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Patellofemoral Pain Syndrome Risk Associated with Squats: A Systematic Review.

Pablo Monteiro Pereira1, João Santos Baptista1, Filipe Conceição2

  • 1Associated Laboratory for Energy, Transports and Aeronautics (PROA/LAETA), Faculty of Engineering, University of Porto, 4200-465 Porto, Portugal.

International Journal of Environmental Research and Public Health
|August 12, 2022
PubMed
Summary

Squat movements can worsen patellofemoral pain syndrome (PFPS), particularly with knee flexion between 60-90 degrees. Factors like knee forward translation and thigh muscle imbalance contribute to PFPS symptoms.

Keywords:
PFPSanterior knee painchondromalaciamusculoskeletal disorderpatellofemoralprevention

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Area of Science:

  • Biomechanics
  • Sports Medicine
  • Orthopedics

Background:

  • Patellofemoral pain syndrome (PFPS) is a prevalent condition causing significant pain and functional limitations.
  • Daily activities like stair climbing and squatting can be severely impacted by PFPS.

Purpose of the Study:

  • To systematically review existing literature identifying squat movements that precipitate or exacerbate PFPS.
  • To synthesize evidence on the biomechanical factors contributing to PFPS during squatting.

Main Methods:

  • Systematic review adhering to PRISMA guidelines.
  • Protocol registered with PROSPERO (CRD42019128711).
  • Inclusion of 37 studies from 6570 collected records.

Main Results:

  • A causal relationship between knee flexion and PFPS was found in 27 studies.
  • Muscle contractions were implicated in PFPS exacerbation in 8 studies.
  • Squat exercises can induce knee tension overload, especially at 60°-90° knee flexion.

Conclusions:

  • Knee translocation past the toes during squats and thigh muscle imbalance are primary contributors to PFPS.
  • All squat variations pose a risk for knee overload in individuals with PFPS.
  • Further research is needed to standardize evaluation parameters and include diverse populations.