Key Points about Patellofemoral Pain Syndrome

  • The primary symptom of patellofemoral pain syndrome is pain in and around the kneecap, which may worsen during physical activity.
  • The most common causes of patellofemoral pain syndrome include:
    • Overuse of the knee joints
    • Abnormal tracking of the kneecap as the knee bends
    • Abrupt changes in training routines
    • Equipment
    • Footwear
  • Women, adolescents and people who play sports that stress the knees are at an increased risk of developing this pain.
  • Knee pain can be prevented by wearing proper footwear when you exercise, stretching regularly, warming up before exercising, and adopting exercises to strengthen your quadriceps and hamstrings.

Overview

Patellofemoral pain syndrome is marked by pain in the kneecap area, which is often exacerbated by activities that stress the joints in the knees, such as running, jumping, or squatting. This pain is caused by damage in the kneecap’s cartilage, which can result from overuse or injury.

Treatment generally involves resting the knees by avoiding activities that worsen your pain, taking over-the-counter anti-inflammatories, wearing more supportive shoes, and doing specific physical therapy exercises to strengthen the leg muscles. In more severe cases, your doctor may recommend surgical methods to treat your pain.

Knee pain can often be prevented by stretching regularly, wearing proper footwear when you exercise, warming up before exercise, and maintaining a healthy body weight. 

Patellofemoral pain syndrome causes

While the precise cause of patellofemoral pain syndrome is often not known, contributing factors may include:

  • Overuse of the knee joints, particularly from playing certain sports
  • An injury or trauma that affects the kneecap
  • Weak or imbalanced muscles in the hips and knees
  • Certain knee surgeries

Patellofemoral pain syndrome risk factors

You may be more likely to develop patellofemoral pain syndrome if you:

  • Are an adolescent or young adult
  • Are a woman
  • Play sports that stress your knees, such as sports that involve jumping or running

Patellofemoral pain syndrome symptoms

The main symptom of patellofemoral pain syndrome is knee pain, that may worsen while:

  • Running
  • Jumping
  • Kneeling or squatting
  • Going up or down stairs

Patellofemoral pain syndrome prevention

You can lower your risk of developing knee pain by:

  • Stretching regularly
  • Warming up before you exercise
  • Strengthening your hip and leg muscles to promote balance and alignment
  • Wear supportive and properly fitting shoes

Patellofemoral pain syndrome diagnosis

When assessing knee pain, your doctor will review your medical history and provide a physical examination of the knee and leg.

Your doctor may also order the following imaging tests:

  • X-ray to visualize bones in the knee and leg
  • CT scan to view soft tissues in the knee and leg, in addition to bones
  • MRI scan to create a detailed image of soft tissues and bones

Patellofemoral pain syndrome treatment

The first line of treatment for patellofemoral pain syndrome generally involves:

  • Resting the knees, and avoiding activities that cause or worsen your pain
  • Taking anti-inflammatory medicines such as ibuprofen and acetaminophen
  • Practicing physical therapy exercises, particularly those that strengthen the quadriceps, core and lower back
  • Wearing orthotics, or shoe inserts, to stabilize the lower leg and relieve stress on the knee joints

In rare and severe cases that do not improve with other treatments, your doctor may recommend surgery. Surgical procedures may include:

  • In this procedure, the doctor uses a small camera and surgical instruments that are inserted into the knee joint to either remove damaged tissue, or to re-align the kneecap.
  • Tibial tubercle transfer. In this open surgical procedure, the doctor will move specific tendons in the lower leg to re-align the kneecap.

Next steps

Your doctor will recommend the best treatment measures for your specific case. These recommendations may involve buying more supportive shoes, maintaining a healthy body weight to reduce stress on the knees, or adopting a specific physical therapy regimen.