From the Guidelines
Patellar friction syndrome develops primarily due to abnormal tracking of the patella over the femoral groove during knee flexion and extension, often resulting from a combination of biomechanical abnormalities, anatomical factors, and overuse from repetitive activities. This condition occurs when excessive pressure or friction develops between the underside of the patella and the femoral trochlea. Several factors contribute to its development, including:
- Biomechanical abnormalities like patella alta (high-riding kneecap), muscle imbalances between the vastus medialis and vastus lateralis muscles, tight lateral retinaculum, weak hip abductors, and excessive pronation of the foot 1
- Anatomical factors such as a shallow femoral groove or patella malalignment can predispose individuals to this condition
- Overuse from repetitive activities, such as running, jumping, or cycling, which can increase the stress on the patellofemoral joint 1
- Obesity, which can increase the forces across the patellofemoral joint, contributing to the development of patellar friction syndrome
The syndrome typically progresses gradually, beginning with inflammation of the soft tissues and cartilage under the patella, which can eventually lead to cartilage softening and breakdown if left untreated. Early intervention focusing on correcting biomechanical issues through physical therapy, proper footwear, and activity modification is essential to prevent progression to more serious cartilage damage 1.
Key considerations in the development of patellar friction syndrome include:
- Abnormal tracking of the patella, which can lead to increased pressure and friction on the patellofemoral joint
- Biomechanical abnormalities, such as muscle imbalances and anatomical factors, which can contribute to abnormal tracking of the patella
- Overuse and repetitive activities, which can increase the stress on the patellofemoral joint and contribute to the development of patellar friction syndrome
- Individualized assessment and treatment, taking into account the person's specific characteristics, symptoms, and needs, is crucial for effective management of patellar friction syndrome 1