Patellofemoral Rehabilitation

Why:

Patellofemoral or anterior knee pain can have many causes. First, it is important to note
that pain of the patellofemoral joint can be in the anterior part of the knee, but also it can
cause posterior knee pain. Genetics can play a part if there is a malalignment of the
patellofemoral mechanism from birth. Trauma can also cause damage to the patella and
lead to anterior patellofemoral knee pain. One of the best treatments for anterior
patellofemoral knee pain is to increase flexibility. The concept is that tight structures in
the back of the knee can apply increased forces on the anterior patella articular cartilage
that is already damaged and this increased pressure can lead to increased pain. If we can
increase the flexibility around the knee, especially the hamstring tendons posteriorly and
the quadriceps tendon anteriorly can decrease these forces and hopefully decrease pain.

Stretches: It is important that this stretching program is done on a consistent basis, initially every
other day, and progressing to every day. The results will not be immediate, but over time,
we hopefully will definitely notice decreased pain in the affected knee. All stretches
should be held for approximately 20 30 seconds and repeated a minimum of 3 times in a
session.
Proximal Hamstring Stretch: Begin lying on your back with
legs out straight. Raise the knee of the leg you wish to stretch to
your chest. With your hands, grab your leg and hug it to your
chest. Relax (straighten leg) and repeat.

Digital Hamstring Stretch: Start lying on your back with one leg out
straight and the other thigh pointing straight up. Grasp behind your
thigh with both hands. Do not leg the thigh move. Extend the knee
until you feel a stretch in the back of the thigh. Relax (let the knee
bend) and repeat. This can also be performed with a towel to help pull
your leg towards your body.

Hurdlers Stretch: Begin by sitting with one leg straight out in front of
you and your other leg folded in to your other leg. With both hands, reach
forward towards your toes. Hold this stretch. Relax and repeat.

1551 Professional Lane, Suite 200, Longmont, CO 80501 Ph: 303.772.1600 Fx: 303.774.0931
300 Exempla Circle, Suite 200, Lafayette, CO 80026

Ph: 720.890.8292 Fx: 720.890.8299

FrontRangeOrthopedics.com

Standing Quadriceps Stretch: Stand up straight near something that can be used for
support. Bend your knee bringing the foot up toward your buttocks. Grab the ankle
and pull it tight to your buttocks. The key with this stretch is to not leg the hip come
forward or bend forward at the waist. For added stretch, pull the thigh further back
into extension.

Prone Quadriceps Stretch: Lying on your stomach on a hard table or on the floor. Begin by reaching
back with the hand on the same side, pulling your ankle tight towards your buttocks. It is important to
keep your hip flat on the ground for this stretch. You can add a small bolster or rolled up towel under
your knee to increase the amount of quadriceps stretching.

Gastrocnemius Stretch: This muscle crosses behind the knee and

travels down the back of the lower leg. Begin in the long sit
position, with your legs out straight in front of you. Loop a towel
around the ball of your foot and hold onto the ends. Pull the towel
toward your body until you feel a stretch in the calf. Relax and
Repeat.
Gastrocnemius Stretch: Begin by placing your hands against a
wall and placing the leg that you are intending to stretch behind the other leg. Gently stretch your calf
by placing the heel of your foot to the ground. The third stretch is done by placing your foot against
the wall and bringing your hips in closer to the wall.

1551 Professional Lane, Suite 200, Longmont, CO 80501 Ph: 303.772.1600 Fx: 303.774.0931
300 Exempla Circle, Suite 200, Lafayette, CO 80026

Ph: 720.890.8292 Fx: 720.890.8299

FrontRangeOrthopedics.com