Patellofemoral pain syndrome refers to pain around the front of the knee related to the patella (kneecap) and femur (thigh bone). The pain may result from overuse, excessive force, or poor tracking of the patella caused by weak or unbalanced muscles.
Damage to the cartilage under the patella or soft tissues around the front of the knee may also cause similar symptoms.
What Is Patellofemoral Pain Syndrome?
Patellofemoral pain most commonly results from improper hip and quadriceps strength, causing the patella to experience abnormal forces that lead to pain and limitations.
Mechanical abnormalities or poor patella tracking may also contribute, particularly in people with significant leg malalignment. Injury to the cartilage surfaces from a patella dislocation or other trauma can also lead to patellofemoral joint pain.
Causes and Risk Factors
Most patellofemoral pain is caused by overuse.
Risk factors include:
- Age and growth
- Obesity
- Chronic instability
- A high-riding patella or poor patella tracking
- Overuse in sports involving running, jumping, or squatting
- Poor leg alignment, including knock knees
- A poorly formed trochlea
- Flat feet
- Previous knee injury or surgery, including patella fracture, dislocation, or cartilage injury
- Muscle weakness from incomplete rehabilitation following surgery or injury
Symptoms
Common signs and symptoms include:
- Knee pain, usually at the front of the knee or behind the kneecap
- Pain that worsens with prolonged sitting
- Pain when rising from a seated position
- Pain when going up or down stairs or hills
- Pain with kneeling or squatting
- Pain when wearing shoes with heels
- Pain with jumping
- Giving way or catching of the knee
- Rare swelling after activity
Treatment
Conservative treatment includes activity modification, physical therapy, medications, and injections.
While it is important to continue using and moving a painful knee, patients should avoid overuse. Keeping activity below the level that causes pain and aggravation can help improve symptoms and prevent further irritation.
Formal physical therapy may help maintain range of motion and strength and promote proper mechanics. Treatment focuses on correcting muscular imbalances of the hip and quadriceps.
Some patients may also find a compressive knee sleeve helpful for comfort and reducing swelling.
Recovery and Outcomes
Patellofemoral pain generally responds well to conservative treatment with activity modification and formal physical therapy. Physical therapy focuses on improving mechanics and correcting muscular imbalances of the hip and quadriceps.
This treatment can provide prolonged relief and allow patients to return to most normal activities.
Potential complications include:
- Recurrent pain
- Impaired balance and strength that may contribute to falls or other injuries
- Increased swelling
- Weight gain and decreased overall health due to reduced knee function
When to See Dr. Chudik
If you are concerned about patellofemoral pain syndrome or your symptoms worsen, schedule an evaluation with Dr. Chudik.
Call 630-324-0402, request an appointment online, or email contactus@chudikmd.com.