PFPS (Alex Gray - QUT)

What is PFPS?!

PFPS stands for Patello-Femoral Pain Syndrome, it is an idiopathic pain, in and around the patella that can involve the patella tendon as well as the patella capsule. Often people with this will feel pain in the eccentric phase of knee extension, this pain will be located either on the posterior aspect if the patella, on the proximal or distal aspect of the patella tendon insertion.
PFPS can be caused by several different things, when located above the patella, it is generally thought to be from a muscular imbalance between the Hamstrings/Gluteus Max, VL/VMO and tightness in TFL. This causes mistracking of the patella laterally and results in irritation to the patella capsule resulting in pain behind the patella. When located below the kneecap, a biomechanical issue can be the cause, generally this is the type that develops in women, as they have a greater Q-angle, above 15 deg, (that is the angle between the hip to proximal aspect of the patella and then to the tibia tuberosity) than men causing a a mistracking of the patella resulting in pain in the distal and posterior aspect of the patella.

Primary treatment is usually NSAID’s and rest to reduce inflammation and decrease the likelihood of osteoarthritis of the patella capsule.
Secondary treatment is usually a visit to a physiotherapist to ‘loosen’ off the tightened muscles, which results in a reduction in mistracking, the physiotherapist while often, after the first couple of visits given knee extensors stretches and isometric exercises.
Tertiary treatment is then strength and conditioning of the knee extensors, this involves un-weighted squats, squat and hold at 90 deg at the knee joint, knee extensions of the last 30 deg.

Treatment is good but prevention is better, so how though?

Proper technique during knee extension exercises is of the utmost importance, as well not pushing too hard and overtraining. Stretching post work outs is another key component if you do suffer, PFPS, tightness in the ITB, or tightness in the Tibialis Anterior. If you are an overpronator as well orthotics are another thing to think about this will help correct the Q-angle issues that can cause problems, but try and get professionally made ones as they will suit your foot properly.