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. 2022 Jul 28;19(15):9241.
doi: 10.3390/ijerph19159241.

Patellofemoral Pain Syndrome Risk Associated with Squats: A Systematic Review

Pablo Monteiro Pereira  1 , João Santos Baptista  1 , Filipe Conceição  2 , Joana Duarte  1 , João Ferraz  1 , José Torres Costa  3
Affiliations

Patellofemoral Pain Syndrome Risk Associated with Squats: A Systematic Review

Pablo Monteiro Pereira et al. Int J Environ Res Public Health. .

Abstract

Patellofemoral pain syndrome (PFPS) is highly prevalent; it can cause severe pain and evolve into progressive functional loss, leading to difficulties performing daily tasks such as climbing and descending stairs and squatting. This systematic review aimed to find evidence, in the literature, of squat movements that can cause or worsen PFPS. This work was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, and its protocol was registered in PROSPERO (CRD42019128711). From the 6570 collected records, 37 were included. From these 37 articles, 27 present a causal relationship between knee flexion and PFPS, 8 describe a relationship, considering the greater existence of muscle contractions, and one article did not describe this relationship in its results. The main limitations stem from the fact that different studies used different evaluation parameters to compare the force exerted on the patellofemoral joint. Furthermore, most studies are focused on sports populations. After analysing the included works, it was concluded that all squat exercises can cause tension overload in the knee, especially with a knee flexion between 60° and 90° degrees. The main causal/worsening factors of PFPS symptoms are the knee translocation forward the toes (on the same body side) when flexing the knee, and the muscle imbalance between the thigh muscles.

Keywords: PFPS; anterior knee pain; chondromalacia; musculoskeletal disorder; patellofemoral; prevention.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
PRISMA Flow diagram of the research [29].
Figure 2
Figure 2
Types of exercise studied in the selected works.
See this image and copyright information in PMC

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