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Patellofemoral Syndrome – What Is It and What Can You Do About It

Patellofemoral Syndrome:

Patellofemoral syndrome, also known as chrondromalacia patellae or runner’s knee, is characterized by pain felt beneath the kneecap and is usually the result of chronic and poor patellar tracking. In the case of patellofemoral syndrome (PFS), this abnormal tracking results in an underlying inflammatory process. It can also be accompanied by crepitus – a clicking or grinding sensation under the kneecap that occurs when the quadriceps muscle is contracted.

Causes

There are many possible causes for PFS  including compromised function of vastis medialis oblique, commonly referred to as the VMO, and poor hip-knee-ankle alignment and mechanics. Prolonged sitting and descending stairs are two activities that often provoke symptoms and can even cause more pain than running, or walking.  However, any activity that involves loaded knee extension can cause an increase in pain.

Diagnosis

Diagnosis of PFS usually involves a thorough evaluation by a trained health practitioner. Once the diagnosis is confirmed, factors that are affecting patellar alignment and tracking need to be determined.

Some predisposing factors, such as tight or weak muscles, can be resolved through stretching and strengthening, while other structural factors including excessive femoral anteversion or congenital recurvatum cannot be changed as they are predetermined by genetics and early development.

Treatment

Like any inflammatory process, modalities including ice, massage, anti-inflammatories, rest and even acupuncture provide individuals some initial relief. In most cases, however, the underlying cause(s) of symptoms must be identified to prevent return of pain.

The course of treatment will depend on the examine findings.   Areas commonly implicated include a tight ITB (iliotibial band)/lateral retinaculum, tight hamstrings, tight and/or weak quadriceps and tightness and/or weakness in one or more of various hip muscles.  Special attention should be paid to the VMO  portion of the quadriceps as it plays a major role in patellar tracking during end-range extension. Other factors include excessive pronation, or rolling in, of the feet and too much or too little movement of the kneecap.

Patellar taping is also a common mode of treatment. In the case of taping, a special tape referred to as McConnell tape is used to fix the patella into a position that allows a pain-free quad contraction. Taping is usually not a permanent strategy but used in the early stages of rehab so that strengthening, stretching and muscle re-educating activities can be performed in the absence of pain.

In more persistent cases of PFS, a patellofemoral brace or support may be prescribed and worn during activities to provide support for the knee, decrease lateral glide of the patella and to assist in decompression of the patellofemoral joint.

**Disclaimer:  This post is for information purposes only.  Any issues regarding your physical or mental health should be discussed with your chosen health-care provider.

Shaun received a Bachelor's of Science in Nutritional Science with minors in Chemistry and Biology from the University of Delaware in 1994 and then completed a Professional Master's in Physical Therapy also from the University of Delaware in 1997. Shaun has worked as an aerobic/group fitness instructor, a personal trainer, a massage therapist, an out-patient orthopedic physical therapist and a consultant for an international credentialing agency that evaluates the educational documents of physical therapists educated overseas. She is an active advisory board member for the Delaware Academy of Massage and Bodyworks, has taught continuing education for massage therapy practitioners and is a course instructor for W.I.T.S. (World International Training Schools) personal trainer certification course. She also writes online fitness and nutrition articles for LIVESTRONG and LIVESTRONG Nutrition and runs a blog titled, Fitness for Smart People.

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