Monthly Archives: May 2020

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This link is for Part B, PFPS power point presentation.

Below is a video of me going through one of my sessions from my 4 week plan with my client. I had trouble doing any sort of editing on this video as I didn’t have any sort of software. If i did i would have added a little video at the start of me explaining everything and i would have also made a few edits.

Patellofemoral pain syndrome blog post 

In the main, patellofemoral pain syndrome (PFPS) is hard to define, the reason for this is that patients experience a variety of symptoms from the patellofemoral joint with varying levels of discomfort. The patellofemoral joint consists of the patella, both distal and anterior parts of the femur, articular surfaces and other surrounding structures (Thomeé et al., 1999). For this blog post I will be discussing the techniques that can be used to lower the risk of PFPS and also the risk factors for developing PFPS. 

Despite its high prevalence, little is known regarding the risk factors which predispose individuals to developing PFPS (Boling et al., 2009) (PFPS) is the most commonly diagnosed condition in people younger than 50  with knee pain. While the general practitioner sees an average of 5 or 6 new patients with PFPS per year, the amount of PFPS cases within the general population is still unknown. Women have higher risk of developing PFPS than men (Lankhorst et al., 2012). A study conducted by Boling et al., (2009) took 1,597 midshipmen from the United States Naval Academy who felt no pain when taking part in a jump-landing test or lower leg strength tests. The results of this test showed that “A total of 40 (females=24, males=16) participants with complete baseline testing and no history of PFPS developed PFPS during the follow-up period and met the inclusion criteria for the injured group. The non-injured group included 1279 (females=489, males=790) participants. The overall risk of PFPS was 3% in this population”.Waryasz and McDermott (2008) suggest that the positive potential risk factors for developing PFPS included: weakness in the following muscles; gastrocnemius, hamstring, quadriceps or iliotibial band tightness; ligamentous laxity; hip weakness; an excessive quadriceps angle and patellar compression. Being overweight is also a risk factor for developing PFPS. As well as intrinsic factors that may cause PFPS there are also Extrinsic factors that need to be considered such as training errors, incorrect footwear/poor surfaces and also psychosocial factors have all been shown to be extrinsic factors for PFPS (Van Tiggelen., et al 2008).

A sport in which PFPS is prevalent is weightlifting, especially in adolescents. The reason for this is because of the excessive weight the athlete is lifting, if any part of their technique isn’t flawless then a lot of stress will be transferred through the patella and in turn causes a high risk in obtaining PFPS. Gharote et al., (2016) conducted a study In which 50 players (44 male and 6 female) aged 15-30 years, the players all underwent a patella grinding test which if found positive would then undergo an X-Ray. The results show that 80% of three players with any anterior knee pain tested positive on the patella grinding test and then 62.5% of those tested positive for PFPS after an X-Ray.

There are always ways to reduce the risk of developing an injury. In the case of PFPS the preventative measures are still somewhat unknown however there are still a few things to do in the hope of reducing them . The first method in reducing the rate of this injury is to do with the quadriceps muscle. The reason for this is because it plays a key role in the pathology of PFPS. The preventative measure simply should be acting on as many modifiable risk factors as possible, for example working on the strength of the muscles and structures around the area and wearing correct footwear when partaking in activity. Stretching however has not been proven to be an effective method in the prevention of PFPS . In contrast, patellofemoral taping has proven to be an effective method for preventing PFPS (Van Tiggelen., et al 2008). A study that backs this statement up is one by Dutton et al., (2014) that states that taping of the area around the patella can reduce PFPS pain by producing a wider distribution of forces around the patella and also relieving pain by taking away contact in painful areas. A study that shows different preventive measures is one by Witvrouw et al., (2011) that say there are 4 main risk factors in the development of PFPS and these factors are also the way to treat/prevent the injury from occurring. The four risk factors are decreased flexibility of the Quadriceps; decreased explosive strength of the Quadriceps; altered neuromuscular coordination between VMO and VL; and a hypermobility of the patella. They say that the main focus needs to be on examination and treatment protocol on these four important parameters.

In conclusion, PFPS will always be a common injury that will affect a lot of people, especially those who put a lot of stress through their knee joints. There are a lot of risk factors in the development of PFPS including, the main risk factors being to do with muscles and structures with strength and flexibility deficiencies around the patella and knee joint in general. Another main risk factor in developing PFPS are extrinsic factors such as training on unsuitable surfaces putting added stress through the patella. Also things like unsuitable footwear and poor technique when lifting heavy objects hence the reason this injury is very prevalent in weightlifters. There is a lot of research that states taping will help in reducing the risk of obtaining PFPS, the reason for this is because the tape spreads the distribution loss of the knee joint so less stress is meant to go through the patella itself, and also the tape is supposedly meant to reduce to the contact with painful sensitive areas. In terms of prehabilitation, strengthening the muscles around the patella, e.g quadricep in particular the VMO, and other structures around the area is shown to decrease the risk in obtaining PFPS.

Reference List

Thomeé, R., Augustsson, J., & Karlsson, J. (1999). Patellofemoral pain syndrome. Sports medicine, 28(4), 245-262.

Lankhorst, N. E., Bierma-Zeinstra, S. M., & van Middelkoop, M. (2012). Risk factors for patellofemoral pain syndrome: a systematic review. journal of orthopaedic & sports physical therapy, 42(2), 81-94.

Boling, M. C., Padua, D. A., Marshall, S. W., Guskiewicz, K., Pyne, S., & Beutler, A. (2009). A prospective investigation of biomechanical risk factors for patellofemoral pain syndrome: the Joint Undertaking to Monitor and Prevent ACL Injury (JUMP-ACL) cohort. The American journal of sports medicine, 37(11), 2108-2116.

Waryasz, G. R., & McDermott, A. Y. (2008). Patellofemoral pain syndrome (PFPS): a systematic review of anatomy and potential risk factors. Dynamic medicine, 7(1), 9.

Gharote, G. M., Shah, S. M., Yeole, U. L., Gawali, P. P., & Adkitte, R. G. (2016). Evaluation of patellofemoral pain syndrome in national level weight lifters with anterior knee pain. Saudi Journal of Sports Medicine, 16(3), 192.

Dutton, R. A., Khadavi, M. J., & Fredericson, M. (2014). Update on rehabilitation of patellofemoral pain. Current sports medicine reports, 13(3), 172-178.

Witvrouw, E. R. I. K., van Tiggelen, D. A. M. I. E. N., & Thijs, Y. O. U. R. I. (2011). Intrinsic risk factors for patellofemoral pain syndrome: Implications for prevention and treatment. Journal of Science and Medicine in Sport, 14, e118.

Van Tiggelen, D., Wickes, S., Stevens, V., Roosen, P., & Witvrouw, E. (2008). Effective prevention of sports injuries: a model integrating efficacy, efficiency, compliance and risk-taking behaviour. British Journal of Sports Medicine, 42(8), 648-652.