Physical Therapy for PFS, Patellofemoral Pain Syndrome

Patellofemoral pain syndrome is a common, high incidence diagnosis give to individuals from teenage to adults to explain anterior knee pain. The treatment for this condition varies from conservative to surgical and offer variable results. However, one of the most beneficial treatments involves physical therapy. PFS is a condition you may now have been diagnosed with, and I want to share with you how the profession can help.

First comes an understanding of how/why patellofemoral pain occurs. With most, it is an issue of the kneecap (or patella) not tracking correctly in the femoral grove. When you straighten your leg to extend it, the kneecap must travel up and inward on the knee. When this does not occur correctly, the underside of the knee will grind against the femoral condyle, and cause the pop/crack/grind pains you may feel.

What causes this not to occur well? There are biomechanical components involved, the biggest being the Q angle that the front of the thigh makes. The Q angle measures how much pull the vastus lateralis quadriceps muscle has on the kneecap with extension. The greater the angle the greater the pull. An over pronated, or "flat" foot will do the same with alignment, as will a genu valgum or "knocked knee" posture.

Probably the most significant muscle involvment is from the weakness of the vastus medialis muscle. This muscle helps to track the kneecap, and is part of the quad. It pulls the knee more towards the inside during extension, and tends to always be found in patients with PFS symptoms. Weakness in the vastus lateralis, and tightness in the lateral retinaculum (connective tissue) on the outside of the knee and iliotibial band will also contribute.

So how can physical therapy help you? There are two components to the treatment that can be provided-one is short tem pain relief and the other is long term correction of dysfunction.