Patellofemoral pain refers to pain in the knee cap and can occur with movement or at rest with multiple cause factors. Patellofemoral pain remains one of the most prevalent causes of knee pain and subsequent hip and back pain in the general population. Fortunately it is highly treatable once diagnosed.

The Anatomy of the knee
When discussing these injuries its best to first have an understanding of the function and anatomy of the knee joint. The Knee joint is comprised of the femur (thigh bone), tibia (shin) and Patella (knee cap). The knee is more or less stabilised by the anterior cruciate ligament (ACL) posterior cruciate ligament (PCL) LCL and MCL (ligaments on the inside and outside of the knee) as well as musculature traveling over the joint line itself.

Common Causes of Patellofemoral Pain
Common causes of patellofemoral pain include poor hip stability, altered mechanics of gait, tightness in the lateral aspects of the thigh and hip, traumatic injury to the joints above and below the knee and some surgeries.

Types of Patellofemoral Injury
Poor gait mechanics: Slight alterations in a person’s walking or running pattern over time, caused by weakness or injury of certain muscles is a common cause of patellofemoral pain. This is because these alterations put strain on different aspects of the knee and alter the forces traveling through the joint itself.

Hip instability: The degree of hip instability or associated weakness a person suffers from tends to contribute to the degree of which the patella is displaced. What this means in basic terms, is that if your hip is struggling to maintain pelvic balance the knee is more likely to be under an altered load leading to poor patella movement. This coupled with constant use of the joint itself gives the individual a large degree of pain over time.

Tight lateral soft tissues in the thigh and hip: Generally speaking, patellofemoral pain is caused by poor tracking of the patella in the lateral aspect of the groove in which it sits. Largely this is caused by quad, ITB, TFL and glute tightness all of which are muscles or sheaths that travel to the knee on the lateral aspect. Because of this tightness the knee cap is dragged to the side and subsequent pain ensues.

Patellofemoral Injury Management
Depending on the overall cause of your patellofemoral pain either manual techniques, stretches or strengthening exercises may be employed for treatment by your practitioner. It is also worth noting that while some cases may take longer and be more severe in nature each of the above mentioned injuries are all manageable and treatable with patients experiencing excellent outcomes.

James O’Connor

Physiotherapist