Patellofemoral pain

Pain around the knee cap (patella) will not develop without a cause.

Although you may have been told that you have 'chondromalacia' or that you suffer from 'patellofemoral syndrome', these terms actually encompass a wide variety of conditions. In this Part of the course I will run briefly through the list of some of these conditions.

Conditions interfering with the mechanics of the knee

Tight structures around the knee

• Tight lateral retinaculum (patellar tilt and/or lateral displacement)
• Tight ilio-tibial band
• Tight hamstrings
• Tight quads
• Tight calf muscles
• Patellar arthrofibrosis & patella baja

Loose structures around the knee

• constitutional laxity (hypermobility syndromes)
• patella alta (high knee caps)

Factors increasing the Q angle

• Flat feet
• Knock knees (valgus deformity)
• Poorly positioned tibial tubercle
• Tibial rotation (including 'miserable malalignment')

Irritation of soft tissues inside the knee

• Plica syndrome
• Fat pad syndrome
• Pre-patellar & infra-patellar bursitis
• Synovial impingement
• Neuroma in the lateral retinaculum
• Early rheumatological conditions

Overuse

• Unusual exercise
• Patellar tendinopathy
• Quadriceps tendinopathy

Deformed bones

• Trochlear dysplasia
• Patellar dysplasia
• Bipartite patella
• Dorsal defect

Stressed bones

• Stress fracture of patella
• Traumatic fracture of patella
• Osgood Schlatters disease & Sinding-Larsen-Johansson syndrome

Knee problems not necessarily involving the mechanics of the knee

• Neuroma under the skin
• Osteochondritis dissecans
• Tumors
• Infection

'Complex Regional Pain Syndrome'

I will go into this in more detail later.

'Referred Pain', not originating with the knee at all

• Hip problem, e.g. slipped capital epiphysis
• Spine problem

This list is for reference and completes this part of the course. I'll explain all the terms as we go along - don't worry!