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Patellofemoral Pain Syndrome

What is patellofemoral pain syndrome (PFPS)?

Patellofemoral pain syndrome (PFPS), also known as runner's knee, means that you have pain in front of the knee or around the kneecap (patella). This is where the knee connects with the lower end of the thighbone (femur).

What causes PFPS?

Patellofemoral pain syndrome may be caused by a structural defect, or a certain way of walking or running. Other causes may include:

  • Malalignment of the kneecap

  • Excessive training or overuse

  • Injury or trauma

  • Weak thigh muscles

  • Tight hamstrings

  • Tight Achilles tendons

  • Poor foot support

  • Walking or running with the feet rolling in while the thigh muscles pull the kneecap outward

What are the symptoms of PFPS?

These are the most common symptoms of runner's knee:

  • Pain in and around the kneecap that happens when you are active.

  • Pain after sitting for a long time with the knees bent. This sometimes causes weakness or feelings of instability.

  • Rubbing, grinding, or clicking sound of the kneecap that you hear or feel when you bend and straighten your knee

  • Kneecap that is tender to the touch

The symptoms of runner's knee may look like other conditions and health problems. Always talk with your healthcare provider for a diagnosis.

How is PFPS diagnosed?

Your healthcare provider can diagnose PFPS knee by looking at your health history and doing a physical exam. X-rays may be needed for evaluation of the knee.

How is PFPS treated?

Treatment will depend on your symptoms, age, and general health. It will also depend on how bad the condition is.

The best course of treatment is to stop running until you can run again without pain. Treatment is aimed at relieving pain and increasing strength and range of motion. Treatments may include:

  • Strengthening exercises

  • Stretching exercises

  • Cold packs

  • Elevating the leg

  • Compression knee wrap

  • Medicines, such as ibuprofen

  • Shoe inserts (orthotics)

  • Knee bracing

  • Patellofemoral taping

What can I do to prevent PFPS?

Preventing PFPS includes not overstressing your knees. You can do this by:

  • Maintaining a healthy body weight

  • Warming up before physical activity

  • Stretching before and after physical activity

  • Increasing your activities gradually

  • Wearing shoes appropriate for your physical activities

  • Running leaning forward with your knees bent

Key points about PFPS

  • PFPS is pain in front of the knee or around the kneecap

  • It may be caused by overuse, a structural defect, or a certain way of walking or running.

  • Symptoms include pain, and rubbing, grinding, or clicking of the kneecap.

  • Treatment includes not running until the pain goes away, and strengthening and stretching exercises. Also cold packs, compression, and elevation may help. Medicine, such as ibuprofen, can lessen pain and reduce inflammation.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

  • Know the reason for your visit and what you want to happen.

  • Before your visit, write down questions you want answered.

  • Bring someone with you to help you ask questions and remember what your provider tells you.

  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.

  • Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are and when they should be reported.

  • Ask if your condition can be treated in other ways.

  • Know why a test or procedure is recommended and what the results could mean.

  • Know what to expect if you do not take the medicine or have the test or procedure.

  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.

  • Know how you can contact your healthcare provider if you have questions, especially after office hours or on weekends.