What is patellofemoral pain syndrome (PFPS)?

Patellofemoral pain syndrome describes pain on and around the kneecap. It is also sometimes called anterior knee pain syndrome or “runner’s knee” because it is common in runners and active individuals. In general, patellofemoral pain syndrome occurs when the patella does not move or track smoothly and with proper alignment on the femur (thigh bone) when the knee is bent.

PFPS symptoms include aching, front of the knee pain that may be provoked by bending the knee, stairs, or sitting for long periods of time with the knee bent. There are several risk factors for PFPS including repetitive deep knee bending, flat feet, technical errors in running or in sports, tight illiotibial band, muscle imbalances, or weak thigh and gluteal muscles.

When to Seek Immediate Medical Attention?

It is important to seek medical attention if you have severe knee pain associated with inability to put weight on the affected leg, severe swelling, or onset of numbness or weakness of the lower leg.

What Can You Do?

To prevent PFPS, avoid excessive training or sudden increases in physical activity level, as that may cause symptoms. Muscles that are involved in running and other lower limb sports should be adequately strengthened, so that they can meet the demands of your sporting and daily activities. Avoid rapid increases in volume or speed of running. Check that your shoes are not worn-out excessively as they may not provide adequate support or shock absorption. Choose a shoe with correct fit that is suitable for your foot type.

How We Can Help You?

Your doctor will take a medical history and perform a physical examination to determine the cause of your knee pain. Imaging tests may be ordered, although PFPS typically does not require imaging to be diagnosed and the X-rays may be normal. You may also be asked to run on a treadmill so that your gait can be assessed.

Treatments that your doctor may recommend include:

  • Strength, flexibility and conditioning exercises through physiotherapy. Physiotherapy exercise can help regain the range of motion in your knee and correct muscle imbalances that affect kneecap movement. You may be taught exercises to strengthen the core, buttock, and thigh muscles. Stretches to improve flexibility will also be taught.
  • Other treatments include sports taping of the knee to help facilitate exercise without pain.
  • Activity modification: It may be helpful to reduce activities that involve repetitive, high-impact on the knees or deep knee bending, such as running, stairs, or step aerobics. Adjust activities to a level that you can comfortably tolerate. You can also replace high-impact activities with exercises such as cycling, swimming, deep water running, rowing or elliptical trainer.
  • Footwear modification. If necessary, a podiatry consult for further assessment and orthotic (insoles) fitting may be scheduled.