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Knee pain and how best to manage it.

Knee pain, or Patellofemoral pain (PFP) as the correct clinical term, is widely recognised to be a multifactorial condition with multiple potential causes and a wide range of treatment options. This can often result in athletes feeling confused and unsure about what treatment path to take. Education, activity modification, rehab exercises, gait re-training or all of the above have been identified as key components of treating this condition but how do we ever know which one is best suited to our clients? Do we tape, prescribe exercise, massage or manipulate or maybe none of these?! With lots of options but limited time and resources it helps to know what the key treatment is for athletes with PFP and what can be done for them.  Recent research can shed some light on this complex topic…

There are a number of research papers which highlight different approaches to the management of PFP.  This paper by Christian Barton (2015) provides an excellent overview of conservative management strategies for PFP.  The multi-dimensional method is a valuable approach to take as it can often be a case of trial and error in treating these conditions due to the varying factors displayed by each unique individual.  It is also worthy to note the emphasis placed on Gluteal strengthening.  During running, the peak load on the Gluteal Muscles is approximately 4 times your own body weight, so it is imperative that this huge muscle group is catered for in any rehab/strength and conditioning work you may do. The simple single leg dead lift is a classic exercise to help activate and strengthen the Glute area.

Simply put, there is no one main method that will treat, cure or prevent PFP from occurring.  Educating our clients is really important so they can understand why these events happen and then understanding that each individual is unique and will react differently to different methods for a wide range of reasons.  Typically, increase in loads is a common factor for PFP and having clients understand this is key to any treatment plan.  Strengthening the wider chain involved in the knee area will also play a pivotal role in any developments.  Usually, a client would start with isometric exercises of the knee before moving onto anything more advanced.  Massage, taping, dry needling, etc…. are also other adjuncts that can be added to treatments and these can complement rehab strategies really well.  It is a case of working with each individual on a separate basis though and finding what works best for them.

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