Patellofemoral Pain Syndrome (PFPS) is the most commonly diagnosed sports injury and yet its cause and treatment are still relatively unclear.
Pain is localized to retropatellar (behind the knee) and is directly related to the tracking of the kneecap. It is a multifaceted pain syndrome that is related to biomechanical dysfunctions, muscular problems, overuse and overload that result in the patellar misaligning and not following it’s structural tracking through the femur.
Weak quadriceps – weakness of one or more of the quadriceps muscles will result in a lack of correct tracking of the patellar. Strengthening of the quadriceps muscles is the most effective known treatment of patellofemoral pain syndrome.
Weakness of the medial quadricep (vastus medialis obliqus -VMO) – the medial quadriceps muscle is a key factor as it is the most commonly identified weak quadricep muscle in this pain syndrome. A weak VMO, often in conjunction with a tight ITB, allows for the lateral displacement of the patellar.
Tight iliotibial bands – the iliotibial band runs from the side of your hip through to the side of your knee. If the ITB is tight it effectively pulls the kneecap laterally thus causing displacement and pain. Regular foam roller exercises are recommended to aid the loosening of the ITB.
Tight hamstrings – as a knee flexor, tight hamstring put greater force between the patellar and femur, which causes greater friction and pain.
Weakness or tightness of the hip muscles – the quadriceps muscles originate from the pelvis area, more specifically the VMO originates from the adductor tendons. Dysfunction with the hip muscles directly affects the quadriceps so optimum strength of these muscles is also required.
Tight calf muscles – the calf muscles run down and under the foot so if they are tight they can lead to compensatory foot pronation (flat foot) and similarly to the tight hamstrings can also cause an increase in the force between the patellar and the femur, which in turn causes pain.
Hip misalignment – misalignment of the bones of the pelvis directly affect the muscles that anchor to it. In compromising the leverage of these muscles it reduces their strength and thus leads to muscle dysfunction of the quadriceps.
Foot pronation/supination – similarly to hip misalignment, if the arch of the foot is too high or too low it changes the angles of the tibia/fibula in relation to the femur which changes the tracking of the knee cap, and thus causes pain.
Patellofemoral Pain Syndrome is a multifaceted condition that requires a whole body analysis in order to correctly diagnose and treat the pain.
The chiropractors at Spine and Health are the experts in Pain and Posture. If you are suffering from pain behind your knee it is possible that you have one of the many factors listed above, which could all cause PFPS. In order to diagnose this condition and start treatment we recommend you visit one of our clinics on the lower North Shore and we can conduct a Digital Postural Anaylsis. This analysis will aid us in ascertaining if you have a postural/biomechanical condition that could be the underlying factor. The Chiro’s will create a personalised plan to correct your posture and in doing so may be able to give you symptomatic pain relief. In identifying the key cause of your pain syndrome the chiropractors can help you to counter the problematic muscle/structural issues and return you to a happier, healthier, more upright you! To look better, move better and feel better please contact one of our clinics today: Crows Nest Ph 9460 8459 North Sydney Ph 9955 8055