Treating Patellofemoral Syndrome
Jacques Martin, D.S.S., B.Sc., C.Ped.
President, Footech Inc., Certified Pedorthist
Treating Patellofemoral Syndrome with Foot Orthotics
Aside from being painful, patellofemoral syndrome can cause knee tissue to degenerate over time, and may also lead to a decrease in quadricep muscle mass. Contributing factors of the syndrome include overload or overuse of the patellofemoral joint, biomechanical problems, and muscular dysfunction. Patients diagnosed with patellofemoral pain syndrome often experience anterior knee pain during activities that often worsens when descending steps or hills.
Clinical Review of Foot Orthoses as a Treatment for Patellofemoral Pain
A clinical review of research literature published in the Journal of Orhtopaedic and Sports Physical Therapy (2003 33) has suggested that foot orthoses can play an important role in the treatment of patellofemoral pain. The study evaluated the effects of foot orthoses on pain and function and examined the relationship between foot and lower extremity patellofemoral joint mechanics. The effects of foot orthoses on lower extremity mechanics and patellofemoral joint position were also studied. Results of the review indicated that patients presenting with patellofemoral pain can benefit from the use of foot ortheses if they also demonstrate signs of overpronation or excessive lower extremity internal rotation and increased Q angle during weight bearing. The biomechanical mechanisms eliciting a positive effect on patellofemoral pain in patients included a reduction in internal rotation; a reduction in Q angle; reduced laterally-directed tissues forces from the patellar tendon, iliotibial band and quadriceps tendon; and reduced patellofemoral pressure points.
Foot Orthotics as Part of an Overall Injury Prevention and Management Program
Results of the study indicated that foot orthotics can be a valuable adjunct to the treatment of patellofemoral pain syndrome.
Foot orthotics can be used within treatment programs that include massage, stretches, and strengthening exercises. Gait analyses and other evaluation procedures can be conducted to determine if overpronation is a cause. It is essential that sufferers of patellofemoral syndrome choose and wear appropriate footwear.
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