Patellofemoral Syndrome Flashcards
often due to what problems
tracking or instability problems
where does the patella attach
superiorly to the quadriceps tendon and inferiorly to the patellar tendon
what make up extensor mechanism of knee
patella
femoral condyles
patellar tendon & it’s attachment to the tibia
retinaculum
synovium
quadriceps mm
when the knee is extended the patella glides ___
superior to femoral condyles
(goes inferior when flexed)
gliding occurs along the longitudinal axis of femur in response to contraction of the quads
where does the pull of the patellar tendon move
along the longitudinal axis of tibia
what do most knee joints assume when knee is in extension
slightly valgus
the long axis of femur and tibia are at a slight angle to each other (Q angle)
Q angle results in
slight lateral pull on patella
lateral femoral condyle and patellar groove on femur help prevent lateral movement
what must function in order to prevent the patella from tracking laterally
vastus medialis
medial retinaculum
predisposing factors to patellofemoral syndrom
abnormal biomechanics
soft tissue dysfunction
previous injury
what is patellar cartilage made of
hyaline cartilage
(cartilage is self renewing and self lubricating)
patellar cartilage is the thickest in the body (5mm)
increased foot pronation, internal tibial rotation, internal femoral rotation can lead to
increased Q angle
what direction of patella is less stable
alta (high) - bc it lies in a shallower superior portion of femoral groove
what would allow the patella to track laterally
a less prominent femoral condyle
what structures increase lateral pull on patella
vastus lateralis
IT band
TFL
weakness in vastus medialis allows what motion of patella
lateral
what is the condition that involves softening of the cartilage of the patella
chondromalacia patella
develops in deeper layers of cartilage (OA is superficial fraying of cartilage)
what ares synovial folds at the knee called
plica
can be a cause of knee pain
usually asymptomatic unless overuse
band of medial plica compresses patella and medial femoral condyle causing changes in articular surfaces
observations
pronation of foot/ valgus knee
squinting patella
hypotrophy of vastus medialis
hyperextension of knees
patella alta
glute med weakness
tenderness at med and lateral borders of patella
AROM of knee = excessive lateral motion at med and lat borders
PROM of patella = crepitus
Q angle greater than 18 when standing
McConnels and clarkes patellofemoral grind tests are positive
patellar apprehension test positive
treatment
primary: compensatory structures (vastus lateralis, TFL, IT band, hamstrings, gastrocs, rec fem)
weak vastus med, glute med (stimulate)
moist heat to IT band, lateral retinaculum
patella mobilizations in MEDIAL direction
Swedish to adductors, low back, glutes, hamstrings, gastrocs
passive stretches to hams, gastrocs
joint play to hip and ankle
self care
regain strength of vastus medialis (externally rotate leg)
straight leg raises
quad setting
strengthen supinators of foot (tib ant, ext digitorum longus, extensor hallucis longus)
where do degenerative changes occur w patellofemoral syndrome
articular cartilage on the underside of the patella
increased foot pronation, internal tibial rotation and internal femoral rotation can lead to an increased _____
Q angle
what muscles would be tight
posterior and anterior structures
hamstrings
gastrocs
rec fem
what are synovial folds at the knee called
plica
can be a cause of knee pain
