Patellofemoral Pain Syndrome

Knee painPatellofemoral Pain Syndrome is a common knee complaint of not only the young and nimble, but also amongst the elderly. To break it down, this can be best referred to as pain felt behind your kneecap, where your patella (kneecap) joins to your thigh bone (femur). This part of your knee is referred to as your patellofemoral joint.


Your patella should glide up and down through the femoral groove during normal movement. When the patella moves to one side more than the other due to muscle imbalances or poor biomechanics it is unable to align and track smoothly on the femur, consequently rubbing against the femur and increasing pressure in the joint. Over time, poor alignment of the patella can lead to kneecap pain, joint irritation, and can eventually result in the degeneration of the surface of your patellofemoral joint.

Although aching kneecaps, especially discomfort behind the kneecap, can impact up to 25% of the population at some point in their lives, patellofemoral pain occurs commonly in athletes. This particular condition is typically found in activities that involve jumping, running and squatting. These sports may include running, tennis, basketball, football and netball. It also commonly occurs when an individual’s activity load increases, for example when starting a new sport, gym program, or with additional training before a competition.high knees

This condition is quite common during adolescence, as our ‘long bones’ tend to grow faster than the muscles, ligaments and tendons, therefore placing abnormal strain and pressure on joints. Stretching and strengthening the appropriate muscles is important to achieve optimal biomechanics throughout our lifespan.


The discomfort that you feel behind your kneecap normally increases gradually, rather than it being instant. For those who suffer from this type of discomfort, it is generally noticed during weight bearing activities that require bending the knee.

Movements such as climbing stairs, hopping, running, kneeling and squatting are commonly painful. As your patellofemoral pain syndrome becomes more severe, it may become painful to walk and then ultimately be painful even at rest.


Musculoskeletal physiotherapy intervention is an effective solution both short and long term for your kneecap pain. The aim of treatment for this conditions is predominately to reduce the ache and inflammation, and to find the underlying cause of the condition to avoid it from reoccurring in the future.

Running Recovery and Injury Prevention

Running Recovery and Injury PreventionAs the ‘fun run’ season starts to get into full swing, we are seeing more and more people out hitting the pavement. While running is a great way to improve your fitness (and see the sights), people often underestimate the load it places on your body. Running is predominantly a single leg activity. That is, when running with good technique, there should be little to no time with both legs on the ground. As a result, running requires a lot of leg strength and core (trunk/pelvis) stability. Running can be a fun and rewarding form of exercise, but without the right care, it can also lead to frustrating injuries.

There are lots of steps that can be taken to help eliminate running pain and injury.

Rest and recovery

Soreness following exercise is referred to as “delayed onset muscle soreness” (DOMS). Appropriate rest and recovery strategies can help minimise the severity of DOMS. Below are some recommendations:

  • When you finish your run, do a few minutes of gentle jogging or walking before jumping in the car to head home. This allows your muscles time to cool down gradually and to clear any waste products (such as lactic acid) from your blood. It will help you to feel less stiff the next day and reduce the time needed between running sessions
  • Allowing enough rest time between running sessions. If you have not been running recently, then allow your body a few days between running sessions and only start with 1-2 days of running per week. As you build up your body’s endurance and tolerance to running, you should be able to run more days a week and with less days between
  • Watermelon juice! Studies have shown the tasty fruit juice contains high levels of L-citrulline which reduces the severity and onset of DOMS. Consuming the juice was more effective than taking a supplement of the same dosage
  • There is evidence that hot Epsom salt baths improve muscle soreness. There is also evidence for the slightly less appealing ice-baths… Everyone has their preference so test it out and see what works for you
  • Regular self-releases, massage and physio!

Releases – Musculoskeletal Physiotherapy Brisbane

running injury preventionThe main ‘running muscles’, can get tight from the increased work-load of running. Regular releases of these muscles can help reduce the tightness in them and hence reduce the risk of injury. Below is a collection of muscle releases- all muscle releases should aim for 2-3 spots per muscle, with each spot being released for 60-90 secondsRunning releases recovery

  • Glutes are one of the main stabilisers of the pelvis as well as being the ‘powerhouse’ for propelling the body forward when running. As a result they can get very tight!
  • Hamstrings are also important for helping produce force for running and are also commonly ‘overloaded’ when the glute muscles are tight or underactive
  • Quadriceps and hip flexors lift your leg and control your leg when it hits the ground. Tightness in the quadriceps is often associated with knee aches and painsrunning releases
  • Calf muscles (gastrocnemius and soleus): calves are responsible for the ‘push off’ of your feet and also help control your foot strike when running. Overly tight calves can lead to ‘shin splints’ and Achilles tendon problems



Having an all over body assessment of your muscles, joints, nerves and movements by a running physio can help pick up on any particular areas of restriction that may become a problem.

Happy Running!

Preventing a Climbing Injury

climb-4Climbing is a high demand sport. No question about that. When looking at other sports that are such high demand it is protocol to run through some form of warm-up. All too many times I have gone down to on of Brisbane’s Climbing Spots, Kangaroo Point cliffs and witnessed people just rock up, set-up their gear and get right into their climb. We have all been there, myself included. We’re time crunched, with no time for anything but pumping out a few climbs, right? Sometimes you’ll start with an easier climb, but for the most part no warm up required….

And this is how we set ourselves up for injury.

So why is warming up so important?

Prepares you physically and mentally for the climb by:

  • Increasing blood flow to the muscles
  • Increasing body temperature which increases tissue elasticity and thus increasing joint/muscle range of motion
  • Increasing neuromuscular co-ordination (muscles will fire in the pattern appropriate to climb)
  • Helping you get your head in the game

Prevent Climbing InjuryHow to do a proper climbing warm-up:

  1. Do a general warm up to get your blood flowing and your temperature up: jog, skip, jumping jacks, body weight lunges and squats
  2. If you feel restricted somewhere after your general warm-up you can do some dynamic stretches for the area. This type stretching is done with movement that will prepare the muscles to work rather than relax them into a state they don’t function optimally. Similarly, muscle releases can increase range of motion without affecting strength or performance. NO static stretch prior to climbing. *note static stretching and release work is definitely encouraged post climb!*
  3. Bouldering/easy climbs practicing various holds and moves you expect to use climbing that day. Brisbane Climbing at KP has a range of climbs so you can build into your work out.

A good warm up is key to getting things working from the start and preventing injury!

Other Factors to help Prevent Climbing Injury

Being properly hydrated

Getting enough sleep to allow adequate muscle healing/regeneration

Proper Nutrition: adequate carbohydrate, protein, vitamin C and E

Strength training

New Year Running Program!

Running Physio - 5km run - trainingWith the New Year upon us, many of us are setting health and fitness goals to keep us motivated and focused for
2017. This is a great way to stay committed to looking after your health. However, to truly take great care of yourself, it is important to take a gradual approach to new activities to allow your body time to adapt and minimise the risk of injury. Too often we see people dive head-first into a new exercise or activity without preparing their body and end up stiff, sore and side-lined from working towards their goal. Taking the time to plan and prepare for starting a new activity can help eliminate the need for time-off later on.

One of the most common goals we see people setting for themselves is a target running race. Whether it be the Gold Coast marathon, the Bridge to Brisbane 5km or anything in between! To help you on your way to achieving your running goals, below is a suggested program for working towards a 5km run. This is targeted at people who are currently active in some way, but have not done much running recently.

Sports Physio - 5km runIt is very easy to get focused on just running, when your goal is running related. However running is a high load activity on the body- it is essentially single leg squat jumps one after another for minutes on end! As such it is important to give your body time to rest and recover from running days- especially when it is new. Strength training also plays an important role in achieving your running goals. Resistance training that focuses on trunk and pelvic stability and glute/quad/calf strength will not only reduce your risk of injury but also improve your performance.

Last but not least, make sure that whatever your new health and fitness goals are, you tell your physio! We can help you formulate an appropriate strength program, ensure you are moving well in all the right areas and have self-management strategies to take care of your body between sessions.

Watch this space for more information about running injury prevention and overall body maintenance in the coming weeks. Until then- happy running!


Monday Tuesday Wednesday Thursday Friday Saturday Sunday
Week 1  Strength training Walk 15 minutes Rest Strength training Run 1 min; walk 1 min for 10 minutes
Week 2


Releases/stretches/yoga Strength training Walk 20 minutes Rest Strength training Run 2 min; walk 1 min for 10 minutes
Week 3 Releases/stretches/yoga Strength training Run 2 mins; walk 1 min x 15 mins Rest Strength training Run 2 mins; walk 30 seconds for 10 minutes
Week 4


Releases/stretches/yoga Strength training 5 minutes Rest Strength training Run 5 minutes x 2 (1-3 minutes walking rest between)
Week 5


Releases/stretches/yoga Strength training 5 minutes x 3

(1-3 minutes walking rest between)

Rest Strength training Run 10 mins
Week 6


Releases/stretches/yoga Strength training 5 minutes x 5 (1-3 minutes walking rest between) Rest Strength training Run 3km! (this is a good ‘check-in’)
Week 7


Releases/stretches/yoga Strength training 10 minutes x2-3 (1-3 minutes walking rest between) Rest Strength training Run 15 minutes
Week 8 Releases/stretches/yoga Strength training 15 minutes x 2 (1-3 minutes walking rest between) Rest Strength training Run 20 minutes
Week 9 Releases/stretches/yoga Strength training 15 minutes x3 (1-3 minutes walking rest between) Rest Strength training Run 25 minutes
Week 10 Releases/stretches/yoga Strength training 15 minutes x3 (1-3 minutes walking rest between) Rest 5 minutes easy 5km goal run!