Patellofemoral pain syndrome (PFPS)

Common in adults but also children, Patellofemoral pain does not go away easily. Let me put it right out there, it is not an acute injury, rather it is due to poor mechanical loading at the front of the knee that builds up overtime. Coming from a clinical perspective, PFPS is in a paediatric caseload quite high on the list of reasons children present with pain at the front of the knee. Sometimes presenting as pain, crunchy/cracking knees, poor knee tracking, PFPS or just plain old pain at the front of the knee. PFPS is an umbrella term to describe pain arising from the patellofemoral joint. However, the downside to this diagnosis is that it doesn’t tell you why you have pain, which is a problem if you want it to go away. PFPS is not a patellar tendon issues and it is not Chondromalacia patellar, rather, it is a term used to describe poor loading at the patellofemoral joint which results in pain and dysfunction.

Ok so here is some basic anatomy for you. The Patellofemoral joint is the joint on the front of the knee made up of the femur and patellar. The patellar, a seed-like looking sort of bone sits within the patellar tendon and quadriceps tendon, while fitting snugly within the femoral groove. Every time we bend and straighten the knee, the patellar moves. Adjoining the bone and tendon are bursa, synovial fluid, fatty tissue and cartilage that lubricate surfaces. We also have connective tissue and ligaments which create stability on the outside of this joint. When we diagnose someone as having PFPS, it says something about any one of these structures having an impact on the biomechanics of the joint itself, thus causing pain and dysfunction. In addition, we can’r forget muscle imbalance as having an impact on biomechanics.

Causes of PFPS can be variable from traumatic eg. My knee was hit by a hockey stick, and overuse/overload of the joint itself, poor biomechanics eg. knocked knees, flat feet, weakness at the hip joint which overloads the structures of the knee, knees that hyperextend, muscle tightness or tension especially on the front aspect of the thigh, and muscle weakness, most particularly the quadriceps and inner quadriceps.

Treatment is variable depending on the above factors, the why’s; which is why it is so important to have an accurate diagnosis for your knee pain. See below a snippet of one type of taping we use in the clinic. We have so many things at our disposal to treat this problematic knee you wouldn’t believe and prognosis is very favourable with the right treatment. We take a very conservative approach at our clinic, and work with the best evidence available for treating problematic PFPS.

Let us know if you have any questions by reaching out to us via our social media channels.

Sam and Andy