Relação entre alterações musculoesqueléticas do complexo tornozelo e pé e a ocorrência da síndrome da dor patelofemoral: uma revisão da literatura

Abstract

Patellofemoral Pain Syndrome has demanded concerns and challenges for Orthopedic and Sports Physical Therapy because of the high incidence and diversity risk factors that involve this pathological condition. Ankle and foot biomechanical changes may be responsible for influencing knee mechanics. Structural disorders in these segments can cause dynamic valgus that contributes to the inadequate positioning of the patella. The objective of this work was to investigate musculoskeletal alterations of the ankle and foot complex in the occurrence of PFPS. This is a bibliographical review, carried out based on searches in the eletronic databases of Physiotherapeutic Evidence (PEDro) and Medline (via PubMed). Seven articles on the relationship between musculoskeletal changes of the anklefoot complex and the occurrence of PFPS were found in the databases consulted. The ankle plantarflexor muscles together with the foot interosseus contribute to good joint positioning and alignment of the ankle and foot. Alterations provided in these segments can alter bone positioning and contribute to the navicular drop. Thus a disorder of these muscles such as shortening and / or weakness, may result in excessive pronation of the subtalar joint, which may predispose the medial rotation of the tibia. Rotational shifting of the tibia also contributes to the inadequate positioning of the patella, with consequent increase of the abnormal compressive forces in patellofemoral join. Intervention programs should be directed at correcting SDPF related changes due to the variety of modifiable factors in the occurrence of this pathological condition.