PFJ Dysfunction

Pathology

  • Pain in the anterior knee usually due to maltracking of the patella in the trochlear groove of the femur

  • Contributing factors
    • —Overweight
    • —Generalised ligamentous laxity
    • —Increased Q angle

    • —Female
    • —Femoral anteversion
    • —External tibial torsion
    • —Genu valgum
    • —Shallow trochlear groove

    • Lower limb biomechanics (increased pronation)
    • —Glutes, quads weakness
    • —Hamstring, calf tightness

Symptoms

  • Anterior knee pain behind or around the patella
  • Often worse on exercises where the quadriceps mechanism is loaded (eg squats, getting up from chair, stairs)

Management

  • Address modifiable risk factors (Physiotherapy)
    • Quadriceps / vastus medialis obliquus and gluteal strengthening

    • Improve Quadriceps / ITB / Hamstring Length

    • Weight Loss
    • —Taping / Bracing

      • —Can help to pull the patella medially
      • —May provide more proprioceptive feedback than mechanical support
    • Foot mechanics (Podiatry)

      • Podiatry review
      • Appropriate Footwear