Effectiveness of patellar mobilization in patellofemoral pain syndrome

Patellofemoral pain syndrome (PFPS) is a common cause of knee pain in young people, especially who are reguarly active in sports involving running and jumping.1,2 PFPS usually involves pain in the anterior part of the knee or pain beneath or sides the patella, resulting from conditions such as Osgood-Schlatter, patella synovitis, patellar instability, patellar hypomobility, and chondromalacia.3 This pain and dysfunction results from excessive load or prolonged repetitive in the patellofemoral joint (PFJ).1 Another common reason for PFS pain are decrease strengthening of hip abductors and increase power of adduction muscles, knee ligaments injuries, and foot issues.1 Symptoms are commonly aggravated by walking up or down stairs, climbing or descending hill, squatting, lunge, running, biking and sitting with knee 90 degree for long time.1–4 Detailed subjective and objective examination sometimes involves imaging is necessary for diagnosis.2,4 To determine the exact source of pain leg strength, alignment, Qangle, and knee ROM, as well as check patella functions such as tracking, mobility, and normal anatomical features should be assessed.2–4 This research focuses on patellofemoral stability and mobility. Stability of the patellofemoral joint involves active and static stabilizers that control movement of the patella within the trochlea groove, known as patellar tracking, that are affected by stabilizing forces such as the patellar tendon, quadriceps tendon, and the nearby soft tissues such as iliotibial band. Loads on the patella during walking vary between one third and one half of body weight, approximately three times the body weight during walking up stairs, and with squatting reach up to seven times the body weight. Therefore, the possible causes of anterior knee pain must be understood to determine an adequate treatment.4