Patello-Femoral Pain Syndrome (PFPS)

1. CLINICAL FEATURES

1.1. pain with activity

1.2. pain with stairs

1.3. aching with knees at 90º

1.3.1. +movie house sign

1.4. catching, grinding, giving way

1.5. swelling uncommon

2. BIOMECHANICAL CONSIDERATIONS

2.1. hip mobility

2.2. check pelvic alignment

2.3. ankle flexibility

3. TREATMENT CONSIDERATIONS

3.1. correct biomechanical issues

3.2. strengthen gluteus maximus

3.3. work on knee alignment

3.3.1. squat in line with 2nd toe

4. LOCAL FACTORS

4.1. historically

4.1.1. patellar tracking problem

4.1.2. VMO weakness

4.2. evidence suggests

4.2.1. abnormal femur motion

4.2.2. not abnormal patella motion

5. DISTAL FACTORS

5.1. overpronation

5.2. foot orthoses

5.2.1. at least 2º forefoot valgus

5.2.2. up to 78º great toe extension

5.3. worn out footwear

5.4. ankle-foot ROM

5.4.1. ankle dorsiflexion

5.4.2. subtalar eversion

6. PROXIMAL FACTORS

6.1. hip abduction and external rotation

6.1.1. females weaker than males

6.1.2. females with PFPS weaker than females without

6.2. hip adduction during functional tasks

6.2.1. females have more motion than males

6.2.2. females with PFPS have greater motion than females without

6.3. femoral internal rotation

6.3.1. increases lateral patella tracking

6.3.2. increases patellofemoral joint stress