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== Patellofemoral Pain
Contents: 1.) Description of PFPS 2.) Anatomy 3.) Common complaints 4.) CPR for taping 5.) Other forms of management 6.) References
Patellofemoral Pain Syndrome DESCRIPTION: This is most commonly seen in the clinic as anterior knee pain being cause by biomechanical changes occurring along the patellofemoral joint. This ortheapedic condition can be caused by several factors including decreased arch support, decreased hamstring flexibilility, decreased quadricep strength, decreased calf flexibility, overuse, decreased hip strength, and IT band tightness. (1, 2)
ANATOMY: The patella is the round shaped bone located on the anterior aspect of the knee that slides up and down the femoral groove as the knee is bending and straightening. At the proximal pole of the patella the quadriceps tendon attaches and the inferior pole the patellar ligament attaches to the tibial tuberosity. The purpose of the patella is to increase force production.( 2) Once the knee is bent approximately 30 degrees the patella is not secured in the femoral groove and is prone to subluxation causing anterior knee pain.(2)
COMMON COMPLAINTS WITH PFPS: (1, 2, 3) -pain located on the front of the knee -pain with sitting (knee in flexed position) -pain with going down stairs/hills -pain maybe unilateral or bilateral knees -pain with running, jumping, and squatting
PATELLA TAPING WHO DOES IT WORK FOR?: Lesher et al. came up with a clinical perdiction rule to find which patients would respond to medial patellar taping.(3) They found that if patients tested positive for the talar tilt test and had genu verum greater than 5 degrees they were more then likely to have 50% or greater reduction in pain based on the global rating of change, which was considered to be a successful treatment (+LR=4.4).
OTHER FORMS OF MANAGEMENT FOR PFPS: Based on Cochran review good quality studies indicated the use of acupuncture, quad strengthening, resistive brace, orthotics for over pronators and biofeedback.(4)
References: 1.) Cutbill JW, Ladly KO, Bray RC, Thorne P, Verhoef M. Anterior knee pain: a review. Clin J Sport Med 1997;7:40-5. 2.) Warvasz Gregory, Mc Dermott Ann, Patellofemoral pain syndrome (PFPS): a systematic review of anatomy and potential risk factors. Dyn Med. 2008; 7:9. 3.) Jonathan D. Lesher, Giselle A. Miller, Nicole J. Chine, Matthew B. Garber, Maj Robert, S. Wainner, Thomas G. Sutlive. Development of a Clinical Prediction Rule for Classifying Patients With Patellofemoral Pain Syndrome Who Respond to Patellar Tapping.J Orthop Sports Phys Ther. 2006; 36(11):854-866. doi:10.2519/jospt.2006.2208 4.)Bizzini M, Childs JD, Piva SR, Delitto A. Systematic review of the quality of randomized controlled trials for patellofemoral pain syndrome. J Orthop Sports Phys Ther 2003 Jan;33 (1):4-20.
