Patello-Femoral Syndrome

Post Rehab Goals and Objectives:

The goals for the post rehab fitness program are to improve quadriceps strength and specifically vastus medialis recruitment, improve range of motion and flexibility, increase functional capacity.

Description

Patello-femoral syndrome can be very painful and debilitating. Patello-femoral syndrome is characterized by anterior knee pain with athletic activities or after sitting for long periods of time. Often the cause of patello-femoral syndrome is quadricep weakness Or imbalance in the quadriceps. The imbalance usually involves the vastus medialis, a much stronger vastus lateralis and a tight IT band. This imbalance causes the patella to track laterally in the patella grove. The abnormal tracking produces high compressive forces in the patello-femoral joint. These high compressive forces produce pain.

The vastus medialis is underdeveloped in the majority of the population. The medialis serves to prevent the capsule around the knee from being impinged under the patella during the last 30 degrees of knee extension. The common misconception is that the vastus medialis acts to move the knee into the last 30 degrees of knee extension. The medialis works throughout the entire range of motion of knee extension not just the last 30 degrees. When training a client with patello-femoral syndrome the trainer should work to increase strength and muscle firing of the vastus medialis along with stretching the IT band and the other structures of the thigh.

Damage to cartilage along the posterior aspect of the patella or retropatella surface is commonly seen with patella-femoral syndrome. This surface is covered in hyaline cartilage. As with other joints, when there is damage to the cartilage arthritic changes occur. The arthritic changes are a source of pain and swelling.

The patello-femoral client will benefit from a exercise program emphasizing strengthening of the overall quadriceps in both open and closed chain modes. The strengthening of the quadricep improves firing of the vastus medialis, thereby improving patella tracking.