Static Postural Variables and Patellofemoral Pain in Females

Female participation in athletic activities continues to rise. Mirroring this rise in activity is an increase in injuries to these participants. Patellofemoral dysfunction is a common, chronic, debilitating disorder among this group. Despite its common occurrence, patellofemoral pain is often misdiagnosed and not properly addressed during rehabilitation. Excess quadriceps (Q) angle and foot pronation have long been suspected to be predisposing factors for patellofemoral pain in females. Other static postural deviations such as knee recurvatum and anterior pelvic tilt have been shown to affect the biomechanics of the lower extremity, altering such variables as Q angle, foot pronation and rotatory status of the tibia. This leads one to question the contribution of static posture to patellofemoral pain pathology. The purpose of this study is to examine the postural variables of Q angle, foot pronation, recurvatum, and anterior pelvic tilt in an attempt to clarify our understanding of patellofemoral pain in females. A total of 49 subjects were used for this study. Twenty-eight females (36 symptomatic knees) with diagnoses or signs and symptoms directly relating to patellofemoral dysfunction were assigned to the patient group. This was further divided into subset groups: unilateral and bilateral dysfunction. Twenty-one additional asymptomatic females (62 asymptomatic knees) were used as a control. Subject groups were evaluated for Q angle, foot pronation, knee recurvatum, and anterior pelvic tilt. A Student\u27s t-test was employed to analyze the variable significance with respect to patient versus control groups. A Pearson R was used to analyze correlation between variable and patient group. The data analyses failed to show any statistically significant findings to suggest a relationship or correlation between each of the individual variables and patellofemoral pain. It was theorized by the researcher that failure of these hypotheses was due to multiple possible scenarios. Perhaps the most important issue was difficulty measuring the biomechanical variables as evidenced by reproducibility with prior data. These individual factors may also overlap to the degree that one individual factor is not a significant enough causative factor; however, with contribution of other factors, patellofemoral pain is provoked. It has also been theorized that further studies including intrinsic factors of trochlear congruence, patellofemoral contact pressures, and dynamic measures (such as valgus moment, quadriceps timing, and activation) need to be addressed