Females and Knee Pain

Contributed by Mandy Huggard PT, DPT, ATC, CSCS

Knee pain is the number one complaint that I hear in the clinical setting.   Most of the time it is coming from a female.  Whether it is a young adolescent soccer player, a 40-something year old avid runner, or the older active woman, more females are complaining about their knees then males.  Why is this the case?  Well, there is not just one answer to that question.  There are many factors that contribute to the anterior knee pain of females.  The typical complaint regarding knee pain is typically diffuse in nature.  There often is not a mechanism of injury, but just the complaint that the knees began hurting with activity.  Often stairs, squatting and sitting are the activities that are sited in reproducing pain.  The condition of anterior knee pain is termed Patellofemoral  Pain Syndrome (PFPS).  This is a broad diagnosis that refers to the joint including the knee cap (patella) and the thigh (femur) and how the action of this joint is causing pain.  Often the patella is poorly aligned due to muscle and soft tissue tightness or weakness which allows the joint to have excessive stress on one side.   Due to the characteristics of the female body including wider hips and narrower knees compared to their male counterparts, this predisposes females to malalignment issues.

Q-Angle

 

To counterbalance this anatomical set up, the muscles of the lateral hip must be strong and stable to help control the position of the patella.  In addition, females tend to have excessive laxity (joint looseness) in their joints which contributes to the instability of their pelvis, hips and knees.  The most recent research in sportsmedicine has sited that the main causes of PFPS are hip weakness and core stability deficits.   The other common causative factor in PFPS are tight muscles.  Because young girls are growing and as a whole, our population spends too much time sitting which results in excessive tightness of our hips, muscle restrictions are a common problem.  In addition, many people who are active do not spend enough time working on their flexibility and mobility and excessive stress on the patellofemoral joint occurs.  Although this can happen in both males and females, because the females are more predisposed to problems because of their anatomy, the flexibility deficits tend to take a toll more on the female knee.  Stretching and soft tissue mobilization are important treatment tools to reducing the pain.  Also strengthening of the lateral hip and core musculature will help to reduce the painful symptoms.  Most importantly finding the causative factors will ensure that the treatment be the correct solution for that individual’s problem.  There is not a one size fits all program to eliminating PFPS in the woman and girls.  But a well-designed rehabilitation program is often just what the doctor ordered.