Patellofemoral Syndrome

Patellofemoral syndrome refers to pain felt in or around the knee cap (patella). This condition is typically due to excessive patellofemoral joint pressure from poor kneecap alignment, which in time, affects the joint surface behind the kneecap.

Usually patients complain of a dull ache behind the knee cap with activity and often get worse when going up or down stairs, squatting, kneeling or running. Pain is often worse on repetitive activity such as running or walking long distances. You may notice a grinding or clicking sound when bending and straightening the knee. Once the syndrome progresses your knee cap may even become painful at rest.

This syndrome is often caused by:

• Running on hard or uneven surfaces.
• Muscle imbalance such as tight calf muscles and hamstrings resulting in extra stress placed on the knee.
• Poor footwear.
• Knock knees.
• Overloading/overusing the knee joint.
• Weak quadriceps muscles.
• Poor alignment of the lower limbs.
• Over pronation (rolling in of ankle).
• Women have a higher predisposition due to their wider pelvises than men, which increases the size of the angle where the bones in the knee joint meet.

At Mint Foot Care Podiatry, we diagnose this condition by taking a comprehensive history, performing a biomechanical assessment and video gait analysis. The podiatrist may prescribe diagnostic imaging such as an X-ray or ultrasound.

Based on the findings a combination of treatment options may be prescribed including:

• Rest and Ice – keeping off the foot and reducing activity prevents further injury and encourages healing. Ice can reduce inflammation, swelling and symptoms.
• Non-steroidal anti-inflammatory medication – help reduce the pain and inflammation such as ibuprofen or aspirin.
• Proper fitting and supportive footwear recommendations.
• Custom made orthotic therapy – orthotics may be prescribed to address any biomechanical factors such as over pronation.
• Exercises to strengthen the muscles within the quadriceps group, restoring muscle balance and stabilising the kneecap. Exercises may also be given for stretching of hip muscles, hamstrings and calf muscles to help improve biomechanics of the patellofemoral joint.
• Ultrasound therapy.
• Dry Needling.