Andre Ishmael
Patellofemoral Pain
Syndrome also
commonly known as
PFPS is a general term
for anterior knee pain or
discomfort.
 Usually arises from
increased contact of the
posterior surface of the
patella with the femur or
inflammation of
structures around the
patella.
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The cause of PFPS is usually from
malalignment or biomechanical
dysfunction with the patellofemoral
joint.
According to Mascal and Powers, this
includes impairments that cause an
increased functional Q-Angle such as:
 Femoral anteversion, external tibial
torsion, genu valgum, foot
hyperpronation, or increased hip
flexion and adduction.
There may also be a tight retinaculum,
weak VMO, patella alta, patella baja, or
dysplastic femoral trochlea.

All these can predispose the person to
abnormal patellar tracking, which
increase contact forces between patella
and femur, increase pull on patellar
tendon, or inflamed fat pads or bursa,
thus causing the pain.
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Pain or poor control
when ascending or
descending stairs.
Pain with walking,
running, and jumping.
Pain and stiffness
associated with
prolonged sitting and
squatting.
Grating and grinding
under patella with
movement.
There is none because
every patient has
different causes of
PFPS.
 Most included
strengthening muscle
and stretching muscles
and soft tissue around
the knee.
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SAQ (OKC terminal ext)?

No
▪ Lieb and Perry JBJS 1968, JBJS 1971
▪ Basmajian
Anat Rec 1971
▪ Hallen et al
Acta Orthop Scand 1967
▪ Jackson
Med Sci Sport Exe 1972
▪ Reynolds et al Am J Phys Med 1983
▪ Salzman et al. Clin Orthop 1993
Quad exercises

No
▪ Cerny
Phys Therapy 1995
▪ LaPrade
JOSPT 1998
▪ Vaatainen et al Int J Sports Med 1995
▪ Mirzabeigi et al AJSM 1999
Biofeedback

Yes
▪ Cowan et al
Med Sci Sport Ex 2002

No
▪ Dursun et al
Arch Phys Med Rehab 2001

Hip Adduction

Yes
▪ Hanten and Schulthies
▪ Hodges and Richardson
1993

No
▪ Karst and Jewett
▪ Grabiner
▪
▪
Cerny
Laprade
Phys Ther 1990
Scand J Rehab Med
Phys Ther 1993
Eur J Exp Musculoskel
Res 1993
Phys Ther 1995
JOSPT 1998

Robinson JOSPT 2007

Fukuda JOSPT 2012

Fukuda JOSPT 2012

Fukuda JOSPT 2012
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More research with different demographics
Implementing into current practice
Other causes
Questions?