Knee Pain Continued: Patellofemoral Syndrome and Other Patellar Injuries

This week's topic: patellofemoral pain syndrome (PFPS).  For those of you who aren't familiar with this terminology, patellofemoral pain syndrome is characterized as pain originating from the areas underneath or around the patella (kneecap), due to abnormal forces being placed upon the patellofemoral joint. This can result in potential irritation to the underlying articular cartilage (chondromalacia), irritation/inflammation of the synovium, and finally damage to the bones themselves. Common signs and symptoms that accompany patellofemoral pain syndrome are anterior knee pain that occurs with activity, and is exacerbated with ascending/descending stairs/hills.

The question that may be running through your mind, is WHY DOES THIS HAPPEN?  As stated earlier, the probable cause for PFPS is abnormal forces acting upon the patellofemoral joint.  In my clinical experience, it seems as though muscle imbalances (tightness/weakness of certain muscles) seem to be one of the primary causes of this issue.  Weakness of the quadricpes/gluteal musculature and tight hip flexor musculature seem to be quite prevalent in my encounters in the clinic. 

Prior to jumping right into treatment, it's important that we use a special test to verify that the individual is suffering from PFPS.  For these purposes, we will use the eccentric step down test, which a study conducted by Nijs et al, determined that it's results are most likely to indicate PFPS.  The test can be completed as shown in the following video:             

Finally, let us examine treatment of patellofemoral pain syndrome.  Before we start, let me remind you that the information presented on this blog should not be used as a substitute in any manner for skilled services. In addition, I am in no way making diagnoses or providing treatment via the blog. This blog is solely intended to educate the readers in the area of injuries/rehabilitation. If feel as though you may need help, please see your physician or physical therapist (in direct access states) for a referral/evaluation.  As stated earlier, we will be focusing on fixing the muscle imbalances of the lower extremities.  Use the following stretches and exercises to help with your  PFPS:

Let me apologize for the lack of posts in the past couple weeks.  When I started the blog off, I was writing 1-2 articles per day and I got a bit burnt out.  Needless to say, from here on out, I am going to try to do a lengthier post every other week, and then post the sports stuff whenever something important comes up.  Tiger Woods' latest knee pain/achilles tendonitis will probably be my next professional sports subject, so keep an eye out for that one golf fans.  Thanks again for reading my blog! Keep checking it out for new updates!