The Vancouver bobsled: cool patellofemoral runnings.

In September 2013, Vancouver hosted the International Patellofemoral Pain (PFP) Research Symposium, where the best experts presented and debated the latest developments in this area. In the same city the unforgettable 2010 Winter Olympics took place, which included the bobsled competitions in Whistler. The link between these two events is that patellar tracking on the femoral trochlea is often compared with a bobsled within the ice track. The traditional view is that the patella/bobsled is unstable within the trochlea/track. However, the research at the symposium demonstrated that the patella is influenced by the position of the femur and ‘follows’ its orientation. To illustrate this, dynamic valgus and femoral internal rotation at the knee pushes the patella laterally, stressing the medial structures and potentially leading to PFP. These biomechanical changes in turn can affect many soft tissues (capsule, ligaments, tendons, muscles and fascia) that may be the source of the pain.