Patellofemoral Pain

Patellofemoral Pain Treatment Melbourne

Patellofemoral Pain (PFP) is a condition where pain is felt on the front of the knee, either around, under or behind the patellar.

The patella is also known as the knee cap that sits at the front of your knee in a groove on your femur (thigh bone). The articulation between these two bones makes up the patellofemoral joint. PFP is a common knee condition that can affect anyone at any age and is mainly felt in activities such as walking up and down stairs, squatting, running, and jumping.

PFP is often also called or diagnosed as patellofemoral pain syndrome, chondromalacia patellae, and runner’s knee.

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Runner's Knee

PFP or runner’s knee can occur due to a variety of reasons. For some, it may be a change in loading that the knee isn’t accustomed to (whether that be an increase in intensity, volume, or surface changes in activities etc.). For others, it may be after a separate injury or after surgery (for example after ACL reconstruction). Importantly, you do not need to be a runner to develop PFP. It is the most common knee pain condition in adolescents and young adults, and common in all walks of life.

Our Approach to Patellofemoral Pain

Treatment for PFP depends on the person and their knee symptoms. At Complete, you will be seen by world leading clinicians. Our team is lead and mentored by A/Prof Christian Barton, the number 1 international researcher in the field of patellofemoral pain according to expertscape.

We take a thorough assessment of your history and presentation to understand what changes or contributing factors may be causing your knee pain. Due to our experience and expertise in this area, our physiotherapists see a large volume of people with knee pain, and we are regularly consulted for second opinions in difficult and challenging cases.

Rehabilitation for PFP

Rehabilitation for PFP will depend on the person and what their knee symptoms are, and the factors we identify that are contributing to their pain and/or difficulties with activities they want to return to. Our team will complete a thorough assessment of your knee to identify why you are getting your pain, and what can be done to help you. You’ll be provided with clear explanations about why your knee might be painful or stopping you doing what you want to do, and provided individualised care, including hands on therapy if helpful. We will develop an exercise program tailored to your needs to improve your strength and function, and teach you how to improve your walking or running mechanics where needed.

Our Holistic Approach to Patellofemoral Pain

Sometimes, if necessary, our team will use taping, shoe inserts and/or manual therapy to help provide immediate relief for your knee, and teach you skills to achieve similar things at home. If needed, we can also refer you to other health professionals to assist with treatments like foot orthotics, support with diet, or for injections. Rehabilitation for PFP can differ from person to person and timeframes can be different, depending on the severity. That is why our programs and exercises are tailored to the individual and their presentation to make sure you get back to the things you love.

Video: Taping for Patellofemoral Pain

In this video, Dr Christian Barton demonstrates a method to tape the patellofemoral joint and control against lateral tracking. The second part of the taping provides support to the fat pad. Both can be very effective at reducing pain.

Published Patellofemoral Pain Research by our Team

Barton, C., de Oliveira Silva, D., Patterson, B., Crossley, K., & Nunes, G. (2019). A proximal progressive resistance training program targeting strength and power is feasible in people with patellofemoral pain. Physical Therapy in Sport, 38, 59-65. https://doi.org/10.1016/j.ptsp.2019.04.010

Barton, C. J., Crossley, K. M., & Macri, E. M. (2018). Should we consider changing traditional physiotherapy treatment of patellofemoral pain based on recent insights from the literature? Br J Sports Med. https://doi.org/10.1136/bjsports-2017-098695

Willy, R., Hoglund, L., Barton, C., Bolgla, L., Scalzitti, D., Logerstedt, D., . . . McDonough, C. (2019). Patellofemoral Pain: 2019 Clinical Practice Guidelines Linked to the International Classification of Functioning, Disability, and Health from the Academy of Orthopaedic Physical Therapy of the American Physical Therapy Association. J Orthop Sports Phys Ther, Accepted May 1st.

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(Barton et al., 2019; Barton et al., 2018; Coburn et al., 2018; Crossley et al., 2016; De Oliveira Silva et al., 2020; de Oliveira Silva, Pazzinatto, et al., 2020; de Oliveira Silva, Rathleff, et al., 2020; Holden et al., 2017; Lack et al., 2018; Macri et al., 2020; Nunes et al., 2019; Nunes et al., 2018; Rathleff et al., 2014; Willy et al., 2019)

Coburn, S. L., Barton, C. J., Filbay, S. R., Hart, H. F., Rathleff, M. S., & Crossley, K. M. (2018). Quality of life in individuals with patellofemoral pain: A systematic review including meta-analysis. Phys Ther Sport, 33, 96-108. https://doi.org/10.1016/j.ptsp.2018.06.006

Crossley, K. M., van Middelkoop, M., Callaghan, M. J., Collins, N. J., Rathleff, M. S., & Barton, C. J. (2016). 2016 Patellofemoral pain consensus statement from the 4th International Patellofemoral Pain Research Retreat, Manchester. Part 2: recommended physical interventions (exercise, taping, bracing, foot orthoses and combined interventions). Br J Sports Med, 50(14), 844-852. https://doi.org/10.1136/bjsports-2016-096268

De Oliveira Silva, D., Pazzinatto, M. F., Crossley, K. M., Azevedo, F. M., & Barton, C. J. (2020). Novel Stepped Care Approach to Provide Education and Exercise Therapy for Patellofemoral Pain: Feasibility Study. J Med Internet Res, 22(7), e18584. https://doi.org/10.2196/18584

de Oliveira Silva, D., Pazzinatto, M. F., Rathleff, M. S., Holden, S., Bell, E., Azevedo, F., & Barton, C. (2020). Patient Education for Patellofemoral Pain: A Systematic Review. J Orthop Sports Phys Ther, 50(7), 388-396. https://doi.org/10.2519/jospt.2020.9400

de Oliveira Silva, D., Rathleff, M. S., Holden, S., Bell, E., Azevedo, F., Pazzinatto, M. F., & Barton, C. (2020). Patients and clinicians managing patellofemoral pain should not rely on general web-based information. Phys Ther Sport, 45, 176-180. https://doi.org/10.1016/j.ptsp.2020.07.004

Holden, S., Rathleff, M. S., Jensen, M. B., & Barton, C. J. (2017). How can we implement exercise therapy for patellofemoral pain if we don't know what was prescribed? A systematic review. Br J Sports Med. https://doi.org/10.1136/bjsports-2017-097547

Lack, S., Neal, B., De Oliveira Silva, D., & Barton, C. (2018). How to manage patellofemoral pain - Understanding the multifactorial nature and treatment options. Phys Ther Sport, 32, 155-166. https://doi.org/10.1016/j.ptsp.2018.04.010

Macri, E., Hart, H., Thwaites, D., Barton, C., Crossley, K., Bierma-Zeinstra, S., & van Middelkoop, M. (2020). Medical interventions for patellofemoral pain and patellofemoral osteoarthritis: a systematic review. Journal of Clinical Medicine, In Press.

Nunes, G. S., Barton, C. J., & Viadanna Serrão, F. (2019). Females with patellofemoral pain have impaired impact absorption during a single-legged drop vertical jump. Gait Posture, 68, 346-351. https://doi.org/10.1016/j.gaitpost.2018.12.013

Nunes, G. S., de Oliveira Silva, D., Pizzari, T., Serrão, F. V., Crossley, K. M., & Barton, C. J. (2018). Clinically measured hip muscle capacity deficits in people with patellofemoral pain. Phys Ther Sport, 35, 69-74. https://doi.org/10.1016/j.ptsp.2018.11.003

Rathleff, M. S., Rathleff, C. R., Crossley, K. M., & Barton, C. J. (2014). Is hip strength a risk factor for patellofemoral pain? A systematic review and meta-analysis. Br J Sports Med, 48(14), 1088. https://doi.org/10.1136/bjsports-2013-093305

Patellofemoral Pain Rehab Course

Patellofemoral pain (PFP) is one of the most common injury presentation to orthopaedic, general practice and sports medicine clinics. During this course, the complex clinical reasoning required to provide an optimal management plan for the varying PFP presentations clinicians see every day will be explored. The course is taught in Melbourne by Dr Christian Barton who is an international expert in PFP management with more than 160 peer reviewed publications in the medical literature.

Learn More

Dr Christian Barton discusses Patellofemoral 'Knee-Cap' Pain

Christian has a chat with Brad Beer on The Physical Performance Show about managing patellofemoral pain

Patellofemoral Pain Blogs & Resources

January
21

Is it ‘all in the hips’? Treating patellofemoral pain
March
20

The Obsession With Strike Pattern Continues: But Be Careful
Common questions

Patellofemoral Pain FAQ

Pain during rehabilitation is normal, and during exercise may go up and down. Our team will tailor your program to minimise pain and talk to you about what pain is ok, and what pain should be minimised or avoided

If you have had PFP for a long time and it associated with associated muscle weakness and wasting, you should see improvements in strength by 3-4 weeks. Improvements in your pain may take longer, up to 6-12 weeks

This will vary depending on your goals and initial condition, and something you should talk to your treating clinician about. In many cases, you may return to the activities you want to do in advance of being able to optimally perform them.

Possibly, but many people continue to have very mild symptoms even when back to sport and full function

Yes. Unfortunately, PFP can be recurrent. Your clinician will discuss strategies to prevent the pain from returning, or to minimise its impact if it does.

Yes, your clinician can help you try taping or shoe inserts, and can also provide you with hands on treatment that can help reduce you pain immediately. This should not replace an adequate exercise rehabilitation, but can help in the short term.

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