Patellofemoral pain syndrome

Patellofemoral pain syndrome is a condition involving pain originating from the patellofemoral joint. That is, the joint between the patella (kneecap) and the femur (thigh bone). Patellofemoral pain syndrome is a common diagnosis, particularly in the field of sports medicine.

What does patellofemoral pain syndrome feel like?

People with patellofemoral pain syndrome will often feel generalised pain around the knee, usually under and around the kneecap. The pain can get worse with activities such as sports, walking, climbing stairs, or after sitting for a long time with the knees bent. Pain may be present in one or both knees. There may be mild swelling, however swelling is not a significant symptom of this condition.

What causes patellofemoral pain syndrome?

The exact cause of patellofemoral pain syndrome is not clear, however it is thought to be related to abnormal forces on the patellofemoral joint that affect the way the kneecap (patella) tracks through the groove of the thigh bone (femur).

The condition is more common in athletes (such as runners or basketball players) and in people who have “knock-knees” (an increased angle of genu valgus). Over-pronation or rolling in of the feet can increase internal rotation of the leg which can also be a factor in the development of patellofemoral pain.

Secondary causes of patellofemoral pain syndrome include injury to the knee (such as a strain or fracture injury) and knee arthritis. People with patellofemoral pain syndrome may also have associated weakness in the hip muscles (eg, gluteus medius).

How is patellofemoral pain syndrome treated?

Initial treatment for patellofemoral pain syndrome includes rest from aggravating, high impact activities. Ice and anti-inflammatory medication can also be helpful to reduce inflammation.

Stretching and strengthening exercises may be prescribed to optimise the forces acting on the patellofemoral joint. For example, quadriceps strengthening can assist with stabilising the patella, while stretching of muscles around the hip, hamstring, and calf can reduce tightness that may be adversely impacting biomechanics of the patellofemoral joint. If muscles around the hip are found to be weak then exercises to help strengthen these muscles may be recommended.

Orthotics and appropriate stabilising footwear can improve arch support and reduce abnormal motion of the feet (such as overpronation or rolling in of the feet). This in turn improves biomechanics of the lower limbs, reducing stress on the knees.

Early treatment for patellofemoral pain syndrome is recommended to prevent future complications.

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