Patellofemoral Pain Syndrome

What Is Patellofemoral Pain Syndrome?

PFPS is a condition where the area around the knee cap becomes painful due to muscle tightness, muscle imbalances and/or improper alignment of the patella (knee cap) within the femoral groove it sits in. This causes the improper impact of the knee cap onto the femur.


What Are The Causes Of Anterior Knee Pain?

Improper alignment and orientation of the knee cap, improper impact of the knee cap hitting onto the femur on either side of it’s groove, muscle tightness or muscle imbalances that pull the patella from its correct alignment, decreased patellar joint space, poor/lack of hip stabilization causing biomechanical faults, overpronation of the foot, knee/hip internal rotation “collapse” pattern


What Are The Signs And Symptoms Of Patellofemoral Pain Syndrome?

Pain and tenderness in the front of the knee or surrounding the kneecap and knee joint region. Pain with knee bending, prolonged sitting, climbing stairs, squatting, or kneeling.


What Are The Risk Factors Of Anterior Knee Pain?

Muscle imbalances in the lower leg, lack of hip stability, poor biomechanics, patellar dislocation, knee ligament injury, meniscus injury


How Is Patellofemoral Pain Syndrome Diagnosed?

APT can diagnose PFPS based on the signs and symptoms listed above exhibited by the patient. They will also conduct specialized PT tests and functional tests, including the step-down test and gait analysis to look for improper biomechanics and poor muscular stability.


What Are The Possible Treatments For Patellofemoral Pain Syndrome?

Manual therapy to correct muscle or fascial tightness, joint mobilization to improve the motion of the kneecap, joint mobilization and stretching to improve the alignment of the kneecap, joint mobilization to improve tibial-femoral joint motion, modalities for pain relief. Strengthening of the quadriceps, hamstrings, and hip rotators to correct muscle imbalances, stability training for the hips and core to improve biomechanics. Strengthening that encompasses both open chain (non-weight bearing) and closed chain (weight bearing). Plyometric and sport specific training for athletes. Orthotics may be prescribed if support is needed at the foot.


Are There Preventative Steps Or Measures To Avoid Patellofemoral Pain Syndrome?

The biggest preventative measure is to maintain healthy body mechanics and good hip/core stability. While performing exercise and conducting activities like stair climbing, walking/running, cycling etc. it is important to make sure the knees and hips aren’t “collapsing” inward, which creates excessive strain on the patella and knee joint.


What Are The Risks If Anterior Knee Pain Is Left Untreated?

If left untreated this can lead to chronic knee pain and may increase the risk for developing arthritis within the knee.


Are There Other Related Conditions To Patellofemoral Pain Syndrome?

Conditions with similar presentations may include patellar tendinopathy, chondromalacia patellae, runner’s knee, meniscus injury


Key Takeaways About Patellofemoral Pain Syndrome

-Proper biomechanics and solid hip/core stability are essential in treating and preventing knee pain.
-Manual therapy is key to improving joint alignment and mobility, and individualized exercise aids in reinforcing and maintaining these gains.
-PTs must look above and below the knee and assess how the foot, hips, and core is contributing to the problem.


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