Clinical Education

Patellafemoral Pain

  • The patellofemoral joint is the articulation between the patella and the distal femoral groove.
  • Pain is often caused by an imbalance of the muscles that surround and support the knee, this can alter the load and positioning of the patellofemoral joint
  • Also known as: anterior knee pain, runners knee
  • Potential irritated structures: bursa, patella tendon, ITB, cartilage
  • The patellofemoral joint is the articulation between the patella and the distal femoral groove.
  • Pain is often caused by an imbalance of the muscles that surround and support the knee, this can alter the load and positioning of the patellofemoral joint
  • Also known as: anterior knee pain, runners knee
  • Potential irritated structures: bursa, patella tendon, ITB, cartilage
  • The patellofemoral joint is the articulation between the patella and the distal femoral groove.
  • Pain is often caused by an imbalance of the muscles that surround and support the knee, this can alter the load and positioning of the patellofemoral joint
  • Also known as: anterior knee pain, runners knee
  • Potential irritated structures: bursa, patella tendon, ITB, cartilage

Patellofemoral

Image showing the different forces that can act on the patellafemoral joint in relation to biomechanicas

Subjective Examination:

Insidious onset, usually related to increased load or activity
Usually felt on the anterior aspect of the knee joint. Often a vague intermittent pain that can not be pin-pointed
Patient may also report crepitus.
Pain presents following or during activity, usually weight bearing
Common aggravating factors: walking/running, stairs (down>up), kneeling, squatting
Objective Examination:

Patient may present with full knee joint range of motion or may be limited by pain. PROM should be full
Tight quadriceps or hamstring muscles
Swelling with acute episodes
Weakness in quadriceps and gluteal muscles. Quadriceps weakness may be more prominent in VMO than other muscles
Biomechanical variation: knee valgus during single leg squat, over-pronated feet, patella mal-tracking
References

Image from OpenI – Licensed by CC
Image from OpenI – Licensed by CC
Image from OpenI – Licensed by CC
Image from OpenI – Licensed by CC

Treatment :

If you feel that your patient is suffering with patello femoral joint pain then refer to physiotherapy and we can work with the patient to improve their symptoms through

Initial treatment of acute symptoms – rest, ice, pain relief as indicated
Strengthening local and hip musculature
Stretching tight musculature
Addressing biomechanical variations or abnormalities
Correcting movement patterns
Gradually increasing load through the knee
References

Image from OpenI – Licensed by CC
Image from OpenI – Licensed by CC
Image from OpenI – Licensed by CC
Image from OpenI – Licensed by CC