A frequent problem affecting adults and adolescents characterised by diffuse retropatellar pain induced by and limiting activities of daily living that load a flexed knee. Such activities include ascending and descending stairs, squatting and prolonged sitting” Bolga and Malone, (2005)
- Controversy in literature: overloaded with theories.
- Subchondral bone deformation(Goodfellow et al, 1998, Naslund et al, 2005)
- Intermedullary pressure changes (Arnoldi, 1991)
- Lateral retinacular neuroma formation (Sanchis-Alfonso et al, 1998)
- Vascular dysfunction (Sanchis-Alfonso et al, 2007, Selfe – work ongoing)
- The tissue homeostasis theory/the biological inflammatory cascade (Dye et al, 1999
- Conflicting evidence of delayed onset VMO (Selfe, 2004).
- VMO onset delay in runners with PFPS (Ng et al, 2011).
- VMO-VL timing rations vary between healthy subjects and patients (Selfe, 2004).
- Effusion inhibits quads: VM (Torry, 2000).
- Reduced quads flexibility, VM reflex response time, explosive strength and vertical jump ability (Witrouw, 2000).
- Weakness of hip lateral rotators and abductors (Robinson, 2007 and Ireland, 2003).
- PFPS subjects sig difference in ITB length in symptomatic and asymptomatic sides(Hudson and Darthuy, In Press)
- ITB tightness increases pressure on lateral patella facet (Merican et al, 2009)
- PFPS subjects had significantly shorter hamstrings than asymptomatic controls (White et al, In Press)
- Poor prediction of recovery if pain persists for 2 years (Price, 2000).
- Combination of CKC and OKC exercises required: quads, hip lat rot and abd.
- Flexibility: quads and hams.
- OKC avoided in 1st 30* flex (Doucette, 1996).
- Exercises can be performed in controlled pain.
- Proprioception (Callaghan, 2008, 2010, 2011).
- Physiotherapy mobilisation and manipulation.
- Taping/bracing .
- Combined approach(Mason, 2010).
- Orthotics (Vincenzino, 2010 and Barton, 2009).