Patellofemoral Pain Syndrome (PFPS) is a knee injury characterized by significant pain in the patellofemoral joint (patello=patella and femoral=femur). PFPS is the most common cause of visits to physiotherapy clinics for knee pain, and represents 10 to 25% of all consultations. It should be noted that if left untreated, PFPS may be followed by cartilage degeneration in the patella, called chondromalacia patellae, and even arthrosis.

What causes PFPS?

Except in post-traumatic cases, such as a direct fall on the knee, it can be said that the patellofemoral pain syndrome is the result of abnormal muscular and biomechanical factors that alter the patella’s alignment in an exterior direction. Here are the main predisposing factors to PFPS:

• Poor posture or misalignment of the patella
• Tightness or weakness of the thigh muscles
• Excessive foot pronation (sagging of the foot arch=flat feet)
• Overextension of the medial retinaculum, fibrous tissue whose role is to help stabilize the patella
• A deformity in the knee joint that bends it backward
• Poor posture of the femur.

Symptoms of PFPS

• Knee pain, particularly in the anterior region or around the patella
• Pain while walking down stairs, while sitting or squatting
• Pain during and after physical activity such as running, swimming (breaststroke), cycling, etc.
• Pain and crepitation while flexing the knees
• The patella seems less mobile in a backward movement and more mobile toward the exterior.

Who’s more at risk of PFPS?

Runners, soccer and football players, young athletes and women (women are more at risk then men because of a biomechanical characteristic). There is also a link with the growth spurt experienced during the teenage years.

Treatment: an integrated approach for optimal rehabilitation

Proper management of PFPS requires the implementation of a comprehensive rehabilitation program which may involve:

• Rest and application of ice
• Reduction of pain and inflammation with analgesic modalities, such as electrical nerve stimulation (TENS) and ultrasound
• Taping to correct abnormal patellar position
• Passive stretching and strengthening of key muscles to correct imbalances
• Massage therapy and manual therapy to improve tissue mobility
• Bracing and orthotics to stabilize the patella
• Resistance-free cycling
• General recommendations, such as avoiding exercises like squatting, and sitting down with legs crossed
  Home exercise program.

Remember: the faster you get treatment, the better your chances of success!

Do you think you may be suffering from patellofemoral pain syndrome? Contact us to consult one of our health professionals.