Recognizing Patellofemoral Ache Syndrome—Plus Workouts for Prevention

When interventional backbone physician and Kuchipudi dancer Pranamya Suri was doing her medical residency, she had much less time to bounce than traditional. When she did get the prospect to observe, she seen a persistent ache growing round and behind her kneecap. Suri recognized this ache as a warning signal of patellofemoral ache syndrome (PFPS) and was capable of rehabilitate utilizing a mixture of relaxation and focused strengthening workouts.

Suri explains that it’s widespread for dancers to develop PFPS, however the situation can also be extremely treatable. By studying about PFPS and the way it impacts dancers, figuring out warning indicators early on, and making use of mitigation techniques earlier than it turns into a problem, dancers can safeguard their joints and set themselves up for an extended, wholesome profession.

What Is PFPS?

PFPS is characterised by generalized ache round and behind the patella, or kneecap. It’s normally exacerbated throughout cases of knee flexion (like grand pliés), strolling up and down stairs, and even prolonged sitting. PFPS is an overuse damage­—the extra the quadriceps contract and the knees flex, the larger the pressure pushing the patella again towards the underneath­­mendacity femur. The result’s ache, explains Karen Clippinger,­ creator­ of Dance Anatomy and Kinesiology and a professor emerita at California State College, Lengthy Seaside.

“For those who take a look at grand pliés and hinges and spirals to the ground, there are loads of actions in dance which are related to excessive compression forces, which places dancers in danger for having this situation,” Clippinger says.

The turned-out positions favored in some dance types may heighten a dancer’s threat for PFPS, provides Jennifer Coviello, a health care provider of bodily remedy specializing in treating dancers—particularly in the event that they battle to trace their knees over their toes in bent-leg positions. Hyperextension, too, can add threat if dancers over-rely on sure muscle mass, making the knee much less steady, Clippinger explains.

Treating PFPS

For those who suppose you may be experiencing PFPS, it’s vital to hunt individualized consideration from a medical skilled. More than likely, you’ll work with a bodily therapist to develop a repertoire of workouts tailor-made to your particular wants. It’s widespread for bodily therapists to recommend strengthening the quads and the hip abductors. In some cases, dancers may also must work additional up the kinetic chain, strengthening the abdominals and obliques, Coviello explains. Tightness within the hamstrings and interior thighs may contribute to PFPS, she says, so stretches that focus on this area might also be integrated.

Suri provides that she typically makes use of instruments like kinesiology tape and knee-bracing sleeves, however these shouldn’t substitute for the suggestions of a bodily therapist or different medical skilled. “They’re extra of a proprioceptive reminder that will help you information your kneecap to go this manner, not that approach,” she says.

Stopping Future Ache

As a result of many dance kinds involv­e repetitive knee flexion, it’s importan­t for dancers to consider PFPS earlier than it’s a problem. Think about adjusting your cross-training routine to combine some preventive­ measures. Clippinger recommends three easy workouts which goal completely different PFPS culprits (see sidebar). You too can work your approach as much as these workouts by beginning with out the props.

Clippinger advises dancers to familiarize themselves with their very own anatomy by palpating the entrance of the thigh above the kneecap because the quads contract. Ensure that the interior and outer parts of your quads are each contracting, as that can assist your kneecap observe correctly in flexion. “It actually takes loads of focus and focus to begin discovering methods to activate that interior half and get it to contract,” she says.

Terminal knee extension with ankle weight

1. Place a prop, like foam curler or bolster, underneath your hamstrings. Ensure that the knee is bent lower than 30 levels to maintain compression forces low, Clippinger says.
2. Straighten the knee, palpating together with your hand to gauge equal contraction of the interior and outer thigh muscle mass.
3. Maintain for 5 seconds. Repeat for 3 units of 10. Add an ankle weight for extra problem.

Aspect leg elevate with band

1. With a TheraBand round your higher thighs, lie on one facet.
2. Externally rotate your legs and elevate your high leg, resisting the pressure of the band.
3. Maintain for 4 counts in the long run place, then repeat between 8–12 occasions, beginning with one set and progressing to a few.
4. Think about doing this train together with your again to a wall, specializing in utilizing the deep outward rotators­ by urgent into the wall together with your pinky toe. This train helps develop the muscle mass that can enable your knee to trace correctly in exterior rotation, in addition to strengthening the hip abductors, Clippinger says.

Hip rotation on elbows

1. With a TheraBand round your thighs simply above the knees, lean again together with your weight supported by your forearms.
2. Externally rotate your legs, specializing in turning out from the hip, versus the knee joint.
3. As you straighten the knees, keep away from hyperextension. As a substitute, deal with utilizing the identical muscle mass you palpated within the first train.
4. Maintain for 4 counts in the long run place, then repeat between 8–12 occasions, beginning with one set and progressing to a few.