Patellofemoral dysfunction in tennis players. A dynamic problem.
Our mechanically-based dynamic approach to PFD focuses on immediate alteration of symptoms during functional activities. This approach and this article focuses on mechanically-based PFD. The athlete benefits from this approach because if symptom alteration is successful, activity modification may not be necessary. The success of our ability to alter symptoms is an excellent indicator of the athlete's rehabilitation prognosis. Although remaining active is an immediate benefit to the athlete, this program focuses on correction of mechanical faults and musculoskeletal imbalances in an attempt to permanently eliminate symptoms. As noted, diagnosis of PFD is relatively easy to determine, whereas treatment often is both controversial and frustrating. To date, the authors have had great success treating tennis players and other athletes with this approach. We believe that our success rate is an indicator of the value of this program. A standardized yet adaptable approach to treatment and follow-up is recommended to understand the natural course and long term prognosis of these athletes. As we continue to investigate this problem it is clear that there are many unanswered questions about PFD. Many of these questions could be more easily answered if an objective way to classify PFD can be developed, as well as a way to evaluate, treat, and follow-up PFD on a long-term basis. The authors are confident, however, that this functional approach provides a simple and dynamic way to rehabilitate athletes with PFD.