Risk factors for patellofemoral pain include excessive hip adduction and internal rotation during dynamic tasks (such as running and jumping), weak quadriceps, greater vertical peak force to the lateral heel and second or third metatarsophalangeal joint during walking, delayed activation of the vastus medialis obliquus (identifiable with a patellar tendon tap), and increased knee-abduction impulses during running and landing activities.
Non-surgical, comprehensive management is recommended for treatment. Treatment plans should include:
- Hip and quadriceps strengthening exercises
- Neuromuscular retraining
- Ankle and foot exercises
- Calf and hamstring stretching
- Hip movement retraining
- Patient education (contributing factors, activity modification, and rehabilitation adherence)
Jack Cush, MD, is the director of clinical rheumatology at the Baylor Research Institute and a professor of medicine and rheumatology at Baylor University Medical Center in Dallas. He is the executive editor of RheumNow.com. A version of this article first appeared on RheumNow, a news, information and commentary site dedicated to the field of rheumatology. Register to receive their free rheumatology newsletter.