Patellofemoral syndrome describes pain and dysfunction in the front of the knee. The most common complaints include pain which worsens when going up and down stairs, or after prolonged sitting. The mechanism of injury is not clearly understood, but theories include muscle weakness, muscle tightness, foot mechanics and misalignment of the patella. According to the American Academy of Family Physicians, patellofemoral syndrome responds best to a multifaceted treatment approach.
Exercises
Exercises aimed specifically at strengthening the muscles that help control the tracking of the patella can often resolve patellofemoral syndrome. In addition, stretching specific muscles and tissues that affect the patella's alignment are vitally important. The patient should initially be instructed in the proper execution of the exercises and stretches by a qualified practitioner, and can then perform them at home. The exercise program will take weeks to provide noticeable results, so the patient should be instructed to be patient and persistent.
Taping and Bracing
According to the American Academy of Family Physicians, patella taping and knee braces is a controversial treatment that produces inconsistent results. However, most physical therapists and sports medicine providers are trained in patella taping and teach patients how to tape their own knee. This program, known as McConnell taping, also involves exercises and stretches to provide long-term relief from patellofemoral syndrome. Knee braces for patellofemoral syndrome are generally knee sleeves with a hole cut out for the patella. The braces may have extra cushions that surround the patella to provide extra control of patella movement.
Orthodics
Many patients with patellofemoral syndrome have mechanic issues in the foot. Patients with flat, or pronated, feet may have more patella alignment issues. Patients with a high arch may have more issues associated with lack of shock absorption. Foot orthodics and over-the-counter shoe inserts can provide additional treatment for patellofemoral syndrome for some patients.
Surgery
Surgery for patellafemoral syndrome is used sparingly and only after conservative efforts have failed to provide relief. The surgeon can clean up any fraying of cartilage behind the kneecap and attempt to realign the patella by releasing the tissues which hold it in place. Following any surgical procedure, the patient will need to follow a strict rehabilitation program to maximize the likelihood of a successful outcome.
