Patello-femoral pain syndrome

Patello-Femoral Pain Syndrome is one of the most common sources of knee pain out there. It’s characterized by improper motion of the knee cap relative to the upper and lower leg bones. PFPS usually presents with pain around the knee cap during weigh-bearing and bending as well as generalized weakness in the area. PFPS is primarily an alignment issue.

The knee cap has a very specific path it is supposed to follow during knee bending. If the tissues that attach to the knee cap don’t pull with proper force and in proper proportion, the result is poor tracking of the knee cap, increased wear-and- tear and pain. PFPS tends to just get worse with time, and can lead to other issues of the knee as well, including but not limited to chondromalacia patella which is a softening and wearing away of the articular cartilage on the under-surface of the knee cap. Poor alignment and stability at the foot, ankle, knee and hip are the usual culprits leading to PFPS.

The good news is, in many cases, most of if not all the issues leading to PFPS can be corrected through bodywork and corrective exercise, that is to say, non-surgically.Varying combinations of imbalance can lead to a knee cap that’s too high (patella alta), too low (patella baja), tips to one side or towards the top/bottom (patellar tilting), rotates to one side or most commonly, tracks to one side. With lateral tracking (by far the most common tracking variation), imbalances among the quadriceps, groin and ilio-tibial (I.T.) band are the usual suspects.

Refer to my article on Self-Mysofascial Release for tips on how to release these areas. Areas to strengthen include the outside of the hip, the hip rotators and most importantly, the portion of the inner muscle of the quadriceps (thigh) group that’s closest to the knee, the vastus medialis obliquus.After doing all the release and strength work, all that remains is improving hip, knee, ankle and foot coordination through dynamic, unstable and multi-planar exercises. This usually does the trick. If you think you may have PFPS or want tips on how to address it, contact me.

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