Patella Femoral Pain Syndrome (PFPS)
There is no specific cause to PFPJ but its normally due to a change or increase in load to the patella-femoral joint, the most common presentation is through runners hence its nick name 'Runner's Knee'. PFPS has lots of alternative names like, Anterior Knee Pain, Chondromalacia Patellae, Runner's Knee, or Patella Mal-tracking.
The reason why this over/altered load can cause this is normally due to a muscle weakness somewhere around the joint or lower limb. Identifying possible issues around the PFJ can help towards a management strategy to cope with this condition.
Diagnosis
Its diagnoses with a mostly description of symptoms and subjective history however its also confirmed in objective by looking at muscle strength and using tests such as Clarke's Sign and Waldron's Test. Both of these tests can be very provoking of symptoms so use with caution to avoid aggrivating the area to much.
Risk Factors
Various Sports (Use of PFJ)
Quadriceps Weakness
Overpronation
Iliotibial band tightness
Hip muscle disfunction
Leg length discrepancy
Patella malalignment/hypermobility
Weight
Occupations that require frequent kneeling
Symptoms
Pain predominantly around the front of the knee and behind the knee cap
Worsening pain after exercise
Pain after prolonged sitting
Pain when squatting or going down stairs.
Management
Exercise
Progressive in nature
Strengthen weaknesses
Work towards endurance
Muscle activation techniques
Other
Weight management
Orthotics
Pacing of tasks
Differential Diagnosis
Knee OA
Osgood Schlatter's disease
Hoffa's fat pad
Quads/Patella Tendinopathy
Referral of pain from Hip or Low back
1. NHS Lanarkshire. (NO DATE), Patellofemoral Pain Syndrome. Available from: https://www.nhslanarkshire.scot.nhs.uk/services/physiotherapy-msk/patellofemoral-pain-syndrome/. [Accessed March, 2023.]
2. Bump, J., and Lewis, L. (2023), Patellofemoral Syndrome. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557657/#:~:text=Differential%20Diagnosis&text=These%20include%20patellofemoral%20OA%2C%20Osgood,pain%20from%20hip%20or%20back.. [Accessed March, 2023.]