14.5.1 Lateral tracking
An essential cause of the mal tracking, of the patella is determined by an imbalance between the dierent
heads of the quadriceps muscle.
A particularly significant weakness of the vastus medialis in comparison with the vastus lateralis creates
a lateral displacement of the patella with hyperpressure between the lateral condyle and the adjacent
retropatella surface.
Specific reinforcement of the vastus medialis is the ideal way to treat this pathology.
It can be enhanced eectively with electrostimulation.
14.5.1.1 Protocol
Weeks 1 – 2: Patellofemoral syndrome Level 2
Weeks 3 – 4: Patellofemoral syndrome Level 3
If the patient is experiencing associated pain symptoms, TENS stimulation can be performed in addition on
the other channels.
In this case, the specific practical rules for TENS (electrode placement, regulation of intensity) should be
followed for each channel used for this purpose.
14.5.1.2 Treatment frequency
Three sessions per week.
14.5 Treatment of patellofemoral syndrome
A distinction must be made between two types of patellofemoral syndrome:
1. With patellar mal tracking, which means the patella is not running centrally in the trochlear groove,
commonly being pulled laterally.
2. Without patellar mal tracking, i.e. with a centred patellofemoral syndrome, as in post-traumatic
chondropathy.
The proposed protocols are based mostly on the studies carried out by Dr. Gobelet (University Hospital
of Lausanne, Switzerland, Physical Medicine Department) and by Dr. Drhezen (College of Physiotherapy,
Liège, Belgium).
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