Static malalignment includes dysfunctions while the patient is not moving. A
common link to patellofemoral pain is the Q angle or the angle formed by the intersection
of a line connecting the anterior superior iliac spine to the center of the patella and
another line connecting the tibial tuberosity to the center of the patella. A greater Q
angle is theorized to increase lateral forces on the patella which may therefore cause
improper patellar tracking [30]. Factors thought to lead to increased Q angles include
femoral anteversion, genu valgum and external tibial torsion. Although females
typically have greater Q angles and higher incidences of PFPS than males, there are
inconsistent findings linking Q angles to PFPS [22, 27]. In addition to the Q angle,
hyperpronation of the foot may be a causative factor involved in PFPS in which
limitations to tibial external rotation leads to femur internal rotation and therefore
potentially more lateral patellar forces [31, 32].