Patellofemoral pain syndrome (PFPS) is a complex problem caused by a combination of factors acting to put extra stress on the knee itself or the surrounding muscles and ligaments. Examples of aggravators include overuse, knee injury, reduced muscle strength, alignment of the knee cap, foot problems causing extra stress on the knee etc.

Alignment problems may be due to the natural conformation of your knee i.e. your knee cap naturally sits very high or low or, more commonly, it is due to one side of your quadriceps muscle pulling harder than the other side. This results in the knee cap not gliding smoothly in its groove but actually rubbing on one side or the other. The quads muscle, unsurprisingly, comprises 4 different parts. When one part is stronger than another your knee cap gets pulled ever so slightly to the outside, away its natural groove which is what causes the discomfort. The weakened muscle also tends to get very tight and cause pain as well.

Many people find it difficult to pinpoint exactly where the pain is and point vaguely at the knee joint. However, it cannot be ignored and this injury at best impairs performance. The solution is multifactorial. A thorough chiropractic assessment needs to be conducted looking at the movement of all the joints involved in running, the muscular control of the knee, the nerve supply to the knee and the quality of the muscles themselves. chiropractic care would involve treating and/or advising on how to reduce abnormal stresses whilst you run and improve the nerve supply to the area. Specific exercises would be a big part of this as well.

So, should you continue running on your painful knee? You may be able ignore it but I would not advise this as you will not be able to ‘run it off’! If the pain isn’t enough to dissuade you then remember that you are unlikely to perform your best, you risk further more serious injury and it will become less and less enjoyable – and let’s face it, you started because you enjoyed it so don’t give yourself a reason to stop!