What implications does q angle have for patellofemoral problems?

The quadriceps angle (Q angle) is the angle formed by the line of pull of the quadriceps muscle and the line of action of the patellar tendon. It is an important factor in patellofemoral problems, as an increased Q angle can increase the risk of patellar malalignment and instability.

Normally, the Q angle should be between 10 and 15 degrees. When it exceeds 20 degrees, it can lead to patellar malalignment, which can cause pain, discomfort, and instability in the knee. The higher the Q angle, the greater the risk of patellofemoral problems, such as chondromalacia patellae, patellar tendonitis, and even dislocation of the patella.

There are several factors that can contribute to an increased Q angle. These include:

- Wide hips: Wider hips can increase the distance between the quadriceps muscle and the patellar tendon, which can lead to an increased Q angle.

- Weak hip abductor muscles: The hip abductor muscles help to stabilize the hip joint and keep the patella in place. Weak hip abductors can allow the hip to rotate inward, which can increase the Q angle.

- Tight lateral retinaculum: The lateral retinaculum is a band of tissue that runs along the outside of the knee joint. A tight lateral retinaculum can pull the patella to one side, which can increase the Q angle.

- Pes planus: Pes planus, also known as flat feet, can also lead to an increased Q angle. Pes planus causes the foot to roll inward, which can put stress on the knee and lead to patellofemoral problems.

An increased Q angle can be treated with a variety of methods. These include:

- Physical therapy: Physical therapy can help to strengthen the hip abductor muscles and improve flexibility in the tight lateral retinaculum. It can also help to improve the alignment of the knee and reduce the stress on the patella.

- Orthotics: Orthotics are shoe inserts that can help to correct pes planus and improve the alignment of the foot and knee.

- Surgery: In some cases, surgery may be necessary to correct the increased Q angle. This may involve a procedure to release the tight lateral retinaculum or to realign the patella.

If you have patellofemoral problems, it is important to see a doctor to determine if an increased Q angle is the cause. Early diagnosis and treatment can help to prevent further damage to the knee and improve symptoms.