Patellofemoral Syndrome

Patellofemoral Syndrome & Our Approach

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What Is It, and How Does It Happen?

Patellofemoral syndrome is a patella (knee cap) tracking problem. It if often refers to as “runner’s knee”. The lateral quadriceps muscle, Vastus Lateralis (and often the ITBand) becomes very tight and over powers the medial quadriceps muscle, Vastus Medialis. Ideally the patella should slide up and down in the patellar groove as the quadriceps contract. When the lateral side is too tight the patella is pulled to the lateral side. This causes a tracking problem for the patella and therefore rubbing and inflammation under the patella. The pain underneath and around the patella is the symptom but the areas that need to be corrected are the lateral quadriceps and ITband. At this point we need to examine further and try to determine why the lateral quad is tight. It may not always be a quadriceps problem! 

“Other areas including the hip and the foot also are of concern in this condition.”

This injury is seen in people with poor mechanics of the foot. A person that over pronates with their ankle/foot will put extra strain on these structures. This may be corrected with something as simple as a change of shoes. If the shoe still does not give enough support to control the over pronation, often a custom orthotic will help.

“This syndrome is more common in women due to our wider hips causing a more extreme angle down to the knee (the Q-angle). The increased angle automatically puts more tension on the lateral side of the leg. We cannot change the boney structure of the hips but we can address the muscles in the area and make our clients aware of the importance of stretching.”

This injury is often seen in beginner runners, runners that ramp up their mileage too quickly and runners that are over training. It is important to see a sports specialist when you are having pain or discomfort (even better, see a sports specialist that is also an athlete). We tend to see the same injuries over and over and will therefore have a better understanding of what you can and can’t train through.

How We Approach This

Deep massage therapy is successful in treating patella-femoral syndrome, but I use NeuroKinetic Therapy or NKT to test and never guess what is really happening. This ensures that I can identify the proper structures that are neurologically involved with the biomechanical issue happening at the knee, treat the cause of it, and to assign the correct exercises to keep it away. With NKT the results are seen FAST and I can often get the client back out to regular activity after only a couple visits. For cases that do not immediately respond or that are chronic in nature, I resort to Shockwave Therapy as the tissues need to be stimulated to heal again in order to regain full function. A similar goal is achieved with Graston Technique as well.

 

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This is NOT Graston Technique Therapy

“Oh, Graston® is going to hurt a LOT.” “My friend had Graston done, she looked bruised like she had been hit by a truck.” “My buddy just uses a spoon or mortal rod, it’s the same thing right?” If I had a dime for every time someone said something like those…

Graston Technique Therapy is 6 specifically designed stainless steel instruments that are used to detect and assist in the treatment of soft tissue dysfunction. A Certified Graston Technique Provider will know 14 different strokes and no less than 8 ways to make treatments more conservative or aggressive.

To clarify, It’s not about bruising a patient. For example, If a patient is treated and bruised on Monday, on Thursday we aren’t just treating the original complaint. We are treating the original complaint and bruised up, sore tissue.

What is it about then?

  • The stimulation of fibroblast. Graston Technique has been shown to increase fibroblast and these little cells can differentiate (change) into what your body needs (muscle, tendon, a communicating type cell).
  • Cellular reorganization. I have seen both stained slides and electron microscopy pictures of ligaments at 4 weeks out from time of injury both with and without Graston Technique. The difference is remarkable, see for yourself below!
  • The stimulation of resident mesenchymal stem cells. These cells are key for vascular repair, tissue healing and regeneration.
  • Change in elastic modulus. It’s about making tendons able to recover from loads without lasting deformation. Graston Technique has many case studies and case series showing positive changes in tendinopathies.
  • Changing range of motion. Scour the research and you’ll find numerous clinical trails where people have an increase range of motion in the shoulder or hip post Graston Technique Therapy.
  • Reducing pain. By increasing the activity in local mechanoreceptors (movement receptors), the brain will reflexively decrease the activity in local nociceptors (pain receptors).

Ricki Porter, RMT, owner and founder of R3 Integrative Health is a Certified Graston Technique Provider, and uses this method on a daily basis.

Do you think you have a condition that Graston Technique could help? Call us today ask, you wouldn’t want to miss an opportunity to fix a nagging problem. 506-863-8844

Click here for Graston Technique research resources.

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