Patellofemoral syndrome is a condition that describes pain in the front of the knee and around the kneecap, known as the patella. Patellofemoral pain syndrome physiotherapy treatment. Adults with patellofemoral pain, randomized controlled trials only, any conservative treatment compared with placebo, sham, other conservative treatment, or no treatment. Running or jumping walking when it is flared up sitting going up or down stairs. This pain is sometimes called runners knee as its common in athletes. Effectiveness of conservative treatment for patellofemoral. It may be caused by a structural defect, or a certain way of walking or running. Clinicians should also use performance of other functional activities that load the patellofemoral. It is sometimes called runners knee or jumpers knee because it is common in people who participate in sportsparticularly females and young adultsbut patellofemoral pain syndrome can occur in nonathletes, as well. The role of hip muscle function in the treatment of patellofemoral pain syndrome.
Currently, there is not a gold standard assessment to diagnose pfps. A variety of treatments for patellofemoral pain syndrome are available. There is no clear consensus in the literature concerning the terminology, aetiology and treatment for pain in the anterior part of the knee. Patellofemoral pain syndrome runners knee runnerclick.
A randomized controlled assessor blinded trial was. Patellofemoral pain syndrome what is patellofemoral pain. Patellofemoral pain syndrome symptoms and treatment. Patellofemoral pain syndrome pfps is one of the most prevalent musculoskeletal injuries comprising 25 % of knee injuries seen in sports medicine clinics 1, 2. The rest of this leaflet deals with patellofemoral pain, which is much more common. Also termed anterior knee pain, patellar malalignment, and patellofemoral anthralagia. Patellofemoral pain syndrome pfs case type diagnosis. Wed like to understand how you use our websites in order to improve them.
Patellofemoral pain pfp is a common musculoskeletalrelated condition that is characterized by insidious onset of poorly defined pain, localized to the anterior retropatellar andor peripatellar region of the knee. Although the exact cause is unknown, patellofemoral pain syndrome can develop because of overuse, typically as a result of highimpact athletic activities that require running and jumping, or because of improper tracking of the patella on the femur. Rest no running, jumping, kneeleg extension machine, stair machine, or biking for exercise. This study compared the efficacy of two electrotherapy modalities for pain treatment in rehabilitation programs of patellofemoral pain syndrome. Patellofemoral pain syndrome pfps is also commonly referred to as anterior knee pain, chondromalacia patallae, or patellar malalignment. Patellofemoral pain syndrome is a broad term used to describe pain in the front of the knee and around the patella, or kneecap. Patellofemoral pain syndrome university health services. Patellofemoral syndrome symptoms, exercises, and treatment. The role of hip muscle function in the treatment of patellofemoral pain syndrome article pdf available in the american journal of sports medicine 344. Patellofemoral pain syndrome brigham and womens hospital. Symptoms include pain, and rubbing, grinding, or clicking sound of the kneecap. For this test to be valid, it must be flexed painfree beyond 90 degrees. There are a few methods runners can use to treat patellofemoral pain syndrome, varying in effectiveness and cost.
Pdf patellofemoral pain pfp syndrome is a frequently encountered overuse disorder that involves the patellofemoral region. Patellofemoral pain syndrome pfps linkedin slideshare. The hallmark symptom associated with patellofemoral syndrome is a dull, aching pain that usually occurs on the front of the knee. Managing patellofemoral pain syndrome is a challenge, in part because of lack of consensus regarding its cause and treatment. Greek adaptation and validation of the patellofemoral pain. There can be pain around or under the kneecap and sometimes in the back of the knee. Patellofemoral disorders comprise nearly 25% of all knee injuries evaluated in orthopedic clinics. The clinician flexes the knee until the patient reports pain. This means avoiding going up and down stairs and hills, deep knee bends, kneeling, stepaerobics and high impact aerobics.
Knee and kneecap pain patellofemoral pain symptoms and. Patellofemoral pain, is the pain you can have around or behind your kneecap patella. Patients with anterior knee pain have to be examined carefully with regard to functional causes for a pfps. If patient education and multimodal physiotherapy applied at an early stage of patellofemoral pain syndrome proves effective, it may serve as a basis for.
Patellofemoral pain affects physically active and sedentary individuals, accounting for 1117% of knee pain presentations to general practice1,2 and 2540% of all knee problems seen in a sports injury clinic. Patellofemoral pain syndrome pfps is a very common knee condition with. Also using cold packs, compression, and elevation may help. Xrays arent usually helpful as cartilage doesnt show up on them. Overuse, a change in activity, and an altered metabolic status are frequently responsible for the development of pfps. Patellofemoral pain syndrome pfps is a common knee disorder, which often affects the senior athlete and those involved in running and jumping sports. Runners knee is dull pain around the front of the knee. Patellofemoral dysfunction, also known as patellofemoral pain syndrome, is a common cause of pain in adolescents and in some children. The diagnosis of patellofemoral pain syndrome is made by ruling out patellar tendinitis, prepatellar bursitis, plica syndrome, sindinglarsen and johansson syndrome, and osgoodschlatter disease. In a prospective randomized study, 16 patients 23 affected knees were treated with tens and 14 patients 19 affected knees were treated for the same period with diadynamic current ddc. It is caused by imbalances in the forces controlling patellar tracking during knee flexion and. A total of 75 patients with patellofemoral pain syndrome were included, of whom 44 were female.
The severity, and resulting pain and dysfunction, of patellofemoral syndrome and chondromalacia varies greatly in patients that are affected by it. Avoid or modify activities that increase the pain, such as climbing stairs, kneeling or squatting. To evaluate the evidence regarding the effectiveness of conservative treatment in reducing patellofemoral pain. The first was before and the second was right after their first treatment. Overthecounter pain relievers include acetaminophen tylenol, ibuprofen advil, motrin ib or naproxen sodium aleve. Pfps is the most common knee condition in runners and adolescents 3, 4. The official guidelines of the crosscultural adaptions were used in the current study 11, 12.
The integration of hip soft tissue regimens are not always emphasized, although current literature implies that there is a significant relationship between the two and there is a lack of randomized clinical trials to substantiate this relationship in clinical practice. Patellofemoral pain syndrome is defined as pain around the kneecap. Patello femoral syndrome pfs is an irritation under the knee cap patella and the surrounding tissues due to increased compression. Treatment includes activity modification, stretching, and strengthening the affected limb. As this is a diagnosis based on exclusion, should one go for surgical intervention or simple conservative management. Patellar taping in the treatment of patellofemoral pain. Patellofemoral pain pain around, behind or under the knee cap is very common. Article information, pdf download for patellar taping in the treatment of patellofemoral pain open epub for. Graston technique used in the treatment of patellofemoral. Patellofemoral syndrome pfs is an irritation under the knee cap patella and the surrounding tissues due to increased compression. Patellofemoral pain syndrome pfps is one of the most common knee problem physicians have to confront, and the second. Most knee conditions cause pain in the front anterior of the knee.
Make sure to elevate the knee above heart level until swelling subsides. Once it has been established that the pain you are experiencing is a result of this condition, treatment is the next step. Patellofemoral syndrome pfs is characterized by a group of symptoms that are easily diagnosed and often respond to simple management. Wearing wellfitted and supportive shoes such as trainers. The clinician externally rotates the patients foot and then extends the knee while palpating the medial knee for click in the medial compartment of the knee or pain reproducing pain from a meniscus injury. Management of patellofemoral pain targeting hip, pelvis, and trunk muscle function. Patellofemoral pain syndrome pfps is the most common cause of knee pain in the outpatient setting. The onset of symptoms can be slow or acutely develop with a worsening of pain accompanying lowerlimb loading activities eg. The common presentation is knee pain in association with positions of the knee that result in increased or misdirected mechanical forces between the kneecap and femur.
The multitude of terminology is secondary to the nature of pain described in or around the patella. A good starting point, as is the case with many running injuries, is. Clinical practice guidelines diagnosis a clinicians should use reproduction of retropatellar or peripatellar pain during squatting as a diagnostic test for patellofemoral pain pfp. Clinical tests for differentiating between patients with and without. Rehabilitation for patellofemoral syndrome chondromalacia. Patellofemoral pain syndrome diagnosis and treatment. The pathophysiology of pfps is not fully understood, but is thought to have multiple.
The purpose of this case report was to investigate a plan of care that included gt in a 38yearold male. Contributing factors include overuse and overload of the patellofemoral joint, biomechanical problems and muscular dysfunction. Taping your knee, the right shoes and shoe inserts can help. Women are two times more likely to develop pfps than men. Treatment of the patellofemoral pain syndrome when a patient is diagnosed with pfps, the treating physician usually faces a dilemma. In each case the physician and his or her staff evaluates the individual case and determines the best plan of care for the patient. Why so many canadians experience knee pain nutshell nutrition.
While studies have shown gt to be effective with injuries such as achilles tendinitis, it has not been extensively studied in patients with patellofemoral pain. Patellofemoral pain syndrome barts health nhs trust. Antiinflammatory medication aspirin, ibuprofen, etc may be helpful in reducing both pain and inflammation stretchingcalf and hamstring stretching hold each stretch 30 seconds, repeat 23 repetitions, 2 times per day. Blood tests dont help in diagnosing it but may be useful for ruling out more serious problems. The term anterior knee pain is suggested to encompass all painrelated problems. Pdf the role of hip muscle function in the treatment of. Patello femoral pain syndrome pfps is a common knee joint disability. Effects of taping on pain and function in patellofemoral pain syndrome. This includes medicine, therapy, icing and restricted activity. Treatment includes not running until the pain goes away. Patellofemoral pain syndrome manhattan orthopedic care.
Chondromalacia patellae the disorder most commonly affects adolescent females, and pain can be reproduced when the patella is tightly apposed to the femoral condyles, as. Patients were followed for 1 year with the cincinnati knee rating system ckrs scale as the main outcome measure. Pain at the back of the knee is usually caused by a bakers cyst also known as a popliteal cyst. Individualized acupuncture treatment twice weekly for 4 weeks. By excluding anterior knee pain due to intraarticular pathology, peripatellar tendinitis or bursitis, plica syndromes, sinding larsens disease,osgood schlatters. Patellofemoral pain pfp is the accepted term for localized pain of the anterior aspect of the knee. Treatment the best treatment for patellofemoral syndrome is to avoid activities that compress the patella against the femur with force. Patellofemoral pain syndrome patellofemoral pain syndrome is usually easily recognised from your description of your symptoms and confirmed by an examination of your knee. Treatment of patellofemoral pain often begins with simple measures. There are a few other diagnoses that may be used for pain at or around the kneecap. Patellofemoral pain syndrome an overview sciencedirect. If needed, take overthecounter pain relievers, such as acetaminophen tylenol, others, ibuprofen advil, motrin ib, others or naproxen.