Patellofemoral pain (PFP) is one of the most common causes of knee pain and can significantly affect your quality of life. The lack of quality long-term evidence can leave physical therapists scratching their heads about the best treatment options for their PFP patients. For clients who want to get rid of their PFP and achieve their goals, here are some tips based on current evidence.
Ultimately, individualized treatment should be multimodal, chosen in collaboration with the physical therapist and follow an active rehabilitation approach. This may require some trial and error; a good understanding of the pain and functioning of your complaint through reassessment is essential to determine the most meaningful treatment modalities for you.
Education is the cornerstone of any physical therapy intervention - without a good understanding of the condition, how can we enable the patient to self-manage with active rehabilitation? First, education about load management strategies, positioning and graded activity can be helpful in pain management and increasing patient self-efficacy. Second, a transparent discussion of treatment options and the lack of long-term evidence for the efficacy of these modalities is recommended to ensure that the patient is informed, and thus can actively participate in treatment planning.
It may also be important to discuss concerns and reassure him about the integrity of the patellofemoral joint. Qualitative research on the beliefs surrounding cracking in the knee found that it causes negative emotions and leads to altered, fear-avoiding behaviors. Taking the time to discuss the complaint with you physical therapist about symptoms such as crackling, and address concerns, may therefore help reduce non-helpful coping strategies.
The lack of high-quality evidence to guide conservative intervention for PFP can be difficult for physical therapists. However, the new qualitative information may help guide clinicians toward a more patient-centered approach to PFP, with the goal of improving long-term outcomes. It is vital to work with the physical therapist to choose the most appropriate treatment options.
