We are a Galway City physiotherapy clinic that specialises in treating knee pain. Patellofemoral Pain Syndrome (PFPS) is an umbrella term used for pain arising from the patellofemoral joint itself, or adjacent soft tissues. Historically, PFPS has been referred to as anterior knee pain but this is misleading as the pain can be felt in all aspects of the knee.

PFPS can be due to a patellar trauma, but it is more often a combination of  several factors (multifactorial causes): overuse and overload of the  patellofemoral joint, anatomical or biomechanical abnormalities, muscular weakness, imbalance or dysfunction. It is more likely that PFPS is worsened and resistive to treatment because of several of these factors.

Causes

One of the main causes of PFPS is the patellar orientation and alignment. When the patella has a different orientation, it may glide more to one side of the facies patellaris (femur) and thus can cause overuse/overload (overpressure) on that part of the femur. This can result in pain, discomfort or irritation.

Sometimes the pain and discomfort is localized in the knee, but the source of the problem is somewhere else. Pes planus of the feet (pronation) or pes cavus of the feet (supination) can provoke PFPS. Foot pronation (which is more common with PFPS) causes a compensatory internal rotation of the tibia or femur that upsets the patellofemoral mechanism. Foot supination provides less cushioning for the leg when it strikes the ground so more stress is placed on the patellofemoral mechanism. The hip and strength of the gluteal muscles can also influence the knee and provoke PFPS.

Symptoms

Patient’s usually present with the complaint of anterior knee pain that is aggravated by activities that increase patellofemoral compressive forces such as: ascending/descending stairs, sitting with knees bent, kneeling, and squatting.

Treatment

Common interventions for the treatment of PFPS are listed below:

• Manual Therapy
• Open vs. Closed Chain Exercises
• Quadriceps strengthening
• Patellar Taping
• Orthotics
• Proximal Muscle strengthening
• Modalities

PFPS is one of the most common injuries we see in runners and other endurance athletes here at West Coast Physio. We often advise people on correct running techniques and strength training that will result in reduced pain and improved function. Give us a call and we would be happy to assist.