Often observed in adolescents and young athletes, patellofemoral pain syndrome (PFPS) is a knee pathology Complex and multifactorial, because it can have a lasting impact on a patient's motor skills and mobility, accurate diagnosis by a practitioner and appropriate management are essential aspects to consider. In this article, we will review the various symptoms of this type of syndrome, its origins, and the different diagnostic and treatment techniques currently used in the management of PFS.
Patellofemoral syndrome: definition
Le patellofemoral syndromePatellofemoral pain syndrome (PFPS), also known as patellofemoral pain syndrome, is characterized by sharp pain in the knee joint, particularly in the patellofemoral joint (between the femur and the kneecap). This type of syndrome accounts for between 25 and 40%* of knee injuries related to sports activities. Furthermore, if left untreated, this syndrome can lead to degeneration of the patellar cartilage (chondromalacia) or even osteoarthritis.
What are the possible causes of patellofemoral pain syndrome?
Patellofemoral pain syndrome (PFPS) can have several origins. While it can be caused by trauma (accident, etc.), it can also result from a combination of several abnormal biomechanical and muscular factors, potentially leading to patellar malalignment.
Furthermore, scientists have already identified several key factors in the development of patellofemoral pain syndrome. These include:
- bad posture;
- a lack of flexibility in the leg muscles;
- a more pronounced pronation of the foot;
- excessive stretching of the fibrous plate responsible for stabilizing the patella (internal patellar retinaculum);
- poor posture of the femoral bone.
| Did you know? Patellofemoral pain syndrome mainly affects runners. It accounts for approximately 16 to 25%** of all running injuries. |
The various risk factors
The development of patellofemoral pain syndrome is linked to several intrinsic risk factors. In the majority of cases, quadriceps weakness due to muscle atrophy is a significant contributing factor. Weakness in the hip abductors and external rotators can also be considered a substantial risk factor. Similarly, anatomical abnormalities of the patella, hamstring tightness, patellar hypermobility of certain soft tissues of the knee, or a history of patellar trauma or surgery can all contribute to the development of patellofemoral pain syndrome.
| Did you know? Extrinsic risks (practicing a sport, wearing a certain type of shoe, etc.) can sometimes influence the appearance and intensity of a PFS, but this hypothesis remains to be confirmed today. |
What are the symptoms of patellofemoral pain syndrome?
Patients suffering from patellofemoral pain syndrome describe very specific symptoms. Among them, we can highlight:
- sharp pain in the knee, particularly on the front and/or around the kneecap, which may occur when going up or down stairs, when doing sports activities (running, swimming), or in certain positions (when the patient is squatting or sitting);
- a crackling sensation in the joint when bending the knee.
How to diagnose patellofemoral pain syndrome?
To diagnose patellofemoral pain syndrome, a thorough clinical examination of the knee is necessary. This includes an assessment of the affected joint and allows, among other things, the identification of the risk factors previously discussed.
To be effective, a clinical examination for the diagnosis of a FSGS must consist of several key steps:
- The inspection: during this stage, the practitioner can assess, among other things, the alignment of the lower limbs, the presence of quadriceps asymmetry, the strength of the abductors, as well as the level of foot pronation;
- palpation: the healthcare professional here seeks to identify the painful area and perform patellar tests to detect the presence of patellar instability or osteoarthritis;
- Exploration of joint ranges of motion: this step involves assessing the ranges of motion of the knees and hips in active and passive positions. These should not be altered in the context of a SFP;
- the assessment of musculotendinous extensibility: the practitioner is interested here in the flexibility of the muscles of the lower limbs (quadriceps, hamstrings, iliotibial band, hip flexors and triceps surae);
- Patellar tests: subsequently, the healthcare professional performs a series of tests (plane sign, glide test, Smilie test, patellar tilt and Zohlen test), in order to assess, among other things, the level of mobility of the patella (the kneecap).
Following this initial clinical diagnosis, the healthcare professional may decide to order some imaging tests for their patient. This may be the case if the patient continues to complain of pain despite effective treatment. Furthermore, imaging tests can help to identify certain other conditions (osteochondritis dissecans, cartilage abnormalities in younger individuals, or patellofemoral osteoarthritis in patients over 50).
What are the different treatments offered?
Treatment for patellofemoral pain syndrome relies on a rehabilitation program tailored to the patient's individual situation. First and foremost, relative rest is essential to reduce pain associated with patellofemoral pain syndrome. Physical activity (such as cycling or swimming) can be undertaken as long as it remains below the patient's pain threshold. In addition, applying cold compresses locally can help alleviate inflammation.
The next stage is rehabilitation, which is a crucial aspect of treating patellofemoral pain syndrome. Determined based on a prior clinical examination, this program should focus on improving patellar tracking (improper patellar movement during knee mobilization). Performing a few exercises at the patient's home (particularly to strengthen the quadriceps, abductors, and external rotators) is often combined with physiotherapy.
| Did you know? In some very problematic cases, particularly a lack of improvement after 3 months of treatment, surgery may be considered. This is determined on a case-by-case basis, after the healthcare professional has conducted a more thorough investigation of the causes of the PFS. |
The use of the Allyane method in post-patellofemoral syndrome rehabilitation
Used in the treatment of patellofemoral pain syndrome (PFPS), the Allyane method reduces pain and improves patellar tracking by addressing motor inhibitions and dysfunctional patterns specific to this type of syndrome. Based on a combination of proprioception, mental imagery, and listening to low-frequency sounds emitted by a patented device, the Allyane neuromotor reprogramming method is a neurophysiological process that allows for the modification, correction, or acquisition of motor automatisms. It is designed to facilitate the rehabilitation, modification, or acquisition of a movement quickly and sustainably, particularly in the case of patellofemoral pain syndrome.
Would you like to learn more about the Allyane method and its effectiveness in treating patellofemoral pain syndrome? Don't hesitate to contact us!