFPS.

2) Malalignment

  • Large Q-angle (wide hips), knock knees and asymmetrical kneecaps can contribute to PFPS. Additionally, over pronation (excessive rolling-in) of the feet can cause the lower leg to rotate inwards, increasing stress on the knee joint.

3) Overactivity

  • Increasing your running/training mileage, speed, intensity and hill work  too quickly without enough rest are common training errors that can cause PFPS.

Treatment:

Physiotherapy can effectively treat PFPS. The first step of treatment is identifying the cause of the problem. A treatment plan will then be created to deal with the cause and prevent injury recurrence. Initially, resting and icing the knee will be important to decrease pain and inflammation. A variety of soft tissue techniques, andjoint mobilization, as well stretching and strengthening exercises will be used to further rehabilitate the knee and surrounding structures. If necessary taping techniques, knee bracing and foot orthotics may recommended to deal with malalignment issues. It is important to note that addressing this issue early will promote faster recovery.

For more information about Kinetic Physiotherapy, visit our website:http://www.kineticphysiotherapy.ca  Contact Kinetic Physiotherapy via e-mail:info@kineticphysiotherapy.ca or phone: 905-637-1414 to set up an appointment.

Connect With Your Core

What is my core?

core-muscles-diagramThe core can be divided in to two groups of muscles, the “inner core” and the “outer core”.

The “inner core” is composed of 4 deep stabilizing muscles: the transversus abdominus, multifidus, diaphragm and pelvic floor muscles.  These muscles do not create any specific movement. Instead, when correctly working together, these muscles turn on before you move your body to provide stability to the spine and pelvis. Therefore, having a strong inner core helps to prevent back injury. It also provides a strong base of support for leg and arm movement which can help to prevent and rehabilitate neck, shoulder, elbow, hip, knee and ankle injuries.

Conversely, when these muscles don’t work correctly, the body must resort to less efficient movement strategies to perform various tasks. This increases your risk for injury, dysfunction and recurrent pain. Research shows that following a back injury, the anticipatory co-contraction of the inner core muscles is impaired. This can create a cycle of: injury, pain, impaired “inner core” muscles and increased risk of injury. This cycle can be broken through targeted “inner core” strengthening.

manage_abs5The “outer core” is composed of the rectus abdominis (“six-pack” muscle), inner and outer obliques and the back extensor muscles known as the erector spinae. These are the muscles that are normally targeted during abdominal exercise programs and “core” exercise classes. The problem with this is that the “inner core” muscles remain untrained and weak while the “outer core” muscles get stronger. During injury, the outer core muscles can tighten up in an attempt to compensate for “inner core” muscle weakness. This can actually contribute to and exacerbate back pain.

Strengthening Your Core
It is very important to add inner core strengthening to your daily routine. We normally do not think consciously about engaging these muscles and you may not even know how to isolate them. A physiotherapist can assess your current inner core strength and co-contraction, teach you how to contract these muscles and provide progressive exercises to strengthen these deep stabilizing muscles. You can also check out this video by Shawna, who takes your through an inner core workout.

Don’t Get Trapped in the Boom-Bust Cycle

Do you have a persistent injury that just does not seem to go away? Do you get better for a while but are plagued with set backs? Do you ever feel  like you are never 100% recovered from your injury? If so, you might be trapped in the boom-bust cycle.

Chronic injuries are undoubtably very frustrating and rehabilitation can feel painstakingly slow.  People with persistent injuries tend to ‘overdo’ an activity which causes a ‘pain flare’ and results in a set back.  This process is known as the boom-bust cycle.

Boom-Bust Cycle

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So, what is the solution? How can you prevent this boom-bust cycle? Here is some advice:

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We hope this advice will help you avoid the boom-bust cycle and lead you on the path to recovery.

For more information about Kinetic Physiotherapy, visit our website: http://www.kineticphysiotherapy.ca  Contact Kinetic Physiotherapy via e-mail: info@kineticphysiotherapy.ca or phone: 905-637-1414 to set up an appointment.

Successful New Year Resolutions

  • new-years-resolution-for-siteIt is hard to believe that 2014 is already here. With a new year just beginning, many people are thinking about self-improvement and the term “New Year Resolution” has been a popular topic of conversation. Everyone has high hopes of… getting  fit, losing weight, eating better, spending more time with family etc. Although motivation  is high right now, enthusiasm tends to dwindle as the month and year continues. The question is, how do we stay motivated to successfully accomplish our New Year’s Resolutions?  One way to succeed is by creating SMART goals. We use these types of goals in the physiotherapy setting to help people succeed in rehabilitation. However, the same principles can be applied to any goal you have and can help you succeed with your New Year resolution.

A “SMART” goal is:

Specific: Goals should be simplistically written and clearly state exactly what you want to achieve (who, what, where, when, which, why, how). You are more likely to accomplish a specific goal than a general one.
Example of a general goal: Get fit.
Example of a specific goal: Join a gym and work out 3 days a week.

Measurable: Goals should be measurable so that you can evaluate when the goal has been met. To determine if your goal is measurable ask questions such as: how much, how many and how will I know when it is accomplished?
Example of a non measurable goal: Get healthy.
Example of a measurable goal: Become more healthy as measured by lowering my blood pressure to a healthy range (120/80 mmHg).

Achievable: Goals should challenge you but be achievable. This requires you to reflect on the strengths, weaknesses and resources that you possess that will enable you to reach your goal.

Realistic: Goals must represent an objective that you are both able and willing to work towards.

Time-Bound: Goals should be grounded within a time frame. This will provide a sense of urgency to help you start working towards your goal.
Example of a goal that is not time-bound: Learn something new.
Example of a time-bound goal: Take a cake decorating class within the next 3 months.

Reflect on your New Year Resolutions. Are they SMART? If not, revise them so that they are. Write your goals down and tell someone to help keep you accountable. We wish you all the best in this New Year and hope these principles will help you succeed with all of your New Year Resolutions.

Leg Flow

Here at Kinetic Physiotherapy, we believe in helping you holistically achieve your health and fitness goals.  Our highly skilled staff are very enthusiastic in helping you recover from and prevent injuries, attain equilibrium in your body, and ensure that you are following through with your rehabilitation program. Because of this we will be creating regular videos  to help you stay healthy and injury free.

For our first video, Shawna guides you through a leg flow series to help increase lower extremity flexibility.  Great for preventing injuries, reducing low back pain, and increasing circulation, energy, and overall wellbeing.

Stay tuned for regular Kinetic Videos!

 

 

4 Exercises You Can Do at Work

Many Canadians spend the majority of the work day sitting at a desk. Although sitting may not seem like a high risk activity, sedentary jobs can have a negative impact on overall health. These types of jobs contribute to obesity and can lead to various other health issues such as tendonitis and neck and back strain injuries. Fortunately, there is something you can do. Here are 5 exercises that you can do at work to help keep you active, healthy and injury free at work.

1. Stretch

Stretching regularly will help to decrease tension and tightness in your muscles. Here are 10 simple stretches you can do at your desk. Try to perform a few of these stretches, 3-4 times a day. Hold each stretch for 20-30 seconds. Stretching should be pain free. (If any of these stretches cause pain, numbness or tingling, contact a health care professional)

2. Strengthen Muscles

-Glute squeeze: while sitting at your desk, tighten your buttocks, hold for 5 seconds, then relax. Repeat 10 times

-Heel raises: if you are taking a standing break, raise up on the balls of your feet by lifting your heels off the ground. Repeat 20 times

-Chair Squat:  without using your hands stand up and sit back down in your chair. Repeat 10 times

-Leg raises: When sitting, tighten your thigh muscle and kick your leg out straight. Hold for 5 seconds, repeat 20 times.

3. Stand Up

Every 15-20 minutes, take a break and stand up. Standing helps to improve circulation and posture, relieves stress and can decrease low back pain.

4. Go for a Walk

On your lunch break, go for a walk. Walking for just 10 minutes can help to control blood sugar and cholesterol, burn fat, increase energy and decrease stress. If possible, change into walking shoes to ensure your feet are well supported.