Abstract
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Highlights
• Foot pronation causes faulty joint coupling, including tibia internal rotation and hip internal rotation.
• Faulty joint coupling increases the patellofemoral joint reaction force.
• Distal approaches correct the faulty joint coupling.
• Correction of faulty joint coupling reduces patellofemoral joint reaction force and pain.
Plain Language Summary
The foot and ankle play an important role in the patellofemoral pain etiology. Foot pronation through joint coupling causes tibia internal rotation along with hip internal rotation. As a result, the patellofemoral joint reaction force in-creases. Distal approaches by correcting foot pronation cause normal joint coupling of the lower limb. As a result, the patellofemoral joint reaction force decreases and subsequently reduces the pain. Distal approaches along with proximal interventions can be effective in the clinical symptoms of patients with patellofemoral patients.