Patelofemoral Pain Syndrome (PFPS)
Patellafemoral pain syndrome is a painful condition of the knee joint due to an imbalance between patella (knee cap) and femur bone. In a properly aligned knee ligament & tendons are attached to the tibia & quadriceps, hold the patella as a glides smoothly in the femoral groove. Force between the patella & femour is eventually distributed on the surface of the femoral grove. Most important in assuring the proper patellar alignment in the femoral grove is balance between the soft tissues, mainly the muscle called VMO & lateral retinaculum has an imbalance .Imbalance between these two tissues usually courses one of two principle types of malallinment. Patellar tilt & lateral glide, both condition involved a weak VMO & Tight Lateral Retinaculum. If it is untreated, the condition worsens, coursing a lateral soft tissue contracture with a corresponding weak VMO hence the patella is effectively locked out in his normal tracking position. Two main problems result from this abnormal positioning of the patella.
1st:- the force between the patella & femour is now shifted & concentrated in to a small area of the lateral condyle of the femore. Increase the pressure transfer into the nerve rich subcondral bone creating pain.
2nd:-The lack of contact of the medial articular cartilage will couse chondromalacia of the patella or softening of the cartilage .To decrease pain greater surface contact area must be restore in the joint. To correct the malallinment of the patella balance must be restored.
Ankel mechanics is also important, If the upward movement (dorsi flex) is restricted by the cuff muscles or if there is any bony block that means the tallocural joint is block. This imbalance can also lead to a imbalance in the Knee joint.
Patellofemoral pain syndrome is often misdiagnosing with Osteoarthritis of the Knee joint.