Patellofemoral syndrome / Patella tendon / Quadriceps strains
Patellofemoral syndrome is a common cause of pain around the knee cap in both children and adults. It is particularly common in active females. Whenever we move, the knee cap (patella) tracks through a groove in the thigh bone (femur). In patellofemoral syndrome, there is generally maltracking of the patella which produces friction and irritation of tissues less able to cope with load and stress (Heintjes et al. 2009). This abnormal movement of the patella may be caused by several factors. These include an imbalance in the muscles around the knee with weaker muscles on the inside, damaged structures after patella dislocation, malaligned knees, pronated (flat) feet, decreased flexibility, hypermobility or laxity of the patella and weakness of the pelvis and hip musculature (Davis & Powers 2010; Fagen & Delahunt, 2008).
People with patellofemoral syndrome often describe vague pain around or behind the kneecap especially when ascending or descending stairs, squatting, or sitting with bent knees for prolonged periods (Heintjes et al., 2009). There may also be a grating or grinding feeling or noises when the knee moves which is called ‘crepitus’. Interestingly, and frustratingly, patellofemoral symptoms can actually worsen when people cease exercise in an attempt to reduce their symptoms.
Pain with patellofemoral syndrome often comes and goes. Long term research has found that of those who continue to push through patellofemoral pain and do not rehabilitate effectively, some 94% still report pain 2-4 years later and 25% of these individuals report pain lasting over 20 years (Vicenzino, 2010).
Fortunately there is hope for this condition. Clear evidence shows that performing a multimodal physiotherapy programme is effective for the management of patellofemoral syndrome (Collins et al., 2012). Undoubtedly one of the principal goals of rehabilitation is to address factors contributing to the abnormal tracking of the patella, including facilitating a balance between the inner and outer knee muscles to ensure that load through the joint is distributed as evenly as possible (Fagen & Delahunt, 2008).
This concept seems logical and straightforward yet achieving this balance can be difficult and frustrating for many – this is where KneeCare can help you.