A 30 year old female runner 17mo post partum presented to Results Physiotherapy with a referral from an orthopedist for left ant/lateral knee pain, diagnosed as patella-femoral pain syndrome (PFS) by an orthopedist. Her pain caused her to cease running 2 weeks after starting. She also reported difficulty with going up/down stairs and kneeling to play with her children.
• Limited squat mobility with bilateral knee valgus during movement
• Patellar hypomobilty
• Tenderness to palpation L infrapatellar fat pad
• Hip abductor and external rotator weakness
The diagnosis of PFS was confirmed in conjunction with infrapatellar fat pad irritation.
• Patella mobilizations
• Hip strengthening exercises
• Taping to offload infrapatellar fat pad
• Single limb balance training
• Single limb functional strengthening
The patient began running on 8th visit and was progressed from run/walk program to running while weaning off of tape. Upon further assessment, a persistent diastasis recti was found in conjunction with pelvic floor muscle weakness.
This patient was referred to a Results Physiotherapy Women’s Health specialist to assess and treat specific core weaknesses resulting from giving birth to triplets 17 months prior.
The patient was seen for 15 total visits including Women’s Health consultation and was discharged with no pain with running or squatting. Currently, this patient is running 3-4 times per week and up to 4 miles per run without pain.
Consider PT for your patients that have orthopedic related pain with return to exercise post partum. Hormonal and mechanical changes can lead to functional “instabilities” leading to a wide range of pain presentations. Early intervention can help prevent chronic pain syndromes and promote a healthy lifestyle with regular exercise.