The E3 Rehab Podcast 220. Patellofemoral Pain: A Practical Guide w/ Marc Surdyka and Chris Hughen
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Sep 30, 2025 In this engaging discussion, clinician and educator Marc Surdyka shares insights on patellofemoral pain, revealing why common terms like 'chondromalacia patella' can be misleading. He emphasizes the importance of personalized prognosis and debunks risky beliefs about foot anatomy and body mechanics. Surdyka presents effective management strategies, including tailored exercise progressions and the use of foot orthoses. Tune in for practical advice on navigating this common issue and improving patient outcomes!
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What Patellofemoral Pain Actually Is
- Patellofemoral pain describes diffuse, non‑traumatic pain where the kneecap meets the thigh bone, often with activities that load the quadriceps.
- Symptoms include squatting, running, stairs, kneeling, and prolonged sitting ("movie theater sign").
Ditch 'Chondromalacia' Labels
- Avoid using terms like chondromalacia patellae because imaging findings don't change management or prognosis for most patients.
- Imaging is not required for diagnosis and labeling cartilage 'softening' may create unnecessary worry.
Treat It As A Diagnosis Of Exclusion
- Patellofemoral pain is a diagnosis of exclusion; test and rule out other anterior knee sources like patellar tendinopathy, Hoffa's fat pad, OA, or referred pain.
- Age and trauma history help guide differential diagnosis and further workup.