In order to better understand the way patellofemoral braces work it is important to understand the anatomy and function of the knee and the knee cap (patella). Please review the sections on knee anatomy and patellofemoral pain prior to reviewing this section.
The knee cap (patella) is a small bone in the front of the knee. It glides up and down a groove in the thigh bone (femur) as the knee bends and straightens. The patella has a smooth coating (articular cartilage) on its underside, which allows it to slide easily in this groove. The groove in the femur is called the femoral groove and it is also coated with articular cartilage. The patellar tendon is a thick, ropelike structure that connects the bottom of the patella to the top of the large shinbone (tibia). The powerful muscles on the front of the thigh, the quadriceps muscles, straighten the knee by pulling at the patellar tendon via the patella. One of the quadriceps muscles, the vastus medialis, pulls the patella inward (medially). Another quadriceps muscle, the vastus lateralis, pulls the patella outward (laterally). There are also smaller rope like structures (ligaments) on the inner (medial) and outer (lateral) sides of the patella. These small ligaments work with the quadriceps muscles to help keep the patella in the centre of the femoral groove.
Patellofemoral pain describes the location of the pain but not its cause. Overuse ("too much, too soon") or previous injuries to the knee are common causes of patellofemoral pain. Biomechanical factors such as poor tracking of the patella in the femoral groove, flat (pronated) feet, weak inner thigh muscles and tight outer thigh muscles and/or ligaments can also cause patellofemoral pain. Sometimes "wear and tear arthritis" (osteoarthritis) or damage to the articular cartilage (chondromalacia) on the back of the patella causes the pain but in most cases of patellofemoral pain the knee joint is normal.
The treatment of patellofemoral pain depends on it's cause and may include stretching and strengthening exercises, relative rest, icing, medication, foot orthotics and bracing with a patellofemoral brace. In rare cases surgery is required.
There are many different types of patellofemoral braces available. They are usually made of neoprene and many have straps or pads (buttresses) that help keep the patella in place. The buttress can be adjusted but it is usually placed laterally to push the patella inwards (medially). Patellofemoral braces come in a variety of sizes with or without hinges for additional support. The effectiveness of a patellofemoral brace depends on a correct fit and use.
Patellofemoral braces have some drawbacks. Some people report that they are hot, cumbersome and sometimes the brace material can irritate the skin. Patellofemoral braces can also be expensive. Furthermore, patellofemoral braces do not always work. Sometimes they do not improve patellofemoral pain. However, when patellofemoral braces are fitted properly and when used in conjunction with a general knee rehabilitation program these braces can serve a role in the treatment of patellofemoral pain.
In summary, patellofemoral braces should be considered in the treatment of patellofemoral pain. Doctors and physiotherapists who are skilled in treating patellofemoral pain can advise whether a brace would be helpful and how to get the correct brace.
Please visit the links section for additional information on patellofemoral braces. Links have been provided to other websites as well as online medical journals. Other knee injury topics can also be accessed.