Patello-femoral Pain Syndrome

Question 1

What is patellofemoral pain syndrome?

Answer 1

Pain from the tissues within or surrounding the joint between the patella and femur.

Question 2

What is the pathophysiology of patellafemoral pain?

Answer 2

Multifactoral - combination of biomechanical factors along with soft tissue/muscle imbalances lead to improper tracking of the patella in the trochlea of the femur. This increases the stress at the patellofemoral joint. Hypothetically leading to increased cartilage and subchondral bone stress which leads to pain over time.

Question 3

What are the clinical freatures of patellofemoral pain syndrome?

Answer 3

1. Dull aching pain at front of knee
2. Pain worsened with activity
3. Limited ROM
4. Cracking and popping

Question 4

Aetiology of patellofemoral pain syndrome?

Answer 4

1. Overuse
2. Muscle imbalance/weaknesses
3. Injury
4. Knee surgery
5. Stress

Question 5

Epidemiology of patellofemoral pain syndrome?

Answer 5

2-3 times more likely in females than males

Effects approximately 25% of the physically active population

Question 6

What is patellatracking- function?

Answer 6

Main function- provide a mechanical pulley for the quadriceps.

Question 7

What is maltracking?

Answer 7

1. Key role in functional or dynamic malalignment.

Question 8

What is patellatracking overall pattern?

Answer 8

Gliding joint motion- sup/inf glide, med/lat glide, med/ lat tilt, med/lat rotation.
Overall pattern of contact of the patella increases with knee flexion
During flexion patela inferior, extension superior with some medial and lateral tracking.

Question 9

What is patella tracking stability?

Answer 9

Stability of the patellofemoral joint- dependent on the static and dynamic soft tissue structures

Question 10

What causes maltracking?

Answer 10

1. Delayed activation of vastus medialis, oblique and lateralis. I.e lateralis activating earlier than medialis.
2. Increased internal rotation of the femur, tibia or both- hip abductor weakness. Increases pronation of the foot.
3. Hamstring/calf tightness- trigger overload of the PFJ in combination with dynamic and functional lateralisation of the patella.