Patellofemoral Pain Syndrome

Patellofemoral pain syndrome is a common knee problem that causes pain under and around the kneecap. The problem often occurs because of heavy physical activity that stresses the knees, such as running or jumping. In many cases, the pain develops from doing too much, too soon. For most people, patellofemoral pain subsides with nonsurgical treatment, including anti-inflammatory medications and physical therapy.

  1. The Facts

    • Patellofemoral pain syndrome refers to chronic pain that occurs around or beneath the kneecap (patella). It is a common condition that is sometimes called "runner's knee" because it can develop with heavy physical activity that repetitively stresses the knees, such as running. However, patellofemoral pain can be caused by a number of other things, including weak or imbalanced muscles in the lower body, a misaligned or dislocated kneecap, damaged cartilage or a knee injury.

    Symptoms

    • You might feel pain, puffiness or ache under or around one or both kneecaps. The symptoms might be worse during exercise that puts pressure on your knees, such as running or jumping. It might also be bothersome during everyday activities such as taking the stairs or getting up from a chair after sitting for a long time with your knees bent. In some cases, it might feel like your kneecap is off its track or that your kneecap is scraping the bone beneath it.

    Effects

    • If left untreated, patellofemoral pain can become bothersome and prevent you from doing daily tasks or enjoying regular physical activity. Simply taking pain medication to treat the symptoms might help at first but will not treat the underlying cause. Do not ignore the pain or continue your regular activities without proper treatment. Doing so could cause other muscles or joints to overcompensate, which could lead to more serious injuries.

    Identification

    • Tell your doctor about your knee pain, where it is located and what activities seem to aggravate it. Explain your level of daily physical activity, exercise and any prior problems or injuries in your knees or lower body. Your doctor will examine the stability of your knees, the muscles in your lower body and your overall mobility with some brief stretches and exercises. You might also need to get an X-ray or MRI of your knee to help diagnose the problem.

    Treatment and Prevention

    • The symptoms of patellofemoral knee pain can initially be treated at home using the RICE method:

      Rest: Take a break from physical activities that make the pain worse.
      Ice: Place an ice pack on the affected knee several times a day, for no longer than 20 minutes each time.
      Compression: Gently wrap an elastic bandage around the knee to help reduce swelling.
      Elevation: Rest your knee on a pillow to place it higher than your heart whenever possible.

      Consider taking a nonsteroidal anti-inflammatory medication, such as ibuprofen or naproxen to reduce swelling and manage pain.

      In addition to limiting your physical activity, your doctor might prescribe at-home exercises or a series of visits with a physical therapist to help strengthen the muscles that keep your kneecap stable. You might also receive a prescription for insoles that will lessen the stress on your knees. Over time, physical therapy can improve your strength and flexibility and prevent the pain from returning when you resume your regular activities. Your doctor or physical therapist can advise you on how to gradually return to physical activity and how to warm up, cool down and stretch to prevent injury.

      In some severe cases, a doctor might need to surgically remove damaged cartilage or realign the kneecap. However, in most cases, patellofemoral knee pain improves with anti-inflammatory medication and physical therapy.

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