Patellofemoral Pain Syndrome (PFPS)

Question 1

PFPS Overview

Answer 1

• Repetitive overuse disorder resulting from increased force at patellofemoral joint
• General term describing anterior knee pain
• Also called chondromalacia patella — refers to softening of articular cartilage of patella

Question 2

PFPS Causes

Answer 2

• Decreased quad strength
• Decreased LE flexibility
• Patellar instability
• Increased tibial torsion or femoral anteversion

Question 3

PFPS Etiology

Answer 3

• Females > males
• Adolescence — about 13-25 years old
• Marathon runners
• Overweight
• High impact sports (soccer, gymnastics)

Question 4

PFPS Impairments

Answer 4

• Anterior knee pain
• Pain with prolonged sitting (this stretches patellar tendon)
• Swelling
• Crepitus — popping, crunching during activity
• Pain when ascending and descending stairs

Question 5

PFPS Examination

Answer 5

• Physical examination
• X-ray would show patellar displacement (lateral tracking happens with this diagnosis*)
• Patellar grind test (Clarkes Sign) — two fingers push down from top of patella, two other fingers press down on patella, (+) = pain
• Thomas Test — also tests rectus femoris so it can be positive with this

Question 6

PFPS CPG Guidelines

Answer 6

• Presence of retropatellar or peripatellar pain
• Reproduction of retropatellar or peripatellar pain during squatting or other function activities in flexed position
• All other conditions that could cause anterior knee pain should be excluded

Question 7

PFPS Treatment

Answer 7

• Manual therapy — patellar glides
• Open and closed chain exercises
• Quad strengthening
• Patellar taping — acceptable on NPTE
• Orthotics — KAFO is quad strength is <3/5
• Proximal muscle strengthening — strengthen hips and gluts
• Modalities
• Patient education