Patellofemoral Pain Syndrome (PFPS)

What is patellofemoral pain syndrome (PFPS)?

Patellofemoral pain syndrome (PFPS) is also known as runner’s knee or jumper’s knee. This medical condition causes pain under or around the kneecap (patella). PFPS can occur in one or both knees. It affects both children and adults.

In most cases, pain increases with activity or after sitting for long periods of time with the knees bent. Most people can manage symptoms with rest, changes in activity levels or physical therapy.

Who is likely to have patellofemoral pain syndrome (PFPS)?

Anyone can develop patellofemoral pain syndrome. PFPS is more likely to occur in females and athletes, including children and young adults. People can experience PFPS most often when they participate in sports with frequent running, jumping or squatting. Others may experience PFPS if they are walking or sitting for extended periods of time, kneeling or climbing stairs.

What causes patellofemoral pain syndrome (PFPS)?

The exact cause of patellofemoral pain syndrome is unknown. Several factors may contribute to the development of PFPS, including:

• Overuse of the knee joint.
• Problems with kneecap alignment.
• Certain anatomy or body types.
• Weak muscles surrounding the knee.
• Improper equipment use or sports training techniques.
• Changes to footwear.
• Hard playing surfaces.

What are the symptoms of patellofemoral pain syndrome (PFPS)?

In most cases, symptoms of patellofemoral pain syndrome develop gradually. Symptoms usually get worse with activity.

Many people experience a dull, aching pain in the front of the affected knee. Your symptoms may also include:

• Pain during activities that bend the knee, including squatting or climbing stairs.
• Pain after sitting for extended periods of time with your knees bent.
• Crackling or popping sounds in your knee when standing up or climbing stairs.
• Pain that increases with changes to your usual playing surface, sports equipment or activity intensity.

When should I call my doctor if I think I have patellofemoral pain syndrome (PFPS)?

If you have knee pain or notice other symptoms of PFPS, especially after exercising or sitting for long periods of time, contact your doctor to evaluate your knee.

How is patellofemoral pain syndrome (PFPS) diagnosed?

Your doctor diagnoses patellofemoral pain syndrome with a thorough physical examination.

If necessary, your doctor also orders an X-ray to rule out other medical conditions that may cause pain. An X-ray shows damage to the bones and tissues around the knee.

How is patellofemoral pain syndrome (PFPS) treated?

Your treatment depends on the severity of your symptoms. Surgery is not usually indicated for PFPS.

At home, resting the knee using the RICE method may ease symptoms. RICE means Rest, Ice, Compression and Elevation.

• Rest: Avoid putting any weight on the knee.
• Ice: Do not apply ice directly to your knee. Instead, apply cold packs wrapped in a towel for no more than 20 minutes at a time, several times each day.
• Compression: Using an elastic bandage, lightly wrap your knee while leaving an opening over your kneecap. Make sure the bandage is not wrapped too tightly. Be sure the bandage does not cause more pain.
• Elevation: Rest with your knee higher than your heart.

Check with your doctor before taking over-the-counter pain medications, such as non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil®, Motrin®).

In addition to home remedies, your treatment may include:

• Physical therapy: Specific exercises can help you regain knee strength, endurance and range of motion.
• Orthotics: Special shoe inserts stabilize and align your foot and ankle. Better alignment takes stress off your lower leg and knee.
• Other: For severe PFPS, doctors perform an MRI to further evaluate for other structural issues. If these are discovered, surgery may be an option. The procedure may remove damaged bone or cartilage or move tendons to correct any kneecap misalignment.

What complications are associated with patellofemoral pain syndrome (PFPS)?

Left untreated, patellofemoral pain syndrome generally gets worse over time. If you continue using the affected knee without treatment, you may cause further injury.

Can patellofemoral pain syndrome (PFPS) be prevented?

You may be able to prevent patellofemoral pain syndrome by adjusting your activity level or athletic training routine. Other actions to avoid PFPS include:

• Maintaining a healthy weight.
• Wearing appropriate shoes for your activities.
• Stretching and warming up before activity.
• Increasing athletic training intensity gradually.
• Avoiding activities that hurt your knee in the past.

What is the prognosis (outlook) for people with patellofemoral pain syndrome (PFPS)?

Most people recover from patellofemoral pain syndrome with home remedies like the RICE method. Many people also benefit from physical therapy to regain full use of their knee.