The beating heart of the conventional wisdom about patellofemoral pain is mostly nonsense.
The idea of patellofemoral tracking syndrome is that the kneecap may not slide evenly as your knee flexes and extends, because of muscular control and/or a variety of other vague and unconfirmed structural problems, especially the idea that the connective tissues on the side of the knee are “tight.”
|The idea of bad patellar tracking is important (even if the reality isn’t)|
Understanding patellar tracking matters. It matters because, if you don’t know better, your therapy dollars will get spent — and quite possibly wasted — on fixing tracking problems. PFTS is the reason and the target for most treatment recommendations for patellofemoral pain.
Alleged tracking problems are why physiotherapists will prescribe a variety of specific exercises, iliotibial band stretches, and knee taping. It is why doctors prescribe knee braces and straps. It is also why surgeons will cut up the side of the knee or move the attachment of your quadriceps, where it pulls on the shin. It is why massage therapists will work hard on the side of your thigh, and why chiropractors inevitably “adjust” your pelvis. And yet all of this therapeutic enthusiasm is a little dubious, because the only clear thing about tracking problems is that their relationship to PFPS is not clear, the list of problems with diagnosing tracking problems is long, starting with the fact that some studies simply haven’t found a tracking problem in PFPS patients.
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Patellofemoral Pain & the Vastus Medialis Myth in Painscience.com