Information From Your Health Care Provider

PATELLOFEMORAL PAIN SYNDROME

Basic information

description

Patellofemoral pain syndrome (PFPS) is a common cause of pain in the front (anterior) of the knee. The name refers to the knee joint that includes the patella (kneecap) and the femur (thigh bone). It can affect just about anyone. It occurs more often in physically active people (e.g., runners) and those under age 40.

FREQUENT SIGNS & SYMPTOMS

Pain that usually comes on gradually and may be under, behind, or around the kneecap. It can affect one or both knees. The pain may be described as aching, dull, sharp, shooting, or burning. It may last a few minutes, hours, or be chronic.
Pain may occur during and after physical activity or when going up and down (more likely) steps or hills.
Pain may occur with long periods of sitting with bent knees (e.g., watching a movie or airplane trip) or when kneeling or squatting.
There may be a feeling that the knee might give out from under you or the knee may lock up.
Other symptoms can include popping, clicking, or grinding sounds, or snapping sensation in the knee.

causes

The exact cause for patellofemoral pain is unclear. It is likely due to an imbalance in muscles, bones that are not aligned the right way, and overuse of the knee joint.

risk increases with

Overtraining or overuse in a sports or fitness activity (too much, too soon, or too fast).
Injury (such as from a fall).
Prior knee surgery (such as for torn ligament).
Some people are born with slightly misaligned bones or imbalanced muscles and may be more at risk. There is no simple and sure method to identify who may have these conditions and be at risk.

PREVENTIVE MEASURES

In many cases, it cannot be prevented.
You can reduce your risks. Stay in shape. Increase a new sport or fitness activity gradually. Use proper form for the activity and use or wear proper gear. Replace running shoes on a regular basis. Vary your workout intensity. Cross-train with a low impact activity.
Arch supports or shoe inserts (foot orthotics) may be of help in some cases. Ask your health care provider.

expected outcomes

Most symptoms of patellofemoral pain clear up with time and treatment. It may take weeks or months.

possible complications

Rarely, surgical treatment may be needed.
Patellofemoral pain may recur or become chronic.

diagnosis & treatment

general measures

Most often, your health care provider can diagnose PFPS during an office visit. Questions will be asked about your pain symptoms, physical activities, and your medical history. Your knee and the muscles of your leg will be examined. You may be asked to stand, sit, walk, jump, squat, lie down, or do other leg motions to see how the knee is functioning. In some cases, x-rays and other imaging studies are done to check for any knee damage or rule out other knee disorders.
There is no quick cure for the pain. Your health care provider will discuss a treatment plan with you. It depends on any physical problem found (such as weak muscles), severity of pain, your age and health, and your normal level and type of physical activity.
For self-care, icing the knee (for 10-15 minutes, 4-6 times a day) can help relieve pain.
You may be instructed about exercises to do at home.
In some cases, a knee sleeve or brace, taping of the knee, or shoe inserts (orthotics) may be used.
Rarely, surgery may be an option if pain persists.

medications

Nonprescription pain drugs may be used as needed or as instructed by your health care provider.

activity

Avoid any activity that worsens the pain for you.
You may be advised to stop or decrease your sports or fitness activities (such as running). Try low impact exercises (e.g., swimming or elliptical machine). Slowly resume your previous activity once pain eases up.
Physical therapy may be prescribed. It can help improve muscle strength and flexibility.