Risk factors

Although patellofemoral pain is a highly prevalent condition in different populations, the etiology of the condition is not completely understood. Therefore, many studies refer to patellofemoral pain as a multifactorial condition, that is, its development is possibly associated with several factors.1,2,3

On this section, you will find information about the risk factors for patellofemoral pain. What factors increase the odds of developing this condition? Are these factors modifiable?

Considering high incidence and prevalence of patellofemoral pain, and evidence indicating high rates of recurrence and chronicity of symptoms, understanding which factors are related to the increased odds of developing patellofemoral pain is the first step towards prevention.3

Over time, several theories have emerged to explain the development of patellofemoral pain and the possible risk factors for the condition, including biomechanical alterations, overload of the patellofemoral joint and non-mechanical (psychosocial) factors.4 Two recent systematic reviews3,5 investigated more than 100 potential variables to identify risk factors for the development of patellofemoral pain. However, only two variables were identified as risk factors, suggesting their influence on the development of patellofemoral pain:

  • Reduced knee extensor torque in the military population
  • Increased hip abductor torque in the adolescent population

In addition, several other variables were investigated and not considered risk factors for patellofemoral pain, including age, height, body mass, body mass index (BMI), percentage of body fat, Q-angle, and torque of the hip muscle and hamstrings.

It is important to emphasize that the evidence found is predominantly in the population of military personnel, runners and adolescents. Therefore, more studies are needed to identify possible risk factors for patellofemoral pain in other populations, such as the general population.

Watch the video below with Dr. Bradley Neal, answering the most common questions about this topic [COMING SOON]:

Now that you have reviewed everything about the risk factors for patellofemoral pain, test your knowledge by taking the quiz below.

References

  1. Willy et al. 2019. Patellofemoral Pain Clinical Practice Guidelines Linked to the International Classification of Functioning , Disability and Health From the Academy of Orthopaedic Physical Therapy. 
  2. Powers et al. 2017. Evidence-based framework for a pathomechanical model of patellofemoral pain: 2017 patellofemoral pain consensus statement from the 4th International Patellofemoral Pain Research Retreat, Manchester, UK: part 3. 
  3. Neal et al. 2019. Risk factors for patellofemoral pain: a systematic review and meta-analysis. 
  4. Lack et al. 2018. How to manage patellofemoral pain – Understanding the multifactorial nature and treatment options. 
  5. Lankhorst et al. 2012. Risk factors for patellofemoral pain syndrome: a systematic review.