Treatment for patellofemoral pain syndrome (PFPS) has traditionally relied on quadriceps strength training. Some patients also benefit from neuromuscular training, which focuses more on motor control than improving strength.

So far no one has found a “one size fits all” kind of program. Some people seem to get better with one type of exercise while others have less pain and more function with other types of training.

Some time ago researchers saw that hip strength may be an important key to PFPS. One by one studies have been done to confirm this suspicion. Most recently physical therapists at the Nicholas Institute of Sports and Medicine and Athletic Trauma in New York City studied hip strength and flexibility as it relates to PFPS.

They found that 60 percent of patients with PFPS got better after a six-week training program. Exercises to improve hip flexor strength and flexibility resulted in decreased pain and improved function.

The goal was to prevent inward rotation of the thighbone (femoral rotation). Maintaining good alignment of the patella as it moves up and down over the knee reduces the tension on the soft tissues around the knee. This new treatment approach may help you as well!

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com. The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of a visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

Q-angle–or quadriceps angle–is the angle between the quadriceps muscle (front of the thigh) and the patellar tendon (just below the kneecap). This angle can be determined using X-rays. More often, it is measured by placing the person flat on a table with the hips, knees, and feet in a neutral position. A line is drawn from the pelvic bone to the middle of the kneecap. A second line is drawn from the middle of the kneecap through the large bump on the shin (called the tibial tubercle). The angle formed by the crossing of these two lines is called the Q-angle.

Normally, the Q-angle is between 13 and 18 degrees when measured this way. Boys and men usually have smaller angles than girls and women. With a larger than normal Q-angle, the kneecap (patella) moves up and down over the knee joint in such a way that it can cause wear and tear of the cartilage. This causes crepitus, or the crunching feeling people describe when straightening the knee.

Ask your doctor about seeing a physical therapist. Using taping techniques, shoe inserts (orthotics), or muscle strengthening exercises, the therapist may be able to help your daughter learn how to keep the patella in the middle.  These measures can help reduce pain, swelling, and the crepitus sensation.

The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic. For more information on this subject, visit www.zehrcenter.com.