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Call 07 3102 3337

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Call 07 3102 3337
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Your Guide to Total Knee Replacement Surgery

Your Guide to Total Knee Replacement Surgery

by | Jun 1, 2025 | Knee, Pain, Surgery

 Total knee replacement (TKR) is a life-changing procedure for individuals suffering from chronic knee pain, typically caused by osteoarthritis. At Praxis Physiotherapy, we understand that total knee replacement (TKR) surgery is a major decision. As such, we are committed to helping patients navigate their surgical journey and maximize outcomes through tailored prehabilitation and rehabilitation programs.

This guide is designed to walk you through what to expect before and after surgery, how physiotherapy plays a crucial role, and the advanced, evidence-based services we offer to support your journey.

Why Physiotherapy Matters

Physiotherapy isn’t just something you do after surgery—it’s a vital part of your preparation. Prehabilitation (prehab) that begins around six weeks before surgery can improve muscle strength, mobility, and balance, leading to quicker, more successful recoveries post-surgery (Domínguez-Navarro et al., 2020).

Similarly, post-operative physiotherapy supports improved pain relief, better joint function, and faster return to daily activities (Artz et al., 2015), (Fatoye et al., 2021).

Pre-Surgery: Building a Strong Foundation

It’s easy to think, “Why do physio now when the knee is being replaced anyway?” But strengthening and conditioning your body beforehand significantly boosts your post-surgery recovery, helping you get back on your feet faster and with greater confidence. We can address any questions or concerns you may have leading up to the surgery.

Timeline: Ideally begins 6-8 weeks prior to surgery.

Goals:

  • Strengthen muscles around the knee
  • Improve joint mobility
  • Enhance balance and proprioception
  • Educate on post-operative exercises

Key Interventions at Praxis:

  • Reformer Pilates: Our modified prehab programs integrate Pilates to build core stability and lower limb strength. It’s a safe, adaptable way to enhance neuromuscular control before surgery (Levine et al., 2009).
  • Balance Training: Proven to improve post-surgical function when combined with strength training [(Domínguez-Navarro et al., 2020)].
  • Education: We prepare you with strategies to navigate the early post-op period, including mobility aids and pain management.

  • Expert Manual Therapy: Enhances joint mobility, reduces pre-surgical stiffness, and prepares surrounding tissues for optimal post-surgery performance.

Early Post-Op Phase (0-6 weeks)

Immediately following surgery, your primary goals will be managing pain, reducing swelling, and restoring basic mobility.

Many assume recovery only begins once the surgical pain fades—but getting moving early is critical. Guided physiotherapy helps you regain mobility safely, reduce complications, and build confidence from the very start.

Expect:

  • Supervised sessions with focus on safe movement and circulation
  • Gentle range-of-motion and isometric exercises
  • Gait retraining using assistive devices

Evidence-based benefit: Early mobilisation and physiotherapy within days of surgery improve short-term outcomes (Isaac et al., 2005).

Mid to Late Post-Op Phase (6 weeks – 6 months)

At this stage, the intensity of therapy increases to target long-term function. Don’t settle for “good enough” recovery. This phase is where you rebuild your strength, stability, and full mobility—setting the stage for lasting function and confidence in your new joint.

Our Therapeutic Arsenal Includes:

  • Blood Flow Restriction (BFR) Training: Using pneumatic cuffs, we simulate high-load training effects using light resistance. Safe and effective for improving strength post-TKR (Piva et al., 2019).
  • Functional Strength & Balance Training: Tailored to your activity goals.
  • Reformer Pilates: Reactivated in this phase to support low-impact, whole-body conditioning.
  • Access to On-Site Gym Facilities: Ensures continuity and transition from rehab to independent exercise.

Patients receiving a combination of manual therapy and exercise had better functional outcomes than those receiving exercise alone (Karaborklu Argut et al., 2021), a practice we fully embrace at Praxis.

Clinical Expertise You Can Trust

Praxis Physiotherapy works in close collaboration with orthopaedic knee surgeon Dr. Kelly Macgroarty, ensuring a seamless continuum of care. However, we welcome referrals from any orthopaedic surgeon.

You’re not alone in this process. Our experienced team is with you every step of the way—offering expert care, tailored planning, and hands-on support backed by evidence and close collaboration with your surgical team

Our clinicians are highly skilled in post-TKR rehabilitation and stay up-to-date with the latest evidence-based interventions.

What Does the Research Say?

Recent studies underscore the critical value of physiotherapy before and after knee replacement surgery. Prehabilitation, including strength and balance training, has been shown to improve early recovery outcomes [(Domínguez-Navarro et al., 2020)]. Combining manual therapy with exercise yields superior functional gains compared to exercise alone [(Karaborklu Argut et al., 2021), (Abbott et al., 2013)]. Blood Flow Restriction (BFR) training and Pilates have emerged as safe, effective adjuncts to conventional rehabilitation protocols [(Levine et al., 2009), (Piva et al., 2019)]. While short-term improvements in pain and mobility are well-documented, the long-term benefits of physiotherapy interventions vary across studies, highlighting the importance of personalized care and follow-up [(Artz et al., 2015), (Fatoye et al., 2021)].

What Makes Praxis Different?

  • Prehab programs starting 6+ weeks before surgery
  • Use of advanced modalities: BFR cuffs, Reformer Pilates
  • Access to gyms within our clinics
  • Close collaboration with top orthopaedic surgeons
  • One-on-one care tailored to your surgical timeline and goals

Ready to Begin Your Journey?

Total knee replacement doesn’t have to mean months of struggle and guesswork. With the right physiotherapy strategy—starting before your surgery—you can dramatically improve your mobility, reduce pain, and return faster to the activities you love. Reach out to Praxis Physiotherapy today to schedule your pre-operative assessment or post-surgical consultation. Let us guide your recovery with confidence, care, and clinical expertise.

Until next time, Praxis What You Preach…

📍 Clinics in Teneriffe, Buranda, and Carseldine

💪 Trusted by athletes. Backed by evidence. Here for everyone.

References

  • Artz, N. et al. (2015). Effectiveness of physiotherapy exercise following total knee replacement: systematic review and meta-analysis. BMC Musculoskeletal Disorders.
  • Domínguez-Navarro, F. et al. (2020). Preoperative strengthening and balance training. Knee Surgery, Sports Traumatology, Arthroscopy.
  • Fatoye, F. et al. (2021). Clinical and cost-effectiveness of physiotherapy interventions. Archives of Orthopaedic and Trauma Surgery.
  • Karaborklu Argut, S. et al. (2021). Exercise and manual therapy vs exercise alone. PM&R.
  • Levine, B. et al. (2009). Pilates for rehabilitation after total joint arthroplasty. Clinical Orthopaedics and Related Research.
  • Piva, S. et al. (2019). Later-stage exercise vs usual care. JAMA Network Open.
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    Navigating Knee Osteoarthritis: A Physio-Centric Pathway to Strength and Mobility Before Surgery

    Navigating Knee Osteoarthritis: A Physio-Centric Pathway to Strength and Mobility Before Surgery

    by | Apr 22, 2025 | Knee, Reformer Pilates

    Knee osteoarthritis (OA) is one of the most common causes of chronic pain and mobility restriction in Australians over 45. Whether you’re a weekend warrior, an active grandparent, or someone just trying to keep up with the daily demands of life, OA can slowly erode your confidence in movement — long before X-rays show the full extent of joint degeneration.

    At Praxis Physiotherapy, we take a forward-thinking, collaborative approach to managing knee OA. Working closely with renowned orthopaedic knee surgeon Dr. Kelly Macgroarty and drawing from our extensive experience with high-performance athletes and everyday patients alike, we believe the journey toward better knees starts well before surgery — and, for many, might even avoid or delay it altogether.

    What is Knee Osteoarthritis?

    Knee OA is a progressive condition involving the breakdown of joint cartilage and underlying bone, typically leading to:

    • Pain during or after activity

    • Morning stiffness or stiffness after rest

    • Swelling and inflammation

    • Loss of flexibility and range of motion

    • Difficulty with stairs, kneeling, or prolonged standing

    Radiographic OA becomes more common with age, but symptoms often precede visible changes on X-ray. Up to 30% of people over 65 show radiographic OA, yet many remain functionally capable — highlighting the importance of early, movement-based interventions (Naja et al., 2021).

    Why a Physio-Led Model Before Knee Replacement?

    Surgery is not the first or only option. A large systematic review of 19 randomized controlled trials found that non-surgical interventions such as physiotherapy, platelet-rich plasma (PRP), and structured exercise were associated with meaningful improvements in pain and function over 12 months (Naja et al., 2021). Physiotherapy, in particular, is consistently supported by international guidelines as a first-line treatment (Fransen et al., 2015; Bennell et al., 2014).

    Traditionally, knee OA rehab has emphasised quadriceps strengthening — and for good reason, as quadriceps weakness is strongly linked to OA-related pain and disability. However, more recent research suggests that focusing exclusively on the quadriceps may be too narrow. Programs that include hip (gluteal), hamstring, and calf muscle strengthening are now shown to be superior in improving functional outcomes, especially for activities like walking, stair climbing, and maintaining balance (Bennell et al., 2014). This broader approach addresses the full kinetic chain around the knee, optimises joint load distribution, and better supports long-term movement efficiency.

    At Praxis, our physios:

    • Assess gait, strength, joint mobility, and function

    • Design individualised exercise programs targeting quadriceps, glutes, and calf strength

    • Implement manual therapy techniques to restore joint mobility

    • Provide pain education, load management advice, and real-world strategies

    • Monitor progress and adjust programs over time

    This proactive approach not only builds resilience in the knee but also prepares the joint and surrounding muscles should surgery eventually be required.

    Booster Sessions: Keeping Gains, Lowering Costs

    An often-overlooked strategy is the use of booster physiotherapy sessions — structured follow-ups after an initial rehab program. Research by Bove et al. (2018) showed that exercise programs with booster sessions at 3, 6, and 12 months were not only more clinically effective but also more cost-effective over a two-year period compared to standard physiotherapy care.

    At Praxis, we now embed these booster sessions into long-term OA management. They help patients:

    • Maintain strength and conditioning gains

    • Stay accountable with home programs

    • Troubleshoot new symptoms early

    • Reduce future health care costs and medication reliance

    What About Injections and Other Adjuncts?

    We often collaborate with GPs and orthopaedic specialists to incorporate adjunct treatments where the evidence supports it:

    • Platelet-rich plasma (PRP) injections showed significant long-term benefit for pain and function, with improvements of ~20 points on the WOMAC index. PRP ranked just behind stem cells as the most effective non-surgical treatment in a large 2021 network meta-analysis (Naja et al., 2021).

    • Hyaluronic acid (HA) injections have shown mixed results. A review of overlapping meta-analyses concluded that HA is likely safe and modestly effective, especially in early-stage OA, although guideline recommendations remain inconsistent (Xing et al., 2016).

    Ultimately, our philosophy is to build strong knees first, and complement physiotherapy with interventions like PRP or HA only when clinically indicated and appropriately timed.

    Surgical Collaboration 

    In more advanced cases, where conservative management fails, we work closely with Dr. Kelly Macgroarty, one of Queensland’s leading knee surgeons. Our relationship allows:

    • Streamlined triage for surgical consultation

    • Shared prehabilitation planning to improve surgical outcomes

    • Integrated post-operative rehab, using in-clinic gym equipment and reformer Pilates to accelerate return to function

    This continuity ensures you’re never left navigating knee OA alone — whether your journey stays entirely within physio care or progresses to surgical management.

    Why Praxis Physiotherapy?

    At Praxis, we’ve built our care model around best-practice guidelines, decades of elite sport and private practice experience, and a shared goal of keeping our patients active, independent, and thriving.

    Our Teneriffe, Carseldine and Buranda clinics offer:

    • In-clinic rehab gyms

    • Reformer Pilates for joint-friendly loading

    • Real-time strength testing technology

    • Physios with elite sports and post-surgical rehab experience

    Take the First Step

    If you or someone you love has been told you’re “heading for a knee replacement,” don’t wait. There is so much we can do to reduce pain, improve function, and build confidence in your knees — surgery or not.

    Book an appointment today at one of our Brisbane clinics and start your journey to stronger, more resilient knees.

    Interested in ACL specific rehab? Check our guide on return to sport after ACL injury

    Until next time, Praxis What You Preach!

    📍 Clinics in Teneriffe, Buranda, and Carseldine

    💪 Trusted by athletes. Backed by evidence. Here for everyone.

    References

    • Bove, A. M., Smith, K. J., Bise, C. G., et al. (2018). Exercise, manual therapy, and booster sessions in knee osteoarthritis: cost-effectiveness analysis from a multicenter randomized controlled trial. Physical Therapy, 98(1), 16–27.

    • Fransen, M., McConnell, S., Harmer, A. R., Van der Esch, M., Simic, M., & Bennell, K. L. (2015). Exercise for osteoarthritis of the knee: a Cochrane systematic review. British Journal of Sports Medicine, 49(24), 1554–1557.

    • Bennell, K. L., Dobson, F., & Hinman, R. S. (2014). Exercise in osteoarthritis: moving from prescription to adherence. Best Practice & Research Clinical Rheumatology, 28(1), 93–117.

    • Naja, M., Fernandez De Grado, G., Favreau, H., et al. (2021). Comparative effectiveness of non-surgical interventions in the treatment of patients with knee osteoarthritis: a PRISMA-compliant systematic review and network meta-analysis. Medicine, 100(49), 

    • Xing, D., Wang, B., Liu, Q., et al. (2016). Intra-articular hyaluronic acid in treating knee osteoarthritis: a PRISMA-compliant systematic review of overlapping meta-analyses. Scientific Reports, 6, 32790.

    ACL Rehabilitation: The Role of Physiotherapy in Returning to Life, Activity, and Sport

    ACL Rehabilitation: The Role of Physiotherapy in Returning to Life, Activity, and Sport

    by | Apr 22, 2025 | ACL, Gym and Strength, Knee, Return to Sport, Running Injuries

    On today’s Praxis what you Preach, we cover a very common injury here in Australia – the Anterior Cruciate ligament (ACL) injury. At Praxis Physiotherapy, we understand that recovering from ACL reconstruction is more than just healing a knee — it’s about restoring confidence, movement, and returning to the activities and lifestyle that matter most to each person. Physiotherapists are uniquely placed to guide this journey from surgery through to return to everyday function, recreation, and sport.

    What is an ACL Rupture?

    The ACL is one of the key stabilising ligaments of the knee, crucial for controlling rotation and forward movement of the tibia. An ACL rupture typically occurs during sudden changes in direction, pivoting, or awkward landings — common in sports like AFL, soccer, basketball, and netball. It most often affects young, active individuals, particularly females, due to biomechanical and hormonal factors. While not all ACL injuries require surgery, those with complete ruptures who wish to return to cutting or pivoting sports usually undergo ACL reconstruction. Regardless of the surgical decision, structured rehabilitation guided by a physiotherapist is essential for a successful recovery and long-term knee health.

    The Importance of Physiotherapy in ACL Rehab

    Research shows that while around 80% of individuals return to some form of sport after ACL reconstruction, only 65% return to their preinjury level and just 55% to competitive levels (Andrade et al. 2020). Physiotherapy plays a vital role in improving these outcomes by guiding progressive rehabilitation and using structured criteria-based progressions.

    Physiotherapy-led rehabilitation should begin early, with emphasis on knee mobilisation, weight-bearing as tolerated, and initiation of neuromuscular training (Andrade et al. 2020). The BJSM systematic review of clinical guidelines for ACL rehab supports early kinetic chain exercises (both open and closed), strength training, cryotherapy, and neuromuscular stimulation when indicated (Andrade et al. 2020).

    From Healing to Performance: A Continuum

    Recovery after ACL surgery should follow a continuum from impairment-based care to performance restoration. This includes early pain and swelling control, progressive strength and range of motion restoration, motor control retraining, and sport-specific preparation. At Praxis, we follow a phase-based rehabilitation model tailored to individual needs. These needs may include the type of surgical graft used, concurrent injury (e.g meniscus / MCL), the operating surgeon’s post-op protocols, the patient’s goals, sport-specific demands, timelines for return to competition, and previous levels of function — all of which require thoughtful and collaborative clinical decision-making.

    Unfortunately, studies show that many patients are discharged before meeting strength or performance benchmarks — particularly in strength-focused exercises like the split squat, squat, or deadlift, which play a vital role in ACL rehab progression. For example, performing around 22 single-leg sit-to-stands is one such late-stage benchmark that reflects adequate quadriceps strength and control before return to sport (Welling et al 2018). Nichols et al. (2021) found that most published rehabilitation protocols emphasize endurance and hypertrophy without progressing to the strength or power needed to reduce reinjury risk. This underlines the need for physiotherapists to include high-intensity, sports specific strength training and late-stage performance metrics as patients near return to sport.

    Addressing Muscle Atrophy and Weakness

    Quadriceps atrophy remains a key barrier to recovery post-ACL reconstruction. Evidence supports adjunct interventions such as neuromuscular electrical stimulation and blood flow restriction (BFR) training to combat muscle loss, particularly in the early post-operative period (Charles et al. 2020). BFR combined with low-load resistance exercise has been shown to reduce muscle wasting and promote strength gains when higher loads are contraindicated — we explore this more in our Blood Flow Restriction Training blog. We use this frequently at Praxis Physiotherapy in both reformer pilates and early gym based settings. 

    The Role of the Physio: More Than Just Exercise

    Our job as physiotherapists goes beyond prescribing exercises. We support patients through the emotional and motivational challenges of recovery, address fear of re-injury, and help them develop the confidence to return to sport or physically demanding jobs. We tailor plans based on functional goals, sport-specific needs, and personal circumstances.

    At Praxis, this also means working closely with coaches, GPs, surgeons, and families to ensure clear communication and aligned expectations. For sporting patients, this might include on-field rehab or comprehensive return-to-play assessments in collaboration with clubs and teams.

    A Collaborative, High-Performance Rehabilitation Environment

    At Praxis Physiotherapy, we bring high-performance rehab principles to all patients — not just elite athletes. Our team has provided physiotherapy services to the Aspley Hornets AFL Club since 2014, giving us deep insight into the physical and mental demands of competitive sport. We apply this same standard of care to everyday athletes, weekend warriors, and anyone seeking to return to an active lifestyle.

    We also work closely with orthopaedic knee and shoulder surgeon Dr. Kelly Macgroarty, including in-room triage consulting, ensuring a seamlessly integrated, evidence-informed rehabilitation pathway. This collaboration allows us to align surgical timelines, post-op considerations, and physiotherapy progressions — from day one to return to sport.

    Our clinical culture is shaped by exposure to elite-level sports environments, including AFL, representative athletics, and professional national cricket programs. But rather than highlight individual accolades, we’re most proud of the high clinical standards and systems-based approach that ensure our entire team delivers the same quality of care — no matter who walks through the door.

    Each of our Brisbane based clinics includes access to gym facilities and reformer Pilates equipment, allowing for real-world, function-driven exercise. These resources support patients to not only recover structurally but also return to high levels of strength, coordination, and performance in line with the latest evidence-based guidelines.

    A Message to Our Patients

    Whether you’re an athlete aiming for competitive return or someone wanting to run after your kids again, we bring the same level of care and attention to your ACL rehab. Recovery is not just about timelines — it’s about building back strength, movement, and trust in your knee. Ready to get started with your own recovery plan? Explore the ACL physiotherapy services at Praxis and book an appointment today.

    Until next time, Praxis What You Preach…

    📍 Clinics in Teneriffe, Buranda, and Carseldine
    💪 Trusted by athletes. Backed by evidence. Here for everyone.

    For more insights into long-term knee health, including non-surgical rehab, check out our Knee Osteoarthritis blog.

    References

    Andrade R, et al. (2020). How should clinicians rehabilitate patients after ACL reconstruction? A systematic review of clinical practice guidelines. Br J Sports Med, 54(9), 512–519.

    Kochman M, et al. (2022). ACL Reconstruction: Which Additional Physiotherapy Interventions Improve Early-Stage Rehabilitation? Int J Environ Res Public Health, 19(23), 15893.

    Charles D, et al. (2020). A systematic review of the effects of blood flow restriction training on quadriceps muscle atrophy and circumference post ACL reconstruction. Int J Sports Phys Ther, 15(6), 882–889.

    Nichols ZW, et al. (2021). Is resistance training intensity adequately prescribed to meet the demands of returning to sport following ACL repair? A systematic review. BMJ Open Sport Exerc Med, 7(1), e001144.

    Welling W, Benjaminse A, Gokeler A, Otten E, & Seil R. (2018). Low rates of patients meeting return to sport criteria 9 months after anterior cruciate ligament reconstruction: a prospective longitudinal study. Knee Surg Sports Traumatol Arthrosc, 26(12), 3636–3644.

    Osgood Schlatters Disease – More than just growing pains in the adolescent knee

    Osgood Schlatters Disease – More than just growing pains in the adolescent knee

    by | Aug 3, 2023 | Knee, Return to Sport, Running Injuries

    Osgood-Schlatter disease (OSD) (or tibial tuberosity traction apophysitis) is a common condition that affects the knee, primarily in adolescents and young athletes. OSD is more frequently experienced in males 12-15 years old who are involved in activities that require frequent running, jumping, kicking and decelerating, like football (Bezuglov et al 2022). The condition manifests as pain, swelling, and tenderness just below the knee, where the patellar tendon attaches to the tibial tuberosity. Discomfort and potential disruption of daily activities and sports participation is often the result.

    A prerequisite for this condition is high loading. The repetitive stress placed on this area during physical activities leads to microtrauma and inflammation, causing symptoms. While the condition is generally self-limiting and tends to resolve as the affected individual completes the growth spurt, physiotherapy plays a pivotal role in effectively managing symptoms, promoting healing, and aiding in a smooth return to physical activities. Various conservative approaches have been studied and recommended in the scientific literature to manage symptoms and aid in the healing process. Interestingly, the condition is strongly associated with Sever’s disease, another growth and loading related injury associated with active young people (Schultz et al 2022). Read on for a general overview of the treatment options supported by scientific research.

    Rest and Activity Modification

    Rest is often a key component of initial treatment. Reducing or modifying activities that aggravate symptoms, such as avoiding high-impact sports or exercises, can help alleviate strain on the affected area and promote healing. According to a study published in the “Journal of Pediatric Orthopaedics,” activity modification was found to be an effective strategy in managing Osgood-Schlatter Disease, with a significant reduction in pain reported by participants who adhered to activity restrictions.

    Physical Therapy and Stretching Exercises

    Physical therapy plays a vital role in managing Osgood-Schlatter Disease. A study published in the “Journal of Orthopaedic & Sports Physical Therapy” emphasized the importance of a structured physical therapy program involving stretching exercises for the quadriceps, hamstrings, and calf muscles. These exercises aim to improve muscle flexibility, reduce tension around the knee, and address any muscle imbalances that might contribute to the condition.

    Strengthening Exercises

    Strengthening exercises focused on the quadriceps and surrounding muscles can help improve biomechanics and stabilize the knee joint. Research published in the American Journal of Sports Medicine highlighted the positive effects of a quadriceps-strengthening program in reducing pain and improving function in individuals with Osgood-Schlatter Disease.

    Ice Therapy

    Cold therapy, such as applying ice to the affected area, can help reduce inflammation and provide pain relief. A study published in the “Journal of Orthopaedic & Sports Physical Therapy” suggested that ice therapy can be beneficial when used in combination with other conservative treatments.

    Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

    NSAIDs, such as ibuprofen, are commonly used to manage pain and inflammation associated with Osgood-Schlatter Disease. However, their use should be supervised by a healthcare professional such as your GP or pharmacist, and long-term or excessive use should be avoided.

    Bracing and Taping

    Some studies have explored the use of knee braces or taping techniques to offload the patellar tendon and reduce strain on the tibial tuberosity. While research on this aspect is limited, these approaches might offer temporary relief during activities. This can be trial and error as to which technique works best however compression over the tibial tuberosity seems to be the most common strategy.

    Education and Activity Guidance

    Educating patients and their parents about the condition, its natural history, and appropriate activity modification is crucial. A study in the “Journal of Pediatric Orthopaedics” emphasized the significance of patient education in improving adherence to treatment recommendations and facilitating symptom management.

    It’s important to note that each individual’s response to treatment can vary, and a tailored approach is often necessary. In cases where conservative treatments do not provide sufficient relief, and severe pain or functional limitations persist, consultation with a Sports Physician or Orthopaedic surgeon may be warranted. Surgical intervention is rarely indicated and is typically considered only when symptoms are severe, long-lasting, and significantly affecting an individual’s quality of life.

    In summary, Osgood-Schlatter Disease can pose significant challenges for adolescents and young athletes, affecting their quality of life and participation in sports. While the condition typically resolves with time and growth plate maturation, the discomfort and limitations it presents can be effectively managed and alleviated with the help of physiotherapy. If you or someone you know is dealing with this condition, get help from our friendly and qualified Praxis physios to individualise an appropriate rehabilitation plan.

    Until next time, PREVENT PREPARE PERFORM

    Team Praxis

    References:

    Bezuglov, E., Pirmakhanov, B., Ussatayeva, G., Emanov, A., Valova, Y., Kletsovskiy, A., … & Morgans, R. (2022). The mid-term effect of Osgood-Schlatter disease on knee function in young players from elite soccer academies. ThePhysicianandSportsmedicine, 1-6.

    Ciatawi, K., & Dusak, I. W. S. (2022). Osgood-Schlatter disease: A review of current diagnosis and management. CurrentOrthopaedicPractice, 33(3), 294-298.

    Schultz, M., Tol, J. L., Veltman, L., & Reurink, G. (2022). Osgood-Schlatter Disease in youth elite football: Minimal time-loss and no association with clinical and ultrasonographic factors. PhysicalTherapyinSport, 55, 98-

    Capping kneecap pain – Your guide to Anterior Knee Pain (Patellofemoral Pain Syndrome)

    Capping kneecap pain – Your guide to Anterior Knee Pain (Patellofemoral Pain Syndrome)

    by | Jul 11, 2023 | Knee, Return to Sport, Running Injuries

    Patellofemoral Pain Syndrome (PFPS) is a common condition that affects the knee joint, particularly the area where the kneecap (patella) meets the thigh bone (femur). It is a prevalent issue among athletes, active individuals, and people with certain anatomical factors. In this Praxis What You Preach article, we will explore PFPS, its causes, symptoms, and available treatment options, shedding light on how physiotherapy can effectively manage and alleviate this condition.

    What is PFPS?

    Patellofemoral Pain Syndrome, also known as runner’s knee or anterior knee pain, occurs when the patella fails to glide smoothly over the femoral groove during knee movement. This causes irritation and inflammation in the patellofemoral joint, specifically the underlying bone, leading to pain, discomfort, loss of function and even swelling. PFPS can be triggered by multiple factors, such as overuse, muscle imbalances, poor biomechanics, weak hip and thigh muscles, improper footwear, and previous knee injuries. Essentially though it is the kneecap joints’ in ability to tolerate the load of the activities being undertaken.

    Symptoms and Diagnosis

    Common symptoms of PFPS include pain around or behind the patella, especially during activities that involve knee squatting, lunging, bending, climbing / descending stairs, or sitting for extended periods with knees bent (commonly called movie goers knee). These typically can occur when workloads have increased with activities such as running, cycling or weightlifting. Patients may also experience swelling, grinding or even stabbing sensations, and occasionally a feeling of knee instability. A physiotherapist will perform a comprehensive evaluation, considering the patient’s medical history, conducting a physical examination, and possibly using imaging tests, to accurately diagnose PFPS and rule out other potential causes of knee pain.

    Treatment and Management

    Physiotherapy plays a crucial role in managing and treating PFPS. The primary goal of physiotherapy is to exclude differential diagnoses, alleviate pain, improve knee function, manage aggravating workloads and prevent the recurrence of symptoms. Treatment plans are tailored after a comprehensive history taking and examination to the individual’s specific needs and should include the following components:

    • Pain Management: Initially, pain and inflammation may be managed through ice therapy, massage, stretching and non-steroidal anti-inflammatory drugs (NSAIDs).
    • Strengthening Exercises: Targeted exercises aim to strengthen the hip, thigh, and trunk muscles, which can help correct muscle imbalances and improve knee alignment and load tolerance.
    • Stretching and Flexibility: Stretching exercises can help improve flexibility in the muscles surrounding the knee joint, reducing strain on the patellofemoral joint.
    • Biomechanical Analysis: A physiotherapist may evaluate the patient’s movement patterns during functional activities such as jumping and running to identify any obvious faulty mechanics that contribute to PFPS. Corrective techniques, gait retraining may be employed.
    • Activity Modification and Rehabilitation: A gradual return to activities while maintaining a balance between rest and exercise is important to ensure proper healing and prevent re-injury.
    • Taping: taping has been shown to acutely help reduce symptoms by aiding in the improvement of kneecap tracking through the femoral trochlea (groove where the kneecap runs)

    Prevention Strategies

    To prevent the onset or recurrence of PFPS, individuals can incorporate the following strategies:

    • Regular strength and conditioning exercises to maintain muscle balance and strength of the lower limbs and trunk musculature.
    • Proper warm-up and cool-down routines before and after physical activities.
    • Gradual progression of activity levels and intensities to avoid overuse injuries.
    • Being aware of the early signs and symptoms and addressing them promptly.

    Is my knee pain osteoarthritis?

    In short, No. Patellofemoral Pain Syndrome (PFPS) is not the same as Patellofemoral Joint (PFJ) Osteoarthritis (OA). While both conditions involve the patellofemoral joint, they are distinct entities with different causes and characteristics. As mentioned, PFPS primarily involves pain and dysfunction in the patellofemoral joint, often caused by factors such as overuse, muscle imbalances, or poor biomechanics. It is commonly seen in younger athletes and active individuals. PFPS is characterized by pain around or behind the patella, especially during activities that involve knee bending or loading such as running.

    On the other hand, PFJ OA refers to the degeneration and wearing down of the cartilage within the patellofemoral joint. This condition typically occurs in older individuals and is more common in those with a history of knee injuries or conditions such as patellar instability. The primary symptom of patellofemoral joint osteoarthritis is joint pain, stiffness, and swelling, which worsen over time. This pain can be at rest.

    While both conditions can cause knee pain and affect the patellofemoral joint, the underlying mechanisms and treatment approaches differ. Physiotherapy plays a crucial role in managing both conditions, but the specific treatment plans and exercises may vary based on the individual’s diagnosis, symptoms, and physical examination findings.

    In summary, Patellofemoral Pain Syndrome is a common knee condition that can significantly impact an individual’s daily activities. With a comprehensive physiotherapy approach involving pain management, strengthening exercises, and biomechanical analysis, PFPS can be effectively managed and treated, allowing individuals to regain pain-free movement and engage in their desired activities. If your knee cap pain prevents you from doing the things you want to do, book in with of our expert Praxis team members to discuss getting you back to function!

    Until next time,

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    Team Praxis