Knee Pain Vancouver

What is PFPS – Patellofemoral Pain Syndrome

By Brooke MacGillivery, Physiotherapist

Patellofemoral Pain Syndrome, commonly referred to as PFPS, is a syndrome characterized by diffuse pain/discomfort surrounding the knee cap. The pain can vary in intensity, location, and duration, and will commonly present after repetitive activities such as running, squatting, or cycling.

Why does PFPS occur?

In order for the lower extremity to function optimally, the ankle,

knee and hip joints must have functional ranges of motion. The muscles surrounding each joint must be strong and balanced as well. Due to the nature of most jobs, the majority of us sit for a better portion of the day. Sitting for prolonged periods can inhibit the posterior chain (glutes, hamstrings, calves), which can lead to weakened muscles. Anytime a muscle group is weakened, the body develops compensatory patterns to achieve a given movement pattern. If the glute muscles are inhibited while climbing stairs, the body will recruit surrounding muscles to get the job done (cue tight hip flexors and quads). The body can tolerate repetitive movements, but only when all the muscles involved are doing their fair share. Tight quads and hip flexors can pull on the knee cap, forcing it to track improperly which can contribute to PFPS and other conditions such as IT Band Syndrome.

There are a number of different factors that can contribute to PFPS, not just the mechanisms listed above. The good news is that by determining any muscular imbalance or mechanical impairments, a treatment plan can be devised to correct imbalances and decrease the stress on your knees.

If you find you have diffuse knee pain that affects your daily activities, seek out a physiotherapist to assess your mechanics. Simple things like foam-rolling your quads, and doing glute-activation exercises prior to a run can decrease the stress on your knees.

Tennis Elbow – Vancouver

By Lindsay Farr, Physiotherapist

Lateral epicondylalgia (LE), more commonly referred to as tennis elbow, refers to pain on the outer side of your elbow.

This pain is usually worsened with gripping and repetitive activities such as typing, mousing, lifting objects with an outstretched arm, and opening doors. It is typically considered a tendinopathy of the extensor carpi radialis brevis muscle, however evidence shows a relationship between the neck, the radial nerve, and LE. Historically this condition was treated with non-steroidal anti-inflammatories (NSAIDs), ice, and rest.

Current evidence suggests there may not actually be an inflammatory component to this condition and studies have shown that physiotherapy combined with a home exercise program is more effective than ice or NSAIDs.

Studies have started to investigate the role of posture and the nervous system in the development of LE and have shown positive correlations. There is a greater prevalence of neck pain in patients with LE versus age matched controls (Berglund, Persson & Denison, 2013) and individuals suffering lateral elbow pain are more likely to test positive for radial nerve sensitivity (Coombes et al., 2013). Sitting at a desk for prolonged periods of time can lead to a chronic “head forward posture,” as pictured below.

Tennis Elbow 1

This position compresses the joints in our neck and narrows the space through which our nerves pass. Chronic poor postures can lead to compression of nerves, such as the radial nerve, which supplies muscles in our lateral elbow. When our nerves are compressed information moving through those nerves is restricted and slowed and this puts structures innervated by those nerves at risk for injury. Where our muscles would normally be able to withstand the repetitive daily tasks such as gripping and opening doors, nerve compression and irritation has limited their tolerance and so they breakdown sooner and start emitting pain signals. This is when we feel “tennis elbow.”

Here are some helpful tips for those of you who are “9-5 desk sitters,” or anybody struggling with lateral elbow pain:
Adjust your desk station: try to attain posture as shown in this image. If you are unable to adjust your station yourself, speak with your manager and ask to have an ergonomic assessment of your desk station

Tennis Elbow 2

Move: set a timer for 45 minutes. Whenever that timer goes off adjust your position. Lean back over your chair to stretch your chest muscles, stand up and walk to the printer/cooler, twist left and right in your chair.

Tennis Elbow 3

Stretch: use these basic neck and arm stretches daily to avoid tight muscles and relieve pressure on the nerves

Tennis Elbow 4

Posture: try to maintain a posture where your head rests over your body. Shoulders should be slightly back, lengthen the back of your neck and gently nod your chin “yes”. Your ears should nearly align with your shoulders when viewed from the side.

Tennis Elbow 5
See a Physiotherapist: if your symptoms persist and are becoming limiting to simple daily activities you should seek medical advice from a physiotherapist who can instruct you on more specific treatment methods and exercises.

Why do my knees hurt when I run?


  By Brooke MacGillavery, MPT, BSc, CAFCI, CSCS

Ever wonder why your knees hurt when you run? Or why you can’t quite achieve a perfect lotus position in yoga?

As a physiotherapist, I will assess your posture and overall mechanics to determine what can be done to eliminate pain and improve your daily life.  Pain and loss of function can develop from a trauma, or something as simple as repetitive postures like sitting at a desk all day.
My goal as a physiotherapist is to help people realize their full physical potential – whether it be training for a marathon, perfecting squat technique, or simply having pain-free neck range of motion.
As a physiotherapist at Qi, I feel my tools are all the more useful when paired with other services such as Pilates for core strengthening, or massage to decrease muscle tension and increase flexibility or range of motion. To start the new-year off right, ask yourself if you have any goals you’re having difficulty achieving due to physical limitations or pain; physiotherapy can help!

The bridge is an excellent exercise to start with:

  • With a neutral pelvis, bend knees

  • Feel the feet, arms and shoulders firm on the floor

  • lift hips and hold

  • Focus your breath into your low abdomen

  • Keep thighs engaged

  • Knees in line with your ankle and large to

  • Hold for 30 seconds

Perform 3 sets ensuring no back or knee pain.

To book in with Brooke call us at Qihealth # 604-742-8383