Best Exercises for Patellofemoral Syndrome

It's commonly known as runner's knee, but you don't have to run to feel the pain of patellofemoral syndrome (PFPS). This condition occurs often in young athletes and female athletes especially. Nonathletes experience it, too, especially if they are older. The good news is that PFPS usually responds to a combination of rest, physical therapy, and appropriate exercises.

The skeletal structure of the knee is simple. The kneecap is attached to the bottom part of the femur and the top part of the tibia. The network of connective tissue around it isn't so simple. This connective tissue helps the knee hinge and protects its structure. PFPS often involves inflammation or irritation of some of that connective tissue. 

Patellofemoral syndrome is usually triggered by a problem with biomechanics, the way the body moves during a particular activity. Equipment errors, such as the wrong shoes, or training errors may also cause PFPS.

Exercises to Help Patellofemoral Syndrome

According to experts in the field, exercise is crucial for recovery from patellofemoral syndrome. Other strategies commonly used for knee pain, such as braces, are not recommended for PFPS. Ideally, therapy should consist of both knee-targeted and hip-targeted exercises. Even if you have pain only in one knee, your doctor or physical therapist may instruct you to exercise both sides. 

Because these exercises don't require special machines or equipment, you can do them at home:

Hamstring Wall Stretch

Stretching is a valuable part of an exercise program for PFPS. This one uses the wall to stretch the muscles located on the back of the leg.

Step 1: Lie on your back in a doorway with one leg flat on the floor and extending through the doorway.  

Step 2: Slide the other leg up the wall until it is almost straight and you feel a gentle stretch. 

Step 3:  Keep one heel in contact with the wall and one heel in contact with the floor. Don't point your toes. 

Step 4: Hold for at least one minute.

After you have been doing this exercise for a while, work your way up to holding the stretch longer. 

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Straight-Leg Raises to the Front

Although this exercise seems easy, it is a good strength-builder.

Step 1: Lie on your back with one leg bent at the knee, foot flat on the floor. Keep the other leg straight.

Step 2: Tighten the thigh muscles and raise the straight leg about a foot off the ground. Hold. 

Step 3: After a few seconds, slowly lower the leg to the ground.

Step 4: Rest a few seconds between repetitions.

Step 5: Repeat with the other leg. 

Try for 8 to 12 repetitions. 

Hip Circles

This exercise increases both flexibility and strength.

Step 1: Lie on your side with legs slightly bent and hips stacked. 

Step 2: Straighten the top leg and tighten the muscles.

Step 3: Circle the leg in a clockwise direction 20 times. 

Step 4: Do 20 circles in a counterclockwise direction. 

Step 5: Switch to your other side and repeat.

The circles should be medium-sized, neither large and sweeping nor tiny. Try for three sets of this exercise.

Lateral Step-Ups

This exercise requires a step. If you don't have a platform, you can use a stair-step. If your knee pain is severe, you may need to use a lower step.

Step 1: Standing beside the platform, lift the adjacent foot, and place it on the platform. 

Step 2: Step up on the platform and let the other foot come off the ground, hanging loosely.

Step 3: Lower the hanging foot to the ground and step down.

Step 4: After you have completed your reps, repeat on the other side. 

Try for three sets of 15 step-ups. 

Hip Adductor Strengthening

The adductors are fan-shaped muscles in the upper thigh that stabilize the hip joint. This exercise strengthens them.

Step 1: Sit in a chair and squeeze a soft ball between your knees. 

Step 2: Hold the squeeze for 5 to 10 seconds; then release. 

Repeat 5 to 10 times. If you don't have a ball, place your balled fists next to each other between your knees and squeeze. 

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Safety Considerations

These exercises are safe for most people. You may feel a little pain around the kneecap as you are doing the exercises. This is normal. If an exercise makes your knee sore or swollen, talk to your doctor or physical therapist before you do it again.

If your knee pain was an overuse injury,  look for ways to avoid overdoing it again. If you are an athlete, resume training slowly. Be sure you are warming up before exercise and wearing proper footwear.

WebMD Medical Reference Reviewed by Dan Brennan, MD on November 12, 2020

Sources

SOURCES:

American Family Physician: "Patellofemoral Pain Syndrome."}

Journal of Orthopaedic & Sports Physical Therapy: "Patellofemoral Pain."

Kaiser Permanente: "Patellofemoral Pain Syndrome (Runner's Knee): Exercises."

NHS Oxford University Hospitals: "Patellofemoral Pain Syndrome (PFPS): Advice and management." 

OrthoInfo: "Patellofemoral Pain Syndrome."

Princeton University Athletic Medicine: "Patello-Femoral Pain Syndrome."

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