Knee Cap-Patellofemoral Pain Syndrome

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Knee Cap-Patellofemoral Pain Syndrome

Patellofemoral Syndrome (PFS) is a misalignment of the patella and the femoral trochlea (groove). The patella is designed to glide in the femoral groove when the knee joint flexes and extends, however, due to hyperpronation of the foot (fallen arches), the patella migrates medially and rubs against the condyles of the femur. This constant irritation can result in crepitus (grinding sounds) and pain under the kneecap.

Hyperpronation or fallen arches can contribute to the formation of PFS. As the foot pronates, the talus in the ankle rotates medially. The tibia (shin bone), which sits on the talus, also rotates, causing the patella to migrate medially and "de-track" from the femoral groove. With the constant flexion and extension of the leg, especially with running, the posterior aspect of the patella becomes rough.
Strengthening of the quadriceps (thigh) muscles may help to decrease the amount of migration of the kneecap. Shoes may also assist in providing more support on the inside of the sole with a duo-density system incorporated into a variety of shoes.

Foot mechanics are more likely to be changed by a custom-made orthosis (insert) that limits pronation (arches dropping). Pronation is dynamic and must be controlled through the entire gait cycle for treatment to suceed which an orthotic can provide