PT Tip of the Month Archive

Patella Femoral Syndrome

Patella femoral syndrome is characterized by pain around the knee cap that is associated with and increases with activity. The injury is associated with biomechanical faults around the knee that respond with pain when stressed or overused.

Knee Anatomy

There are 3 major types of muscles that control knee motion. These muscles include the quadriceps, hamstrings and tensor fascia lata (which is connected to the knee by the iliotibial band (ITB)). The quadriceps muscles, which are connected through the patella (knee cap) to the tibia or lower leg, contract to extend the knee. The hamstrings, located on the back of the femur (upper leg) contract to bend the knee. The tensor fascia lata and iliotibial band helps to stabilize the outside of the knee joint and secondarily cause extension at the knee joint. (see figure 1) The patella floats above the femur within the patella groove. (see figure 2) The groove serves to help guide the patella during flexion and extension of the knee.

Causes

Patella femoral syndrome is caused by biomechanical faults which create a malalignment of the knee cap and/or compression of the knee cap against the femur (see figure 1&2). The biomechanical faults can be caused by quadriceps weakness, especially the muscles on the inside of the knee and/or tightness within the lateral structures of the knee, including the ITB. The pain centers from either irritation of cartilage that lines the back of the knee cap and/or compression of the structures to the side the patella.

Treatment

Treatment for patella femoral syndrome can vary considerably with symptoms, depending on the amount of biomechanical fault within the knee. Some patients will experience pain all the time, while others will experience pain after 5 miles of running. The main focus of initial treatment is to rest, decrease pain, regain range of motion within the knee and joint mobility within the patella. As the patient's pain decreases, strength exercises can be implemented to regain the strength of the quadriceps muscles. In some cases, patients respond well to taping the knee cap to stabilize the patella within the joint.

If you feel that you have signs or symptoms of Patella femoral syndrome and you would like to schedule an evaluation call 617-232-PAIN for our Brookline office and 617-325-PAIN for our West Roxbury office.

33 Pond Avenue, Suite 107B Brookline, MA 02445 Tel: (617) 232-PAIN (7246) Fax: (617) 232-5196
1208B VFW Parkway, Suite 202 West Roxbury, MA 02132 Tel: (617) 325-PAIN (7246) Fax: (617) 325-7282