Patello-Femoral Pain Syndrome

What is PFPS?

Patellofemoral pain syndrome (PFPS) is prevalent in approximately 25% of the athletic population and most commonly affects young adult females [1].  PFPS is characterised by anterior knee pain in and around the patella [2,3]. When bending at the knee joint, the patella should normally track in a lateral to medial direction before moving laterally again at full knee flexion. This motion is controlled by the quadriceps muscle group, particularly the vastus medialis oblique and vastus lateralis components. Poor coordination or weakness of these muscles can lead to inflammation of soft tissues (lateral retinaculum, infrapatellar synovium and fat pad) in addition to stress on cartilage and bone causing pain [3].

Presentation

  • Acute or gradual onset

  • Aggravated by increased on unaccustomed loads on the patellofemoral joint (e.g. higher training volume, increased running speed, hill/stair running and bounding)

  • Varied presentations including achy/sharp pain, poorly localised under or around the patella

  • Knee/s may feel like it is gives way or buckles [2,3]

  • Pain during squatting [4]

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Aetiology

  • Inadequate neuromuscular control or weakness of quadriceps muscles

  • Patella position (tilt/rotation)

  • Pronated foot type [1,2]

  • Increased knee valgus or femoral internal rotation

  • Reduced strength, coordination or range of motion of hip abductors causing increased stress on frontal and transverse forced around the knee [3]

Complications

May predispose to the development of patellofemoral osteoarthritis.

How can Physiotherapy help?

  • Provide education and advice about your condition and promote strategies to reduce your pain and symptoms

  • Provide an accurate and comprehensive assessment of your condition and address any underlying biomechanical factors contributing to your pain

  • Provide condition specific treatment including manual therapy, massage and stretches

  • Create an individualised exercise program to target muscular imbalances in the hip and/or knee and improve coordination of quadriceps muscles

  • Taping to correct abnormal positioning of the patella [2,5]

 

If you have any questions regarding your knee pain, please give us a call at (02) 8411 2050. At Thornleigh Performance Physiotherapy, we can give you an accurate diagnosis and treatment, to help you get back in action as soon as possible. We are conveniently located near Beecroft, Cherrybrook, Hornsby, Normanhurst, Pennant Hills, Waitara, Wahroonga, Westleigh, West Pennant Hills, and West Pymble.

 

References

  1. Nunes, G. S., Stapait, E. L., Kirsten, M. H., De Noronha, M., & Santos, G. M. (2013). Clinical test for diagnosis of patellofemoral pain syndrome: Systematic review with meta-analysis. Physical Therapy in Sport, 14(1), 54-59.

  2. Brukner, P. (2012). Brukner & Khan's clinical sports medicine. North Ryde: McGraw-Hill. 4th Edition, 87. 725-726.

  3. Panken, A., Heymans, M., Van Oort, L., & Verhagen, A. (2015). Clinical prognostic factors for atients with aterior knee pain in physical therapy: A systematic review. International journal of sports physical therapy, 10(7), 929.

  4. Collado, H., & Fredericson, M. (2010). Patellofemoral pain syndrome. Clinics in sports medicine, 29(3), 379-398.

  5. Collins, N. J., Bisset, L. M., Crossley, K. M., & Vicenzino, B. (2012). Efficacy of nonsurgical interventions for anterior knee pain. Sports medicine, 42(1), 31-49.

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