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Patellofemoral pain in Cross-Fit – Why?


Discomfort or pain in the knee, particularly around the kneecap is a very common complaint amongst Cross-Fitter’s. This pain is often called ‘patellofemoral pain’ or ‘PFP’ by Physiotherapists. Whether you experience pain when you squat, wall ball or box jump, PFP knee can be debilitating and preventing you from hitting your PR’s. PFP usually develops in those new to Cross-Fit who are not used to the sheer volume of squatting, lunge, and jumping or in those athletes whose squat/jump mechanics are not optimal. As there are generally a number of causative factors which contribute to the development of PFP, this blog aims to give you 5 simple tips to avoid PFP and keep you in the box achieving your goals.

1. Improve the lateral rotation movement of your hip

The range of movement in your hip joints is very important to ensure good squat mechanics and efficient power generation in the Olympic lifts. In particular, the amount of lateral rotation (turning the knee outwards) is very important. Without sufficient lateral rotation of the hip, the knees can collapse inwards causing a change in the distribution of force going through your knee which may ultimately may lead to the development of PFP.

2. Improve your quad strength, particularly Vastus Medialis Oblique

The strength of your muscles on the front of your thigh, known as your quadriceps and more specifically the VMO (Vastus Medialis Oblique) which lives on the inner portion are very important for the health of your knee. The stronger your quads are, the more efficient you are able to squat, lunge, run, jump etc and more importantly, ensures the patella (kneecap) tracks optimally within its groove.

3. Improve your glute strength

Cross-Fit is a very quad-dominant sport and we often see an imbalance between the quads and glutes which can be a key contributor to PFP. Not only will strong glutes put your knees in a better position during squat, lunging etc by ensuring the knee doesn’t collapse inwards but will allow you to drive out of the bottom of a squat and generate more power during hip contact for the Olympic lifts.

4. Perfect your technique

Sounds easy right? It’s not hard to look around the Box and seeing people trying squat or lunge more than they can handle result in poor technique or form. Whilst it may get you on the whiteboard faster, in the longer term you are worse off because it is only a matter of time before the knee starts to become irritable due to a change in the forces placed upon it. Take the time to perfect your technique – only add more weight to the bar if you can execute the squat or alike with perfect technique.

5. Modify your training load

Particularly if you are new to the sport, you will notice very quickly that you are doing some form of squatting, lunging or jumping everyday of the week. If you notice your knees start to become niggly, first try to modify the exercises within the WOD such as reducing the depth, weight or reps of the exercise. Another easy modification is to replace the aggravating exercise with a non-aggravating exercise for example replacing the walking lunge with a squat variation or running with everyone’s favourite assault bike or vice versa.

Final Thoughts

As all Cross-Fitter’s know, not being able to Rx a workout, having to modify a WOD or worse, having to rest completely from a WOD never sits well. Hence it is vitally important that if you are experiencing knee pain that you get it checked out by a Physiotherapist to the get the right diagnosis for the right treatment and management plan. Remember that we are here for you – the quicker you get your injury looked at the sooner we can modify and make a plan together to get you back hitting your PR’s.

Book an appointment at Coast Sport by calling 4356 2588 or book online via the button below.

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Disclaimer: The content on this website is for informational purposes only. Do not rely or act upon information from www.coastsport.com.au without seeking professional medical advice. Do not delay seeing a doctor if you think you have a medical problem or injury.

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