Understanding Patellofemoral Pain Syndrome: Causes, Symptoms, and Treatment Options

Patellofemoral pain syndrome (PFPS) also known as runners' knee is a condition involving pain around patella and surrounding soft tissue. Patellofemoral joint pain is very common in individuals with active lifestyle especially individuals involved in athletics. But it doesn't mean it is exclusive to athletes only. When person with sedentary lifestyle attempts to work out and starts vigorous physical activities that puts repeated stress on the knee involving squats, lunges, running, etc. can also suffer from this type of pain.

Putting it in simple terms, patella is in the center of tug of war, quadriceps pulling it superior (figure shows pull of different quadriceps on patella), patellar ligament pulling it inferior and medial and lateral patella-femoral ligaments supporting patella medially and laterally respectively.

Any imbalance caused by ligaments might need surgical intervention, but if the imbalance is caused by quadriceps muscles, physical therapist should be consulted.

Physical therapist based on examination would be able to determine the exact imbalance and plan the treatment. Generally, physical therapy program would involve stretching and strengthening to correct the imbalance.

Physical therapist while designing individualized plan for their patient should incorporate evidence-based approach. In order to minimizing patellofemoral joint stress, squats should be performed from 45° to 0° of knee flexion for close chain exercise and variable resistance 90° to 45° of knee flexion for open chair non weight bearing exercise.

Reference:

Powers, C. M., Ho, K.-Y., Chen, Y.-J., Souza, R. B., & Farrokhi, S. (2014). Patellofemoral Joint Stress During Weight-Bearing and Non—Weight-Bearing Quadriceps Exercises. Journal of Orthopaedic & Sports Physical Therapy, 44(5), 320–327. doi: 10.2519/jospt.2014.4936