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The Multifactorial Nature of Patellofemoral Pain (Anterior knee)

Updated: Apr 9, 2023


Patellofemoral pain (PFP) is a common orthopedic condition, often referred to as ‘runner’s knee’, that causes pain in the knee joint and surrounding area. It affects individuals of all ages, from high-level athletes to recreational exercisers. Common aggravators of pain include: squatting, prolonged sitting, ascending/descending stairs, jumping, or running. As PFP is caused by a variety of factors, diagnosis and treatment must be tailored to the individual. Physical therapy can be used to improve symptoms associated with PFP. The multifactorial nature of PFP has been extensively studied, and it is now understood that there is no single cause of the condition. Instead, PFP is often caused by a combination of anatomical, biomechanical, and lifestyle factors. Anatomical factors include patellar malalignment, hypermobility, and muscular imbalances, which can cause the knee joint to be overloaded and result in pain. Biomechanical factors, such as excessive foot pronation or hip adduction, can also cause abnormal loading of the knee joint. Finally, lifestyle factors, such as inadequate warm-up, poor nutrition, and high-impact activities, can contribute to the development of PFP.


Physical therapists can use a variety of treatment approaches to improve symptoms. The most effective treatment strategies often involve a combination of stretching, strengthening, and modalities. Stretching is important for improving range of motion and decreasing muscle tightness, which can reduce pain and improve function. Strengthening exercises can be used to improve muscular balance and control, which can help to reduce the load on the knee joint.


In conclusion, PFP is a multifactorial condition that can be caused by a variety of anatomical, biomechanical, and lifestyle factors. Physical therapists can use a combination of stretching, strengthening, and modalities to reduce pain and improve function.




References


Gwathmey, F.W., & White, L. (2005). Patellofemoral Pain Syndrome: A Review and Practical Guide to Diagnosis and Treatment. The American Journal of Sports Medicine, 33(7), 1175–1183. https://doi.org/10.1177/0363546505275790McFadyen, B.J., & Miller, B.F. (2013).


Patellofemoral Pain Syndrome: Diagnosis, Treatment, and Prevention. Physical Therapy, 93(10), 1293–1304. https://doi.org/10.2522/ptj.20120462

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