What is it?
PFPS is a generalised term used to describe pain situated in and around the front (anterior) of the knee and the kneecap (patella). It is a very common condition and usually occurs as a result of irritation to the cartilage of the patellofemoral joint.
What are the symptoms?
Due to it’s vague nature it can sometimes be difficult to accurately locate the pain associated with PFPS. Many sufferers will experience diffuse pain behind or under the patella. Symptoms are often aggravated by running, squatting, climbing stairs or prolonged periods of sitting.
What causes it?
The exact cause of PFPS is not completely understood, although many practitioners believe it could be blamed on abnormal tracking of the patella between the condyles of the Femur (Thigh Bone). Abnormal tracking causes friction between areas of the patella and femur not protected by cartilage. This can cause pain and degenerated if left untreated.
There are many theories and research papers outlining different predisposing factors associated with PFPS, however no single cause has been scientifically proven, suggesting that a combination of these factors may be to blame:
- Gluteal or Vastus Medialis Dysfunction
Inactivity or weakness of the gluteals can lead to a greater tendency for the knee joint to drop inwards (medially). This changes the angle between the attachment points of the quadriceps and can lead to abnormal tracking of the patella when the quadriceps are used. Vastus Medialis (1 of the quadriceps) dysfunction can also lead to abnormal patella tracking as it is responsible for stopping the other quadriceps muscles from pulling the patella to one side.
- Muscle or connective tissue restriction
Tightness into structures on the outside (lateral) of the knee joint can pull the patella laterally. It is not uncommon to see restrictions in the connective tissues (lateral retinaculum or ITB) or the muscles (Vastus Lateralis) around the outside of the thigh.
- Increased pronation
Increased pronation at the feet will have a tendency to rotate the shin bone and drive the knee medially. This can again cause abnormal tracking of the patella.
How do you treat it?
To ensure all of the possible causes are properly assessed, it is advisable to consult a qualified practitioner for treatment. Depending on the outcome of the consultation, treatment may include:
- Taping of the patella to improve joint alignment and reduce pain.
- Strengthening of specific muscular regions that may be weak, in combination with stretching of tight structures.
- Correction of foot biomechanics via using a custom orthotic.
- Review of training loads and running / lifting technique.
If you need advice on PFPS or any other injury, please contact the Drummond Clinic Team on 0871 221 9394.