Common Conditions and Diagnosis

Patellofemoral Pain Syndrome - Anterior Knee Pain

Patellofemoral Pain Syndrome is a common cause of pain around the knee cap, that is sometimes referred to as ‘Anterior Knee Pain’. When the knee bends or straightens, the knee cap glides in a special groove on the thigh bone called the ‘Patellofemoral groove’, controlled by the quadriceps (thigh) muscles. However, for several reasons it may stray from this path (usually towards the outside of the knee). This is called Patellofemoral Maltracking and produces abnormal stresses on the under-surface of the patella that can cause knee cap pain.

The knee joint is made up of three bones:

the Femur (thigh bone),
Tibia (shin bone)
and Patella (kneecap).
The Patella is wrapped inside a Quadriceps tendon that connects the thigh muscles (Quadriceps) to the shin. When the knee bends, or straightens, the knee cap normally glides in a special groove on the thigh bone called the Patellofemoral groove.

With Patellofemoral maltracking, abnormal stresses are put on the under-surface of the knee cap that can cause pain. This is similar to having the front tyre of a car slightly out of alignment, leading to abnormal wear. If allowed to progress, these stresses can cause damage to the articular cartilage on the knee cap (a condition called Chondromalacia Patella) and femur.

Patellofemoral maltracking is one of the most common causes of knee pain and can be caused by numerous factors:

Tightness in certain structures. (e.g. calf and hamstring muscles).
Weakness or incoordination in muscles that should help maintain normal patella tracking.
Altered hip, knee or foot posture.
Anatomic variations such as a shallow Patellofemoral groove.
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Patellofemoral Pain Syndrome Signs & Symptoms
The most common symptom of Patellofemoral maltracking is pain at the front of the knee that can occur while ascending or, more often, descending stairs and whilst running. Pain can also result from prolonged sitting and some people may experience instability (this can involve a sensation of insecurity or actual giving way of the knee) or locking of the knee.