Patellofemoral Pain in Young Adults: Tissue Homeostasis, Soft Tissue Flexibility, and Treatment

"Patellofemoral pain (PFP) is a prevalent knee condition with multimodal exercise therapy being the cornerstone of conservative treatment strategies, though long-term outcomes remain suboptimal. This thesis investigates PFP through the lens of the "homeostasis model," hypothesizing that impaired patellar hemodynamics due to vascular insufficiency contributes to the condition. Near-Infrared Spectroscopy (NIRS), a non-invasive optical method, was employed to assess patellar bone hemodynamics, marking its first application in PFP research. Chapter 2 established the reliability of a NIRS protocol for "Prolonged Sitting" and "Stair Descent" in PFP patients and controls, with moderate-to-excellent intraclass correlation coefficients (ICCs). Chapter 3 revealed that PFP patients exhibited reduced changes in (de-)oxygenated hemoglobin concentrations, suggesting impaired patellar hemodynamics. Future studies should target patients experiencing pain during prolonged sitting (PDPS), as Chapter 4 found PDPS affects 73% of PFP patients and correlates with lower functional scores.