Patellofemoral Pain Syndrome

Patellofemoral pain syndrome (PFPS) is a broad term used to describe pain in the front of the knee and around the patella.  It is sometimes called "runner's knee" because it is common in people who participate in sports that involve running. However,  PFPS  occurs in non-athletes as well. The pain and stiffness caused by PFPS can make it difficult to climb stairs, kneel, and perform other everyday activities. 

Many factors may contribute to the development of PFPS, including, problems with the alignment of the patella,  overloading from vigorous exercise and running  or other training errors. 

Symptoms are often relieved by  conservative treatment; such as changes in activity level, a therapeutic exercise programme, education, and taping. 

This online course will serve as a quick reference primarily to aspects of the subjective assessment.  It will save on theory time.  Please study the content carefully and answer the MCQs.

The patellofemoral joint is a joint that can be an area of concern for athletes of various sports and ages.  The joint is somewhat complex with multiple contact points and numerous tissues that attach to the patella.  Joint forces are variable and depend on the degree of knee flexion and whether the foot is in contact with the ground.  The sports medicine specialist must have a good working knowledge of the anatomy and biomechanics of the patellofemoral joint in order to treat it effectively.

The goal of this consensus document is to place known associated factors within the context of a pathomechanical model of PFP. 

An underlying assumption of the proposed pathomechanical model is that PFP is associated with abnormal loading of the patellofemoral joint (elevated joint stress).

In this model, abnormal loading could affect the various patellofemoral structures that can contribute to nociception (ie, subchondral bone, infrapatellar fat pad, retinaculum and ligamentous structures); however, the specific tissue sources related to PFP are not known.

Objectives:  There is an emergent body of evidence supporting exercise therapy and physical activity in the management of musculoskeletal pain. The purpose of this study was to explore potential barriers and facilitators with patients and physiotherapists with patellofemoral pain involved in a feasibility randomised controlled trial (RCT) study. The trial investigated a loaded self-managed exercise intervention, which included education and advice on physical activity versus usual physiotherapy as the control. 

Conclusions: Implementation, delivery and evaluation of the intervention in clinical settings may be challenging, but feasible with the appropriate training for physiotherapists.  Participants’ improvements in pain and function may have been mediated, in some part, by greater self-efficacy and locus of control.

• Describe evidence-based physical therapy practice, includ­ing diagnosis, prognosis, intervention, and assessment of outcome, for musculoskeletal disorders commonly man­aged by orthopaedic physical therapists 

• Identify interventions supported by current best evidence to address impairments of body function and structure, activity limitations, and participation restrictions associated with common musculoskeletal conditions

Anterior knee pain is one of the most common causes of persistent problems after implantation of a total knee replacement. It can occur in patients with or without patellar resurfacing. As a result of the surgical procedure itself many changes can occur which may affect the delicate interplay of the joint partners in the patello-femoral joint. Functional causes of anterior knee pain can be distinguished from mechanical causes. The functional causes concern disorders of inter- and intramuscular coordination, which can be attributed to preoperative osteoarthritis.

Research about anterior knee pain has shown that not only the thigh muscles but also the hip and trunk stabilising muscles may be responsible for the development of a dynamic valgus malalignment. Dynamic valgus may be a causative factor for patellar maltracking.  

The mechanical causes of patello-femoral problems after knee replacement can be distinguished according to whether they increase instability in the joint, increase joint pressure or whether they affect the muscular lever arms.

These causes include offset errors, oversizing, rotational errors of femoral or tibial component, instability, maltracking and chondrolysis, patella baja and aseptic loosening. In these cases, reoperation or revision is often necessary.

Treatment of Patellofemoral pain is changing. In the past, interventions have typically focused on the joint itself. But is that enough? Aren’t there possibly other factors at play –and if so, what approach should be taken to treat it?

This two part on-line course provides:

• fresh insight into the mechanics that may influence the patellofemoral joint; and
• provides treatment options that bring long-term success.

Treatment of Patellofemoral pain is changing. In the past, interventions have typically focused on the joint itself. But is that enough? Aren’t there possibly other factors at play –and if so, what approach should be taken to treat it?

This two part on-line course provides:
fresh insight into the mechanics that may influence the patellofemoral joint; and
provides treatment options that bring long-term success.

At last. An easy to understand insight into the applied biomechanics of the patella. Along with discussions of various exercise and treatment modalities make this online course immediately applicable in your clinical practice.

This on-line course describes an alternative treatment approach with excellent results for patellofemoral pain syndrome utilised for two patients whose chief complaint was of patellofemoral pain and lack of control of the hip in the frontal and transverse planes during functional movements. Recommendations are made for the future assessment and treatment of the hip, pelvis, and trunk musculature

This on-line course describes an alternative treatment approach with excellent results for patellofemoral pain syndrome utilised for two patients whose chief complaint was of patellofemoral pain and lack of control of the hip in the frontal and transverse planes during functional movements. Recommendations are made for the future assessment and treatment of the hip, pelvis, and trunk musculature

This on-line course describes an alternative treatment approach with excellent results for patellofemoral pain syndrome utilised for two patients whose chief complaint was of patellofemoral pain and lack of control of the hip in the frontal and transverse planes during functional movements. Recommendations are made for the future assessment and treatment of the hip, pelvis, and trunk musculature

This on-line course offers practical tips for the selection of taping techniques for knee pain. You will learn which techniques to utilise for severe, moderate and mild knee pain as well as for different pathologies.

In addition, there are tips for taping sporting and non-sporting persons.

Increase your success rate in treating patients with anterior knee pain.

AKP can be one of the most difficult conditions to manage. The success rate of most treatment regimens has been poor and the condition frequently recurs. 

This three-part, online course will equip you with the latest tools to deal effectively with this and other related sports injuries.

You’ll learn about assessing the knee in part one; part two will introduce you to the new integrated treatment approach; and part three deals with patellar tendinopathy.

Increase your success rate in treating patients with anterior knee pain.

AKP can be one of the most difficult conditions to manage. The success rate of most treatment regimens has been poor and the condition frequently recurs.

This three-part, online course will equip you with the latest tools to deal effectively with this and other related sports injuries.

You’ll learn about assessing the knee in part one; part two will introduce you to the new integrated treatment approach; and part three deals with patellar tendinopathy.

Increase your success rate in treating patients with anterior knee pain.

AKP can be one of the most difficult conditions to manage. The success rate of most treatment regimens has been poor and the condition frequently recurs.

This three-part, online course will equip you with the latest tools to deal effectively with this and other related sports injuries.

You’ll learn about assessing the knee in part one; part two will introduce you to the new integrated treatment approach; and part three deals with patellar tendinopathy.