Patellofemoral Pain Syndrome

Patello-femoral pain syndrome is a knee disorder that often affects runners and athletes involved in jumping activities.  Structural alignment, muscular weakness in the knee, overuse, hamstrings tightness and “flat feet” are such causes of patella-femoral pain.  In the case of muscular weakness, this may cause the patella to place itself improperly on the thigh condyles.  All of these knee conditions lead to pain around the patella. This pain tends to worsen with activity (such as going down stairs) and it may also create pain in the sitting position. This intense, dull, aching knee pain may occur in one or both knees.



Patella malalignment

Athlete in jumping

Other terms for patella-femoral pain are: retro-patellar pain, anterior knee pain, and “runner’s knee”.

Different disorders that cause pain around the kneecap include:Infrapatellar tendonitis: this is known as “jumpers knee" and affects the  tendon just below the kneecap, Chondromalacia patella: This affects the tendon attachment just above the patella and involves damage to the cartilage surface of the patella-quadriceps tendonitis


Plica syndrome: This occurs when tissues within the knee joint become inflamed and/or stiff, causing pain and tightness in the joint

Plica syndrome

Symptoms of patella-femoral pain syndrome include an intense, dull, aching pain, in and around the kneecap. Running down stairs, squatting, sitting for a long period of time with the knees bent and then standing will all cause the generalized dull kneecap pain associated with this condition.  Swelling of the knee may exist and a crackling noise coming from the knee may also occur during movement.


Despite all of the variables that might cause the pain surrounding patella-femoral pain syndrome, there are some things patients can do to ease the symptoms.   Here are some recommendations:
• Rest
• Consider turning to non-impact exercise, such as swimming, to continue on a fitness regime, yet allowing your knee(s) to heal
• Wear shock-absorbed running shoes
• Icing the knees after exercise
• Taking NSAID for swelling and pain relief
• Adhere to a physical therapy regime specifically designed to treat Patellofemoral Pain Syndrome

When conservative treatment and therapy has failed to relieve and alleviate symptoms, knee surgery can be considered as a last solution.  Arthroscopic surgery is the gold standard to examine and treat the interior of the knee joint.  During the procedure, rough or frayed spots in the cartilage will be shaved and smoothed and plica can be trimmed.  The patella may also be realigned.  Arthroscopic knee surgery is performed on an out-patient basis.