Recognizing Patellofemoral Pain Syndrome—Plus Exercises for Prevention

When interventional backbone physician and Kuchipudi dancer Pranamya Suri was doing her medical residency, she had much less time to bop than regular. When she did get the possibility to apply, she observed a persistent ache creating round and behind her kneecap. Suri recognized this ache as a warning signal of patellofemoral ache syndrome (PFPS) and was capable of rehabilitate utilizing a mix of relaxation and focused strengthening workout routines.

Suri explains that it’s widespread for dancers to develop PFPS, however the situation can also be extremely treatable. By studying about PFPS and the way it impacts dancers, figuring out warning indicators early on, and making use of mitigation ways earlier than it turns into a problem, dancers can safeguard their joints and set themselves up for an extended, wholesome profession.

What Is PFPS?

PFPS is characterised by generalized ache round and behind the patella, or kneecap. It’s normally exacerbated throughout cases of knee flexion (like grand pliés), strolling up and down stairs, and even prolonged sitting. PFPS is an overuse damage­—the extra the quadriceps contract and the knees flex, the higher the power pushing the patella again in opposition to the below­­mendacity femur. The result’s ache, explains Karen Clippinger,­ creator­ of Dance Anatomy and Kinesiology and a professor emerita at California State College, Lengthy Seaside.

“When you take a look at grand pliés and hinges and spirals to the ground, there are a number of actions in dance which can be related to excessive compression forces, which places dancers in danger for having this situation,” Clippinger says.

The turned-out positions favored in some dance types would possibly heighten a dancer’s danger for PFPS, provides Jennifer Coviello, a health care provider of bodily remedy specializing in treating dancers—particularly in the event that they battle to trace their knees over their toes in bent-leg positions. Hyperextension, too, can add danger if dancers over-rely on sure muscular tissues, making the knee much less secure, Clippinger explains.

Treating PFPS

When you suppose you is perhaps experiencing PFPS, it’s vital to hunt individualized consideration from a medical skilled. Probably, you’ll work with a bodily therapist to develop a repertoire of workout routines tailor-made to your particular wants. It’s widespread for bodily therapists to counsel strengthening the quads and the hip abductors. In some cases, dancers may also have to work additional up the kinetic chain, strengthening the abdominals and obliques, Coviello explains. Tightness within the hamstrings and internal thighs can even contribute to PFPS, she says, so stretches that concentrate on this area may be included.

Suri provides that she generally makes use of instruments like kinesiology tape and knee-bracing sleeves, however these shouldn’t substitute for the suggestions of a bodily therapist or different medical skilled. “They’re extra of a proprioceptive reminder that can assist you information your kneecap to go this manner, not that method,” she says.

Stopping Future Ache

As a result of many dance varieties involv­e repetitive knee flexion, it’s importan­t for dancers to consider PFPS earlier than it’s a problem. Contemplate adjusting your cross-training routine to combine some preventive­ measures. Clippinger recommends three easy workout routines which goal completely different PFPS culprits (see sidebar). You may as well work your method as much as these workout routines by beginning with out the props.

Clippinger advises dancers to familiarize themselves with their very own anatomy by palpating the entrance of the thigh above the kneecap because the quads contract. Make sure that the internal and outer parts of your quads are each contracting, as that may assist your kneecap observe correctly in flexion. “It actually takes a number of focus and focus to begin discovering the best way to activate that internal half and get it to contract,” she says.

Terminal knee extension with ankle weight

1. Place a prop, like foam curler or bolster, below your hamstrings. Make sure that the knee is bent lower than 30 levels to maintain compression forces low, Clippinger says.
2. Straighten the knee, palpating together with your hand to gauge equal contraction of the internal and outer thigh muscular tissues.
3. Maintain for 5 seconds. Repeat for 3 units of 10. Add an ankle weight for extra problem.

Facet leg increase with band

1. With a TheraBand round your higher thighs, lie on one facet.
2. Externally rotate your legs and raise your high leg, resisting the power of the band.
3. Maintain for 4 counts ultimately place, then repeat between 8–12 instances, beginning with one set and progressing to a few.
4. Contemplate doing this train together with your again to a wall, specializing in utilizing the deep outward rotators­ by urgent into the wall together with your pinky toe. This train helps develop the muscular tissues that may enable your knee to trace correctly in exterior rotation, in addition to strengthening the hip abductors, Clippinger says.

Hip rotation on elbows

1. With a TheraBand round your thighs simply above the knees, lean again together with your weight supported by your forearms.
2. Externally rotate your legs, specializing in turning out from the hip, versus the knee joint.
3. As you straighten the knees, keep away from hyperextension. As a substitute, deal with utilizing the identical muscular tissues you palpated within the first train.
4. Maintain for 4 counts ultimately place, then repeat between 8–12 instances, beginning with one set and progressing to a few.