From the Guidelines
Work restrictions for patellofemoral pain syndrome should prioritize temporarily limiting activities that aggravate knee pain while maintaining overall function, with a focus on delivering knee-targeted exercise therapy and supportive interventions as required, as recommended by the most recent and highest quality study 1. When managing patellofemoral pain syndrome, it is essential to consider the individual's needs and current status, and build a personalized plan to address their specific impairments and symptoms 1.
Key Considerations for Work Restrictions
- Avoid prolonged sitting with bent knees, repetitive squatting, kneeling, stair climbing, and high-impact activities like running or jumping until symptoms improve
- Gradually return to activities, with modification rather than complete cessation of work duties when possible
- For desk workers, regular position changes, ergonomic adjustments, and hourly standing breaks can help
- For physical laborers, temporary reassignment to duties with less knee loading, use of knee pads when kneeling is necessary, and proper lifting techniques (using leg muscles rather than placing stress on the knees) are advisable
Importance of Exercise Therapy and Education
- Deliver knee-targeted exercise therapy, with a focus on hip and knee strengthening, as this has been shown to improve patellofemoral pain outcomes 1
- Education should underpin all interventions, adjusted to reflect the needs of the person, and may seek to challenge inaccurate beliefs, build confidence and understanding of the diagnosis, and promote autonomy and reduce fear 1
Additional Interventions
- Prefabricated foot orthoses may be prescribed to those who respond favourably to treatment direction tests, and customized for comfort by modifying density and geometry 1
- Movement/running retraining can be considered in those with symptoms reasoned to be associated with assessment findings aligning with the intervention 1
- Taping may be considered for people where rehabilitation is hindered by elevated symptom severity and irritability 1
From the Research
Work Restrictions for Patellofemoral Pain Syndrome
- Patellofemoral pain syndrome (PFPS) is a common condition that affects the knee, causing pain and discomfort, especially in individuals who engage in activities that involve running or jumping 2, 3, 4, 5, 6.
- The management of PFPS typically involves a combination of physical therapy, strength training, and stretching exercises, with a focus on improving quadriceps and hip strength, as well as patellar mobility 2, 3, 6.
- Work restrictions for individuals with PFPS may include avoiding activities that aggravate the condition, such as running or jumping, and modifying work duties to reduce stress on the knee joint 4, 6.
- A comprehensive rehabilitation program that includes education on proper knee mechanics, strengthening exercises, and modification of risk factors can help individuals with PFPS return to work and reduce the risk of recurrence 2, 4, 6.
Treatment Options
- Strength training and stretching exercises are strongly supported by research as effective treatment options for PFPS, with a focus on quadriceps and hip strengthening 2, 3, 5.
- Physiotherapy programs that include a combination of strength training, stretching, and proprioceptive exercises can help improve knee function and reduce pain in individuals with PFPS 2, 3, 6.
- Adjunctive therapies, such as taping, orthotics, and biofeedback devices, may provide limited additive benefits in select populations, but are not recommended as a primary treatment for PFPS 2, 3, 6.
Return to Work
- Individuals with PFPS can return to work once they have completed a comprehensive rehabilitation program and have demonstrated significant improvement in knee function and reduction in pain 4, 6.
- A gradual return to work, with modifications to work duties and activities, can help reduce the risk of recurrence and promote long-term recovery 4, 6.