What is Patellofemoral Pain Syndrome?

Patellofemoral Pain Syndrome (PFPS) is an umbrella term used to describe pain felt in the front of the knee. PFPS causes pain and stiffness around the knee that is felt especially when running, jumping and landing which can make it difficult to kneel down, climb stairs and perform other day to day activities. Whilst anyone can develop and suffer from PFPS, it is most common in people who participate in sport particularly females, young adults and elderly people.

PFPS can occur due to multiple causes due to the complexity of the joint and its structures. Essentially the knee joint consists of two major joints, the tibiofemoral joint and the patellofemoral joint.

Tibiofemoral Joint is where the femur (thigh bone) meets the tibia (shin bone)

Patellofemoral Joint is where the patella (kneecap), which is shaped like an upside-down triangle (called sesamoid bone), articulates with the femur which covers and protects the front (anterior articular surface) of the knee joint.

Structures of the Knee

The Patellofemoral Joint is supported by a number of soft tissue structures to make movement of the knee joint easier and efficient. These structures include ligaments, tendons, muscles, articular cartilage (which is a slippery substance that covers each end of the joint to allow bones to glide smoothly against each other to stop bone rubbing on bone). Another important element is the synovium or the synovial membrane which is a thin connective tissue that lines the inside of the joint capsule and it produces some fluid that lubricates the cartilage. In addition, just below the kneecap is fatty tissue called a fat pad which provides cushioning of the kneecap and it acts as a shock absorber.

Causes

The most common cause of PFPS is biomechanical dysfunction which can occur from any of the structures involved. Due to the complexity of the Patellofemoral Joint, its function requires an intricate balance of all the soft tissue structures that support the joint. For example, if the muscles that attach to the knee are short and tight or the firing pattern of those muscles are out of line, that can cause poor patella tracking patella tracking means (kneecap (patella) shifts out of place as the leg bends or straightens) causing pain with movement. Similarly, the muscles in the hip play an important role in controlling the thigh bone and therefore the knee joint. However, the hip muscles are often weak and dysfunctional. Therefore, proper strength conditioning of the muscles in the knee and hip is very crucial to ensure the joint is well supported.

It’s also important to remember all of the structures that create and/or support movement of the knee joint can be worn and torn which can develop dysfunctions and conditions. This is why it is important to get any knee pain properly assessed, treated and rehabilitated. Since the cause of the PFPS is often from biomechanical dysfunction, leaving it untreated will result in further abnormal function of the knee and unfortunately repetitive movements will repeatedly traumatise the Patellofemoral Joint causing more pain.

Prevention

If possible, stop the activity that is causing and/or aggravating the pain and book yourself an appointment to get the knee assessed. Myotherapy intervention is a very effective short and long-term solution for knee pain. Here at Myofitness we will give you a treatment plan that outlines exactly what your condition is and what stage it is in as well as what you and your practitioner need to do as managing chronic pain is a team effort.

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