Nicole Redman Physiotherapists 
DISCUSSION
PATELLOFEMORAL PAIN SYNDROME AND EXERCISES
The knee joint is capable of bearing weight and producing a wide range of movement - therefore it plays an important role in activities and weight support. Patellofemoral pain syndrome (PFPS) is a common disorder, characterised by pain located at the front of the knee. The exact cause has not been clearly defined yet.

Various exercises have been ised in PFPS, all influencing stress in the patellofemoral joint in different ways. The aim of a study by Lee et al in 2016 was, to investigate the effects of squat exercises with various tools such as a gym ball, wedge and an elastic band. 

Previous studies have reported that abnormal tracking (movement of the knee cap) causes PFPS because there is an imbalance between the muscles of the inner thigh (vastus medialis obliquus - VMO) and the outer thigh (vastus lateralis - VL). There is less activity of the VMO relative to VL. Various exercises have been reported to aid in reducing the problems caused by PFPS,such as closed chain kinetic exercises such as squats. These exercises can influence the stress in the patellofemoral joint. 

In the study all subjects performed 4 types of squat exercises: the conventional squat exercise, the squat exercise with a gym ball, the squat exercise with a wedge and with an elastic band. All of the exercises were compared and evaluated to see which was most effective. The study showed more muscular activity with a wedge than elastic band. 

The study concluded that closed chain  exercises for the quadriceps (standing exercises) were more effective than other exercises. 

This highlights the efficacy of our current treatment protocols as a practice for PFPS!