What is patellofemoral pain syndrome?
Patellofemoral pain syndrome is an umbrella term for pain under or around the patella (kneecap). It is also called PFPS or runner's knee. Commonly seen in athletes, patellofemoral pain syndrome can worsen with running, jumping, kneeling, squatting, climbing stairs, or sitting for extended periods.
PFPS is mainly seen in athletes, especially younger athletes. Females tend to experience the issue at a greater rate than males.
The cause of patellofemoral pain syndrome can't always be identified, but knee alignment or gait may contribute to the pain. Treatment includes resting, icing, and managing discomfort.
What are patellofemoral pain syndrome symptoms?
Pain around the kneecap is the most common symptom of patellofemoral pain syndrome. The pain can develop over time and increases with activity, especially when bending the knee, sitting for an extended period, or performing actions on hard surfaces.
Along with pain, some patients have a tender kneecap and experience a rubbing or clicking of the kneecap during movement.
If you're experiencing knee pain, request an appointment with a sports medicine specialist at Mass General Brigham for a complete diagnosis and customized treatment plan.
What causes patellofemoral pain syndrome?
Anatomy and activity can both play a role in developing patellofemoral pain syndrome.
Anatomical causes of patellofemoral pain syndrome
PFPS can be caused by problems with kneecap alignment, a kneecap too high in the knee joint, weak thigh muscles, tight hamstrings, a tight Achilles tendon, weak muscles supporting the knee, and muscle imbalances. When the knee moves inward or outward during movements, pain increases.
Risk factors for patellofemoral pain syndrome
Females are twice as likely to experience PFPS. Athletes playing on hard surfaces and using improper footwear may be prone to patellofemoral pain syndrome. A kneecap injury can also be a risk for developing PFPS. Children and young adults more commonly experience pain from patellofemoral pain syndrome.
How to diagnose patellofemoral pain syndrome
A provider's patellofemoral pain syndrome diagnosis will generally include a physical examination and imaging technology.
The physical examination will include questions about the extent of pain and tenderness. The provider will also perform movement testing to evaluate pain, range of motion, and stability.
An X-ray and a magnetic resonance imaging (MRI) scan can rule out other bone and soft tissue conditions.
Patellofemoral pain syndrome treatment
At-home treatments are most common for patellofemoral pain syndrome. The RICE method—rest, ice, compression, and elevation—can help ease pain. Resting the injury may be enough to diminish PFPS symptoms. Your provider may also advise you to reduce running, jumping, moving up and down stairs, and squatting.
Physical therapy can help improve knee strength, alignment, and strength in the muscles around the knee. Some patients may benefit from orthotics to help with alignment and reduce stress on the knee.
Providers typically suggest over-the-counter medications to help treat patellofemoral pain.
Surgical patellofemoral pain syndrome treatment
Surgery for patellofemoral pain syndrome is typically required only in extreme cases. If an MRI reveals cartilage damage around the kneecap, arthroscopic surgery may help alleviate pain. In the most severe circumstances, surgical realignment of the kneecap can help end pain through proper alignment.
Living with patellofemoral pain syndrome
Not treating patellofemoral pain syndrome can lead to increased pain and the potential for additional damage to the knee. Typically, at-home treatments provide relief for patellofemoral pain syndrome. Activities that cause pain should be avoided or modified.
How to prevent patellofemoral syndrome
You may not be able to prevent PFPS, but you can reduce the risk. Work with a trainer to ensure your body is properly aligned during activities. Training can also strengthen leg muscles to increase stability and prevent injury.
Additional prevention tips include:
- Maintain a healthy weight
- Warm up properly before exercise
- Stretch leg muscles
- Wear proper footwear
- Reduce stress on the knee by avoiding deep squats
- Ensure the proper technique for all athletic activities
FAQs
Proper treatment can significantly reduce the symptoms associated with patellofemoral pain syndrome, if not entirely eliminate them.
If you feel pain in and around the kneecap or near the front of the knee and pain increases with at-risk activities, there is a higher probability of patellofemoral pain syndrome.
The first course of treatment for patellofemoral pain syndrome is rest, so modify your exercises to prevent stress on your knee joint that causes pain.
No, an X-ray is best for showing images of the bones, but an X-ray can rule out other causes of knee pain.
A provider will suggest ice for pain management, especially with patellofemoral pain syndrome.
A knee brace or support can help alleviate pain. A brace may provide additional support for the kneecap or help with the kneecap's alignment.
A typical case of patellofemoral pain syndrome can take four to six weeks to heal, but more extreme cases may take many months.
