Definition of Patellofemoral Pain Syndrome
Patellofemoral pain syndrome is a medical term used to describe pain in the front of the knee around the kneecap, also known as the patella. It has been described as “runner’s knee” and is common in those who bike, hike and sit for long periods during the day. It is more common in women. Younger patients who participate in sports are at increased risk of developing this condition.
Symptoms
This condition usually causes a vague dull pain in the front of the knee. It is usually aggravated by going down more than up stairs, sitting for long periods of time, kneeling and squatting.
Causes
Overuse or repetitive activity such as running and jumping can precipitate patellofemoral pain. Structural bony anatomy as well as muscle weakness may cause malalignment of the kneecap along the underlying bones and predispose patients especially females to patellofemoral pain syndrome. In most instances, there is not a history of trauma, but occasionally this pain may occur after a direct blow to the patella.
Diagnosis
Patellofemoral pain syndrome is usually a diagnosis of exclusion after ruling out other knee pathologies. A complete history and physical examination will help your doctor to consider the possible reasons for your anterior knee pain. Initial workup includes weightbearing knee x-rays as well as a special patellar view.
Treatment
Initial treatment is usually started with activity modification or relative rest. Physical therapy is a mainstay of treatment and is directed to quadriceps and hip strengthening with stretching of other muscle groups in an effort to improve the biomechanics of knee motion. Relief may be found with bracing including a neoprene sleeve with a central cut out to stabilize the kneecap. Another type of brace that may help is a patellar tendon strap, which may relieve pressure from the front of the knee. Patients may also benefit from short-term use of acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs). Surgery is rarely indicated.
References
- Micheo et al. patellofemoral syndrome. https://now.aapmr.org/patellofemoral-syndrome/
- Heijden et al. exercise for treating patellofemoral pain syndrome. Cochrane database of systemic reviews 2015.