Patellofemoral Syndrome
The patellofemoral syndrome is a group of conditions in which the hallmark
is pain beneath or surrounding the patella (kneecap). The patella is a unique
bone in the leg because it does not directly bear weight. As the knee flexes
and extends (bends and straightens), the patella tracks along a groove in the
front of the femur (leg bone). Any factor that disrupts this normal "tracking
mechanism" can result in inflammation or pain to the undersurface of the
patella. When mild, the undersurface may simply be inflamed. When more severe,
the cartilage may actually become damaged or arthritis may develop. When the
tracking is poorly controlled or poorly aligned, instability of the patella
may result, with subluxation (slippage) or actual dislocation.
The most common use of physical therapy is in initiating and advancing an exercise
program, the backbone of treatment for the patellofemoral syndrome. In addition,
in the acute stage, modalities such as ultrasound and electricity can reduce
adhesions behind the patella. Mobilization techniques, often helpful as well,
involve the therapist manually "freeing up" the patella so that patellar
tracking is improved and symptoms reduced.