In a healthy knee the patella glides freely. There is a space between your patella (knee cap) and your femur (thigh bone) that is filled with synovial fluid, a natural lubricant, that helps to dissipate the pressure exerted on your knee during activities such as running and climbing stairs. That space is vital to the function of a healthy knee joint.
Runner’s Knee, known medically as Patellofemoral Pain Syndrome (PFPS), often results when the space between your patella and your femur is compromised and your patella can no longer glide freely. When this occurs, your patella rubs against your femur and the excessive pressure leads to inflammation and pain.
In a healthy knee the patella glides freely in the patella groove.(see image above)
What does the research reveal about commonly used methods of treatment and therapy?
Research reveals that knee braces, sleeves, and straps did not reduce pain or improve knee function during exercise programs designed to treat PFPS.
Simply stated, they are ineffective.
If you think about it, most of the products marketed to treat PFPS apply compression to treat the condition. If your patella is rubbing because there is a lack of space, compression will reduce the amount of space even further. Compression does not correct the problem.
So why do so many people wear compression sleeves on their knees? The answer is marketing.
It’s big business. And people dealing from patellofemoral pain are looking for anything that promises relief. In their search for relief they figure “Why not give it a try?”
But there are some people feel that feel like compression sleeves help. Why is that?
One explanation is that compression sleeves help to keep the knee joint warm. A warm knee joint typically feels better than a cold one.
But the root cause of the problem is not being corrected. In fact, the problem is actually being amplified because the pressure and associated rubbing will only increase when compression is applied. Dr Ben Shatto PT, DPT points out that “In some cases, the compression actually alters the position of the patella, which causes the patella to start rubbing on a different area. This can temporarily reduce pain until the new location eventually becomes aggravated and painful as well.” Just like an old frying pan. When the Teflon is gone in one area, you begin using another area until that spot is worn out too. Then it’s time for a new frying pan.
Another explanation is there is a placebo effect that occurs with virtually any type of treatment. Some people feel better just because they are using something that they believe will relieve the pain.
What does research reveal about treatment that works to relieve PFPS?
Let’s begin by establishing that whatever treatment you apply, it must effectively allow the patella to glide freely once again.
For that to occur there must be adequate space between your patella and your femur. Research has shown that physical therapy and proximal exercise is effective at relieving patellofemoral knee pain. Properly applied strengthening and stretching routines can develop and restore balance to knee joint function. It has been shown to deliver relief over the long term.
That said, do not expect immediate relief from physical therapy. It requires compliance to a prescribed routine designed to restore strength and balance to your knee joint. It can improve knee joint function and allow you to return to an active lifestyle feeling better than ever. The long-term benefit of physical therapy will be well worth the effort.
How long will it take before I can resume my activities such as running, hiking, or cycling?
Physical therapy can require 4-8 weeks for a successful outcome. A gradual return and build up to your previous level of activity is typically recommended.
Isn’t there something that can help relieve the pain and allow me to resume activity immediately?
Yes, there is. The use of a novel new device has proven to be very effective at delivering relief and accelerating the ability to return to activity.
It’s called NuNee. It functions as a patella support that places a gentle lift on your patella. NuNee helps to relieve the pressure on your patella. It does not use compression.
So, how can I accelerate my return to activity with a pain free, successful outcome?
Research reveals that if you relieve the pressure you relieve the pain.
The goal is to relieve the pressure on the underside of the patella. As it stands today, there are only two effective treatment options. Those options are 1) physical therapy for long term relief and benefit and 2) a patella support, or NuNee, for immediate relief of patellofemoral pain. It would make sense that combining the two would offer the best outcome overall. With immediate relief being provided by NuNee it will be possible to complete physical therapy and accelerate the return to normal levels of activity without the discomfort of patellofemoral pain.
Dr Ben Shatto PT, DPT agrees. He has used NuNee to treat his patients. “Knee pain is a top 5 diagnosis that I work with in my practice, and so I am always interested in new and novel treatment approaches. NuNee allowed several patients to do trial running and go up/down stairs without pain where they were previously having pain with these activities. I have experimented applying the NuNee before a person's therapeutic exercise program which has allowed the client to work harder and perform a greater volume of exercise without increased pain. This has allowed me to speed up their rehabilitation protocol. So far I have been impressed with the results.”