APPENDIX A.
Movement System Impairment (MSI) Syndromes Associated with Knee Pain (Harris-Hayes, Sahrmann, Norton, and Salsich, 2008)
| Movement System Impairment Syndrome | Description of Syndrome | General Location of Symptoms |
|---|---|---|
| Tibiofemoral Rotation Syndrome | Impaired rotation of the tibiofemoral joint, including either excessive medial rotation of the femur or lateral rotation of the tibia. Can be associated with either varus or valgus deformity | Pain with located on the joint line of the knee with tibiofemoral rotation in weight-bearing or non weight-bearing. |
| Patellar Tracking Syndrome | Impaired alignment or tracking of the patella within the trochlear groove of the femur | Pain is located in the anterior knee either in a peri-patellar or retro-patellar distribution |
| Tibiofemoral Hypo-mobility | Limitation in the physiological range of motion of tibiofemoral joint. Could either results from degeneration or prolonged immobilization | Deep joint pain that will increase with weight-bearing and decrease with rest. Pain is also associated with stiffness |
| Knee Extension Syndrome | Dominance of the quadriceps muscle produces an excessive pull on the patella, the patellar ligament, and/or the tibial tubercle | Pain is located in either the supra- or infra- patellar tendon, particularly with activities that require knee extension |
| Knee Hyperextension | Impairment of the knee extensor mechanism, including dominance of the hamstrings and/or poor functional performance of the quadriceps. Result in prolonged knee hyperextension. | Pain can be located at the joint line of the tibiofemoral joint (anterior or posterior), the infrapatellar tendon, or anterior around the patella |
| Tibiofemoral Accessory Hyper-mobility | Excessive motion/laxity at the tibiofemoral joint. May have a history of an ACL/PCL injury | May not have pain. Most common complaint is a feeling of instability or “giving way” |
| Tissue Impairment Syndrome | Tissue injury/impairment that can occur in the absence of a movement impairment syndrome or secondary to an acute trauma or surgery | Pain varies in location and is associated with the structures of the knee involved with the trauma/injury or surgery |