Knees up-Patellofemoral pain

Anyone who engages in regular  training that is two or three times a week, may at some time suffer with patellofemoral pain.

In our  practice, we  often see this injury in athletes involved in repetitive activities such as squatting with heavy weights and or ground reaction forces from running long distances. The risk of this injury maybe reduced if you follow these suggestions.

The quadriceps muscles are located on the front of the femur bone (thigh) and insert into the top of the patella or knee cap.

When the quads are contracted this pulls on the patella ligament raising the lower leg. 

It is important that the knee-cap rides evenly through its groove and for this it relies on an equal pull from each head of the quadriceps. 

Any muscle imbalance within the quadriceps muscles can misalign the knee cap leading to friction of the cartilage lining the undersurface of the knee cap.

This is one of the factors predisposing the knee-cap to the roughening of its underside or chondromalacia patellae.

Ordinarily, the underside of the knee-cap and surface of the thigh bone are covered in a film of cartilage. It is possible for damage to occur between these two surfaces, even though the cartilage allows for a friction-free glide. The cartilage is continually being rubbed away, but is able to regenerate and reform.

If the amount of wear and tear on the cartilage outstrips its capacity to regenerate then it will start to break down and wear. Microscopic cracks will form in the cartilage and if these two bony surfaces come into contact pain will result.

What can we do to prevent this injury?

One of the basic methods of preventing this condition is by warming the knees up prior to physical activity. Only carry out a half squat and ensure as you go down you place your body weight over your heels to offload the knee cap.

Passive stretching of the muscles of the lower leg may help to prevent muscle asymmetry. 

Here at Blackshot’s Osteopathic Centre we will also look at restoring the neuromotor control of the muscles around the pelvis and leg and address other remote factors that may be altering how you function when participating in physical exercise. 

Please feel free to email-blackshotsosteopathiccentre@gmail or phone 01375377034 should you need an appointment. 







Why are younger patients coming to our clinic?

Younger patients are attending Blackshot’s Osteopathic Centre with neck and shoulder pain.This blog considers acute and chronic soft tissue conditions that cause neck pain.

Structures of the neck that are likely to cause pain are the zygapophyseal joints, cervical discs, the ligaments and muscles of the neck, and neural structures.


Non specific neck pain can arise under both traumatic and non traumatic conditions.A thorough case history and physical examination is taken to establish the duration and time course of neck pain, mechanisms of injury, and factors that may perpetuate, aggravate or ease the patients discomfort.

By way of example if reading aggravates pain this may indicate that prolonged flexion is aggravating the intervertebral disc or posterior cervical structures such as the neck extensors.If looking up (extension) aggravates the pain, this may suggest zygapophyseal joint involvement.

Occupational factors

Enquiry about the patient’s sport(s), hobbies, and occupation and their relationship to the patient’s neck pain provides our osteopaths with vital information regarding typical postures and movements and loads that your neck is being subjected to, that may contribute to the patient’s ongoing symptoms.

This information can guide the need for an ergonomic evaluation of the work station, or a biomechanical analysis of how the patient carries out their sport.

Treatment of neck pain.

Soft tissue techniques for the treatment of increased muscle tone or trigger points, muscle shortening, scar tissue and fascial tightness.

They may be beneficial in helping the patient relax prior to performing joint mobilisations or manipulations.

To address long- term rehabilitation objectives a carefully selected exercise programme can be discussed.

If you are suffering from neck pain please phone or email to arrange an appointment. Our details can be found on our contact us page.