Patellofemoral Pain PROTOCOL

BACKGROUND

` • Description
o Commonly occur in runners and cyclists
o Pain can arise in and around the kneecap,
tendons or the soft tissue around the knee
• Causes:
o Weakness in quadriceps
o Tight hamstring, calf or IT band
o Poor foot posture or footwear
o Weak hip abductors
• Common Signs and symptoms
oPain in the front of the knee, increased with
running or jumping activities
o Pain may be deep or under the kneecap
o Mild swelling
o Tenderness around the patella
• Treatment
o Most often the cause of the pain is soft o Other treatments may include patella
tissue and can be treated with a program of taping, foot orthotics, a patella
rest, ice, activity modification, stretching stabilization brace, or in severe cases
and strengthening of the knee. possibly surgery
Stretching exercises

Hamstring Stretching 1
Patient lies flat on their back with one leg through the door jam
One leg is placed up against the wall
Slowly move the body closer to the wall until a stretch is felt
Continue to move closer as flexibility increases
Frequency: 1 set 3-5 min. 2-3 times a day.
Goal: Increase hamstring flexibility

Hamstring Stretching 2
Patient lies on flat on their back
With a towel wrapped around the foot, slowly raise leg
Continue until a stretch is felt and hold.
Try to keep opposite leg flat on the ground.

Frequency: 3 sets of 60 secs. 2-3 times a day.

Goal: Increase hamstring flexibility

Quadriceps Stretches
Pic 1: Kick back leg and slowly pull heel towards buttock
Try to keep knees close to each other and abdominals contracted
Pic 2: Begin with foot rested on a chair/bench
Slowly lower down until a stretch is felt

Frequency: 3 sets of 60 seconds 2-3 times a day.

Goal: Increased quadriceps flexibility

UCSF Orthopaedic Institute | 1500 Owens Street Ste 170 | San Francisco, CA 94158 | Phone: 415-353-2808 | Fax: 415-353-7593 | orthosurg.ucsf.edu
 Patellofemoral Pain PROTOCOL
Stretching exercises

Hip Flexor Stretch

Begin in a lunge position with knee bent to 90 degrees
Contract abdominal muscles to maintain back posture
Slowly move the hips forwards until a hip stretch is felt
Raise arm to increase stretch. Keep abs contacted!
Frequency: 3 sets of 60sec 2-3 times per day
Goal: Increase hip flexor flexibility

IT band Stretch
Stand next to a rail or stable object and grasp with hand
Step with the leg closest to the rail in front of the other leg
Slowly push hips away from the rail until a stretch is felt
Keep body straight during this exercise
Widen the distance during leg cross to increase the stretch
Frequency: 3 sets of 60 sec. 2-3 times per day
Goal: Increase IT band flexibility

IT band Mobilization
Lay on a foam roller with top leg crossed over.
Keep body in a straight line, do not bend hips.
Roll from the hip to just above the knee.
Use the other leg and hand to offload pressure.
This exercise may cause some bruising to the thigh.
Frequency: 3 sets of 10 reps. 2-3 times per day
Goal: Increase IT band flexibility

Calf Stretch 1
Stand on a step with the ball of the foot on the edge.
Slowly lower heel towards the ground.
This stretch should be performed with the knee straight and
slightly bent.
Frequency: 3 sets of 60 sec. 2-3 times per day
Goal: Increase calf flexibility

Calf Stretch 2
Stand with the ball of the foot against the wall
Slowly move body towards the wall until stretch is felt
This stretch should be performed with the knee straight and
slightly bent.
Frequency: 3 sets of 60 sec. 2-3 times per day
Goal: Increase calf flexibility

UCSF Orthopaedic Institute | 1500 Owens Street Ste 170 | San Francisco, CA 94158 | Phone: 415-353-2808 | Fax: 415-353-7593 | orthosurg.ucsf.edu
 Patellofemoral Pain PROTOCOL
STRENGTHENING EXERCISES:

Straight Leg Raise

Begin in a seated position, resting back on hands.
Flex quad muscles
Slowly raise leg up 24 inches and hold 5 sec.
Slowly lower down.
Frequency: 3 sets of 15 reps. 3 times per week.
Goal: Improved quadriceps strength.

Wall Slides
Stand with feet 18in. infront of a wall
Feet should be shoulder width apart
Slowly lower to 45 degree of knee flexion
Patient can also squeeze a physioball between their knees.
Frequency: 3 sets of 45-60 sec. Three times per week
Goal: Improve quad and hip strength

Single Leg Half Squat

Stand on one leg, next to a stable object like a chair
Keep knee in line with the foot at all times
Slowly bend knee to 45 degrees and hold for 3 sec.
Return to starting position by pushing through the heel.
Work towards performing this exercise without assistance of
a chair

Frequency: 3 sets of 15 reps. Three times per week

Goal: Improve lower leg strength and balance

Terminal Extension
Attach theraband to a stable object at knee level
Place theraband around the leg just above the knee
Step back until theraband is taut with knee slightly bent
Standing up straight, slowly straight leg out by flexing quad
Hold 5 seconds

Frequency: 3 sets of 15 reps. Three times per week

Goal: Increase VMO Quad strength

UCSF Orthopaedic Institute | 1500 Owens Street Ste 170 | San Francisco, CA 94158 | Phone: 415-353-2808 | Fax: 415-353-7593 | orthosurg.ucsf.edu
 Patellofemoral Pain PROTOCOL
STRENGTHENING EXERCISES:

Clam Shell
Patient lies on their side with knees bent
90 degrees.
Keeping feet together, slowly raise knee
towards the ceiling
Squeeze gluteal muscles.
Hold 5 sec. Repeat 10-15 times
Frequency: 3 sets 3 times per week.
Goal: Increase glute medius
strength

Double Leg Bridge

Lie on back with both knees bent 90 degrees
on the floor.
Slow raise hips up towards the ceiling
Hold 5 sec. Repeat 10-15 times

Frequency: 3 sets. 3 times per week

Goal: Increase gluteal strength

Single Leg Bridge

Lie on back with one leg knee bent 90
degrees on the floor.
Pull the other knee towards chest.
Maintaining this position, push foot into
ground and raise hips up
Hold 5 sec. Repeat 10-15 times

Frequency: 3 sets. 3 times per week

Goal: Increase gluteal strength

Lateral Slides
Place theraband around both ankles.
Stand with knees and hips slightly bent.
Take a 6-8 inch step to the side, followed by
the other foot.
Repeat 10 times both directions
Frequency: 3 sets 3 times per week
Goal: Increase hip strength

UCSF Orthopaedic Institute | 1500 Owens Street Ste 170 | San Francisco, CA 94158 | Phone: 415-353-2808 | Fax: 415-353-7593 | orthosurg.ucsf.edu