By: Grant Cutchin, ATC, VATL
Patellofemoral pain syndrome (PFPS) is a common knee ailment that causes anterior knee pain. PFPS affects active individuals particularly adolescents and is more likely to affect females. The anterior knee pain caused by PFPS can be described as diffuse and can become pronounced with a number of activities such as running, walking up and down stairs, performing squatting type exercises and sitting for long periods.
There are a number of reasons why one may develop this condition. Some are structural while others are musculoskeletal. Maltracking of the patella is considered to be a key contributor to PFPS. Maltracking of the patella is when the patella tracks laterally or away from the midline of the body. The patella may track laterally for a number of reasons including atrophy of a medial quadriceps muscle, increased Q-angle, weak hip abductors, iliotibial tract length, foot abnormalities and strength imbalance between the quadriceps and hamstrings.
A thorough physical examination by a qualified healthcare provider is required to determine which factors cause PFPS in each case. Likely, it will be a combination of the factors listed. These factors are most commonly corrected in a non-operative manner. For acute treatment and pain relief from PFPS, cryotherapy and non-steroidal anti-inflammatory drugs can be used. For cases of chronic PFPS, tape, braces and orthotics can be used to correct a maltracking patella. McConnell taping technique, Kinesiotape, and patella braces are used to pull the patella towards the mid-line of the body, or medially, to correct for the laterally tracking patella. Orthotics can also be used to correct foot abnormalities which can affect knee mechanics. Physical rehabilitation is an important part in treating PFPS. The rehabilitation can correct for weakness and imbalances noted in the physical examination. For example, if hip abductor weakness is found, a number of exercises should be performed to increase strength in that musculature. Exercises that can increase musculature of the lower extremity include monster walks to increase hip abductor strength, straight leg raises with hip external rotation to increase medial quadriceps activation, and hamstring stretches to increase hamstring length.
If these conservative methods do not yield favorable results, surgical procedures can be performed. One of the more popular surgical procedures to treat PFPS is called a lateral release. A lateral release is a procedure where the lateral retinaculum of the knee is cut to remove tension pulling the patella laterally.
Contact your physician or physical therapist if you need help with a personalized treatment plan or have questions about PFPS.
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