Patellofemoral syndrome

By Jess Jefferies – Physiotherapist

Patellofemoral syndrome is one of the most common causes of pain in the front of the knee in any age group, whether active or not. It is a bit of an umbrella term used to describe pain around the kneecap and the cause of the symptoms can vary between individuals.

The patellofemoral joint (PFJ) is made up of your patella (knee cap) and femur (thigh bone). Your patella would normally glide up and down through the femoral groove when bending and straightening your knee. The outer and inner quadriceps muscles (front thigh) are responsible for this tracking of the patella.

Anatomically the outer structures of the thigh are much stronger than the inner ones and thereforewith repetitive tasks that require the thigh muscles to work (walking, running, squatting, and lunging), the outer muscles can often become quite tight.

Because of how these muscles attach to the knee cap, the tightness can cause the knee cap to be pulled out to the edge of its groove. Therefore, when the knee is bent and straightened, the knee cap may not track nicely in the centre of the groove which can result in pain that may be felt behind, around or on top of the knee cap.

Another time this pain occurs is after other knee injuries. Often with knee injuries, the inner thigh muscle (the most important muscle for stabilising the knee cap) can stop working correctly. It may lose its ability to stabilise the knee cap in the centre of its groove and as a result, the patella may be pulled outwards by the stronger outer thigh muscles. Again, this may cause the patella to not track correctly and result in pain. Weak glute muscles have also shown to contribute as this can cause more loading through the inner knee.

There are numerous contributing factors to PFJ pain as described above but the main ones would be muscle imbalance, poor biomechanical control and joint alignment at the hip, knee, or foot.

Pain would often be experienced in the front of the knee while walking, running, going up ordownstairs, or walking up/downhill. Symptoms can vary between individuals as it is dependent on their contributing factors.

If this sounds like what you are experiencing, come in and see us. We can assess you and see if this is your problem. With the help of Physiotherapy and Podiatry we can not only minimise the pain, but also help correct the faulty movement patterns you have developed, and therefore prevent it from happening again.

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