Knee pain (part 2) by Charles Alexander, DPT, PT
by jessicag, March 19, 2019
One of the main contributions to PFJ pain are posture problems. Postural deficits include pes planus or flat foot, tibial torsion, femoral anteversion, or a greater q-angle. Having a flat foot can cause issues to arise at the knee or the hip. With the knee in mind, a flat foot will cause the knee to come toward midline (toward your stomach). This movement causes the kneecap to go toward the outside and have increased pressure into the joint behind it.
Tibial torsion is another posture concern that refers to the lower part of the leg which is made of the tibia and fibula. If the tibia rotates it will change the alignment of where the kneecap rests within the patellofemoral joint causing increased repetitive compression to the area. Femoral anteversion is another posture deficit that refers to the position of the femur in correlation to the acetabulum or hip. With femoral anteversion the femur is anteriorly rotated and will typically result in compensations in the foot coming in (this means you look pigeon toed). The compensation will result in increased compression of the kneecap.
One final postural deficit could include the q-angle. Q-angle refers to the angle of the hip to the knee. Typically women will have a greater q-angle for the purposes of giving birth. Having a posture with wider hips often causes the knees to fall on the inside and will increase pressure on the posterior knee cap. All of these posture deficits may be difficult to identify on your own, but knowing if your posture is the cause of your pain is one of the first steps to finding relief.
Stay tuned for more information!