Solving the Patellofemoral Mystery
May 11, 2009 
7 Comments
Disorders of the patellofemoral joint continue to present as some of the most perplexing pathological conditions in orthopedics and sports medicine. Previously described as the “black hole of orthopedics” by Dr. Scott Dye, the patellofemoral joint continues to cause dysfunction for patients and confusion for clinicians. Patellofemoral pain syndrome is often described as a diagnosis that tends to result in poor outcomes. Despite years of research and attention to the joint, the vague use of the term “patellofemoral pain syndrome” continues to be prevalently abused used to categorize patients. This becomes evident when analyzing the myriad of surgical and rehabilitative interventions that are currently being utilized to alleviate symptoms and restore function in patellofemoral patients. It appears that a single surgical or rehabilitative approach cannot be efficaciously used to treat patellofemoral disorders.
Welcome to a new series of posts dedicated to the evaluating and treating the patellofemoral joint.
There will be several posts tied together, similar to my series on SLAP lesions. Each post will have links to one another and a table of contents to help you navigate.
In this series, we will discuss the evaluation and treatment of the patellofemoral joint with topics ranging from differential diagnosis to treatment strategies that can be applied to any rehabilitation or fitness program. My goal will be to develop an easy to understand and implement system to treat patellofemoral pain based on an accurate differential diagnosis and an understanding of the normal biomechanics of the joint.
Solving the Patellofemoral Mystery
Continue on to Part 2: The source of patellofemoral pain or skip around below:
- Part 1: Introduction – Solving the patellofemoral mystery
- Part 2: What causes patellofemoral pain?
- Part 3: Differential diagnosis of patellofemoral pain
- Part 4: Principles of patellofemoral joint rehabilitation
- Part 5: Specific treatment guidelines for patellofemoral pain
- Part 6: Biomechanics of the patellofemoral joint – clinical implications
- Part 7: Understanding the clinical implications of the kinetic chain: The influence of the hip and foot on the patellofemoral joint
I hope you enjoy and interact with each post, please share your thoughts and experience!
Photo credit: Wallpapergate
Hi Mike,
I would also like to hear your opinions on taping, bracing (such as Q lock). I’ve heard that “patellar repositioning” techniques are a bit of a fallacy in that we do not actually “reposition” the patella, but that merely compression (with or without “glides” and “rotations”) assists the patella to stay within the trochlear groove.
Can’t wait to hear.
Thanks Mike! This is truly a ‘mysterious’ diagnosis that is indeed often abused. Can’t wait to read what you’ve got for us. I think the tape acts as a neuromodulatory mechanism and it’s doubtful that one is actually ‘repositioning’ the joint. I believe the brain recognizes the external stimulus (tape) and detects the medial ‘tug’ and perhaps this is the reason for some of its efficacy.
Sounds good, I will include this in the series, would agree with you Chris.
MR
very well formed topic thanks a lot mike !
physical therapy blog http://physiophysio.blogspot.com/
awesome information Your article really helped me get an idea of the difference between a practicioner saying “It’s in your head” which sounds like “your imagining it” and the understanding that there is a neurological component or basis for chronic pain.
TYVM you’ve solved all my preolbms