Patellofemoral Syndrome

Author: Vivian Chak, Registered Physiotherapist

Athletes who frequently engage in running and jumping, as well as individuals with patellar malalignment or muscle imbalances, may experience pain due to abnormal movement or pressure distribution between the kneecap and thigh bone.

Patellofemoral Syndrome (PFS), also known as "runner's knee," refers to pain and discomfort between the patella (kneecap) and the femur (thigh bone).This condition is usually caused by increased pressure or abnormal tracking of the patella as it slides over the femur.Here are several detailed causes of patellofemoral syndrome:

1. Muscle Imbalance or Weakness:

• If the quadriceps (muscles at the front of the thigh) are too strong or tight compared to the hamstrings (muscles at the back of the thigh), it can cause the patella to be pulled laterally.
• Weakness in the hip muscles, especially the hip abductors and glutes, can also affect patellar tracking.

2. Patellar Malposition:

• Abnormal patellar positioning, including patella alta (patella higher than normal) or patellar tilt, can lead to uneven pressure distribution where it contacts the femur.

3. Overuse or Activity Patterns:

• Prolonged or repetitive activities such as running, jumping, and squatting can increase friction between the patella and the femur.
• Overtraining in sports, especially on hard surfaces.

4. Biomechanical Issues:

• Foot abnormalities, such as flat feet or excessive pronation, can lead to internal rotation of the leg, affecting patellar tracking.
• Leg alignment problems, such as bowlegs (genu varum) or knock-knees (genu valgum), can lead to uneven forces on the knee joint.

5. Soft Tissue Restrictions:

• Tightness or lack of flexibility in the muscles and tendons on the inner or outer thigh can lead to deviations in patellar tracking.

6. Congenital Factors:

• Some individuals may have a naturally occurring shape of the patella or femur that results in less than ideal contact between them.

7. Trauma or Post-Surgical Complications:

• Knee injuries, such as patellar dislocation or post-surgical changes, can affect the patella's position and function.

Treatment for patellofemoral syndrome typically involves pain relief measures, such as strengthening and balancing the surrounding muscles through physical therapy and customized myofascial release and exercise programs. In some cases, patellar braces or custom orthotic insoles may be needed to improve leg alignment and reduce pressure on the knee joint.

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