Patellofemoral Pain Syndrome

Patellofemoral pain syndrome is pain in the front of the knee. It frequently occurs in teenagers, manual laborers and athletes. It is sometimes caused by wearing down, roughening or softening of the cartilage under the kneecap.

Patellofemoral pain syndrome may be caused by overuse, injury, excess weight, a kneecap that is not properly aligned (patellar tracking disorder) or changes under the kneecap.

The main symptom of patellofemoral pain syndrome is knee pain, especially when you are sitting with bent knees, squatting, jumping or using the stairs (especially going down stairs). You may also experience occasional knee buckling, in which the knee suddenly and unexpectedly gives way and does not support your body weight. It is also common to have a catching, popping or grinding sensation when you are walking or moving your knee.

Your doctor will conduct a medical history and physical exam to determine the cause of your pain. In some cases, imaging tests including X-rays or an MRI may be done. These tests allow a doctor to view the tissues inside your knee and rule out damage to the structure of the knee and connected tissues.

Patellofemoral pain syndrome can be relieved by avoiding activities that make symptoms worse. Some recommendations include:

• Avoid sitting, squatting or kneeling in the bent-knee position for long periods of time.
• Adjust a bicycle or exercise bike so the resistance is not too great and the seat is at an appropriate height. You should be able to spin the pedals of an exercise bike without shifting weight from side to side, and your legs should not be fully extended at the lowest part of the pedal stroke.
• Avoid bent-knee exercises, such as squats or deep knee bends.

Other methods to relieve pain include:

• Taking non-prescription anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, to decrease swelling, stiffness and pain. Be safe with medicines. Read and follow all instructions on the label.
• Ice and rest. Alternatively, you can also try heat to see if it helps.
• Physical therapy exercises, such as stretching to increase flexibility and decrease tightness around the knee, and straight-leg raises and other exercises to strengthen the quadriceps muscle.
• Taping or using a brace can help stabilize the kneecap.
• Surgery may be recommended in some cases.