Patellofemoral joint pain: Macro versus micro pathology
Patellofemoral joint pain is a challenging and well-recognised clinical condition with associated poor long term treatment outcomes. The onset and persistence of pain and symptoms are located around or posterior to the patella which are irritated by activities such as running, ascending and descending stairs and squatting. Foundational to the condition is its multifactorial aetiologies which, whilst widely acknowledged, the scientific explanation to the source of pain and symptoms remain unclear.
Proposed theories focus on abnormal biomechanics, structure, tissue homeostasis and non-related mechanical factors. An understanding of these theories and contributing factors underpins the approach to clinical assessment and tailored management interventions of patellofemoral joint pain.
The purpose of this lecture is to provide an overview on the theoretical and clinical status of the condition, taking into consideration the proposed theories of aetiologies from a micro and macro pathological viewpoint. This will be supported by practical applications of assessment and effective management strategies for clinical practice.
Chronic ankle instability classification and management
A lateral ankle inversion sprain involves the disruption to one or more of the lateral ankle ligaments and are a common occurrence in athletic and recreational active populations. A significant number of individuals however experience recurrent sprains, symptoms and pain of more than one year post initial sprain. Sensorimotor deficits are key characteristics linked with the persistence symptoms in chronic ankle instability, along with a reduction in strength and range of motion at the ankle, and changes to functional movement patterns. With the complexity of the ankle and chronic nature of the condition, models have been proposed to classify groups and sub-groups of individuals with chronic ankle instability to optimise conservative management and rehabilitation.
This presentation aims to review the anatomy and function of the ankle joint, and mechanism of a lateral ankle sprain. The pathophysiology of chronic ankle instability will also be presented along with proposed classification models that can be used for clinical assessment and management to enable focus on particular deficits in patient sub-groups to minimise the risk of recurrent sprains.