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Patellofemoral syndrome 

Updated on 21 June 2024

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Also known as runner’s knee, patellofemoral syndrome is a condition resulting from a malfunction of the internal structures of the knee and femur.

This pathology is common among athletes and is even more painful when the kneecap is subjected to repeated stress.

If left untreated, patellofemoral syndrome can cause premature wear and tear of the cartilage and may result in irreversible damage.

Let’s look at its characteristics, what triggers its appearance and how to prevent it.

Symptoms of patellofemoral syndrome

A kneecap condition like patellofemoral syndrome triggers symptoms that may be similar to those of other conditions.

That’s why it is so important to be able to distinguish them correctly.

Usually, patellofemoral syndrome manifests itself by these symptoms:

  • Dull pain in the front of the knee, which can extend deep into the kneecap
  • Discomfort that occurs during physical activity and persists afterward
  • Daily activities that are hampered by pain, such as climbing stairs or squatting
  • A noticeable cracking when the legs are bent
  • The affected knee has less inward mobility and more outward mobility

Failure to address these symptoms as soon as they appear can complicate the healing of the patella injury.

Not to mention the more serious complications involved:

  • Chronic recurrence of pain
  • Long-term reduced mobility
  • Degeneration of the patella cartilage
  • Osteoarthritis

To avoid these complications, it is highly recommended to consult a health professional like your podiatrist when you experience any unusual pain.

Causes and at-risk individuals

Although the pain associated with patellofemoral syndrome is more localized in the knee, there are multiple factors that contribute to the underlying cause of the problem.

It is generally acknowledged that patella inflammation is the result of inadequate joint alignment coupled with irritation of the patella cartilage.

The following biomechanical factors may be involved:

  • A deviation of the natural varus or valgus axis of the knees
  • Excessive foot pronation when walking
  • Poor overall posture
  • A lack of flexibility of the lower limbs
  • Insufficient leg muscle strength
  • Knees cambered to the rear
  • Hypermobility of the kneecaps

In addition to these mechanical factors, patellofemoral syndrome sometimes affects some people more than others. 

These at-risk individuals may include: 

Despite the propensity of athletes to suffer from this joint disorder, no one is truly immune to this type of disorder.

That’ s why it is recommended to consult a healthcare professional as soon as you experience any troubling symptoms.

Prevent patellofemoral syndrome

As with any musculoskeletal disease of the lower limbs, the most effective remedy for patellofemoral syndrome is through prevention.

Of course, athletes must be as attentive to the warning signs of the syndrome as older people are.

However, a few simple steps can help everyone to protect themselves.

Here are some recommended techniques to minimize the risks associated with patellofemoral syndrome: 

  • Decrease sports activities that require repeated knee flexion
  • Avoid long-term physical activities s like hiking.
  • Adopt a good warm-up routine before a workout and do a full stretching session following a workout
  • Wear shoes adapted to the morphology and movement of the feet
  • If slight pain develops, apply ice to sore knees
  • Moderate the increase in the intensity level of an exercise

Despite the adoption of these types of preventive measures, the complications caused by patellofemoral syndrome may require the intervention of a health professional.

Medical treatments

In addition to providing an accurate diagnosis, a clinical consultation allows the most appropriate treatment to be administered depending on the severity of the condition. In order to understand the origin of the pain, the podiatrist will first perform a series of tests, such as:

  • A biomechanical exam
  • Postural evaluation 
  • 2D or 3D digital scanning of the feet

Once the patellofemoral syndrome has been clearly identified, the podiatrist will recommend the following therapeutic procedures:

  • Plantar orthotics, to correct the pronation of the feet that causes pain
  • Therapeutic foot bandages (taping)
  • Manual foot therapy
  • Non-steroidal anti-inflammatory medication
  • A customized exercise and stretching program

However, if the pain is due to a structural abnormality, the attending physician is more likely to consider a surgical procedure like realignment osteotomy.

Surgery is only used as a last resort therapy, and the podiatrist generally does their best to offer more conservative alternatives with the foot.

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