Dr. Grant Lum, MD, CCFP, Dip Sports Med, Sports Medicine Physician, discusses patellofemoral syndrome, diagnosis and common treatment options.

Patellofemoral syndrome is a very common knee injury. It’s said that it may affect up to one-third of the population.

The reason is that the patella, which is the kneecap, sits on the front of the knee, and its alignment with the femur - which is the large bone on the top of the leg - dictates whether or not the kneecap’s movement is correct.

When these two bones are not aligned well together, this causes friction or irritation around the area of the kneecap, and that can lead to inflammation and pain. The back of the kneecap is shaped like a V, which fits into a little groove in the femur called the trochlea.

So as those two surfaces move against one another, if there’s any kind of side-to-side misalignment of the kneecap, then that can lead to inflammation and pain.

Sometimes the reason for that misalignment is on the basis of foot structure. So people who have foot pronation or flattening of the arches can have an internal rotation of the kneecap, so it sits medial or central to the line of the leg, and that causes this pressure to occur.

That’s probably one of the most common reasons. There are also dynamic reasons for misalignment, which could include weakness of certain muscles, tightness of certain structures around the knee, and in those cases, the primary treatment for patellofemoral syndrome would be things like physiotherapy.

In order to fix foot pronation, we can fit custom-made foot orthotics or arch supports, which help to lift the arches, and put the kneecap back into the right place.

In more severe cases where the kneecap is significantly displaced or where the symptoms are not resolved through therapy or orthotics, we can fit a patellofemoral stabilizing brace.

So this is a slip-on type brace, which has a bolster inside that helps hold the kneecap in place. Generally speaking to treat the tightness of different muscles, or the muscular imbalances around the knee, which can affect the motion of the kneecap, we can treat that with things like physiotherapy.

If you think you have patellofemoral Syndrome, or have more questions, you could consult your family doctor, a physiotherapy, or a sports medicine physician.

Video shot in conjunction with //www.aesmphysiotherapytoronto.ca/

Presenter: Dr. Grant Lum, Sports Medicine Physician, Richmond Hill, ON

Local Practitioners: Sports Medicine Physician