A common cause of anterior knee pain can be from the patellofemoral joint, or PFJ. This is the joint where the kneecap (patella) sits on the thigh bone (femur).
Some practitioners claim that misaligned, mal-tracking kneecaps are often to blame for anterior knee pains as well as instability. But this simply isn’t the case.
Many people have differing orientations of the patella but no pains or instability so we can’t blame this isolation as a sole cause of knee pain.
This review found 15 studies that looked at healthy pain free people of various ages and checked their kneecap angles and alignment.
And they found huge variations in the depths of the femoral groove, tilts of the patella, distance between the joint surfaces etc.
Knee pain or patella instability isn’t ONLY just about the structure or biomechanics. Often a lack of strength and motor control is an overlooked factor.
Yet “alignment” can be the ONLY thing that some physios and other therapists tend to focus on (and use restrictive taping etc. to help “correct” this alignment – this is a very SHORT-TERM fix, and doesn’t actually address the causes of knee pain).
Numerous structures of the body are highly, highly variable across all individuals, therefore it is important to look at the BIG picture when addressing each and every individuals’ issues, and not try to blame a structural abnormality for their pain.
By Will Ryan, Physiotherapist
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Healthy knees have a highly variable patellofemoral alignment: a systematic review
There is still lack of knowledge regarding the variability of patellofemoral alignment in healthy, non-osteoarthritic knees, without patellofemoral instability. Therefore, a systematic review of the existing literature was performed to evaluate the variability of patellofemoral alignment.
Article source: https://link.springer.com/article/10.1007/s00167-019-05587-z
Image source: Credit – Adam Meakins @TheSportsPhysio