Patella Femoral 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.  The constant irritation can result in crepitus (grinding sounds) and pains 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 duodensity 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 succeed which an orthotic can provide.