Patellofemoral pain syndrome is pain in the front of the knee. It
frequently occurs in teenagers, manual laborers, and athletes. It sometimes is
caused by wearing down, roughening, or softening of the cartilage under the
What causes patellofemoral pain syndrome?
Patellofemoral pain syndrome may be caused by overuse, injury,
excess weight, a kneecap that is not properly aligned (patellar tracking disorder), or changes under the kneecap.
What are the symptoms?
The main symptom of patellofemoral pain syndrome is knee pain,
especially when you are sitting with bent knees, squatting, jumping, or using the
stairs (especially going down stairs). You may also experience occasional knee
buckling, in which the knee suddenly and unexpectedly gives way and does not
support your body weight. It is also common to have a catching, popping, or grinding sensation when
you are walking or when you are moving your knee.
How is patellofemoral pain syndrome diagnosed?
Your doctor will conduct a medical history and
physical exam to determine the cause of your pain. In some cases, imaging tests
magnetic resonance imaging (MRI) may be done. These
tests allow a doctor to view the tissues inside your knee to rule out damage to
the structure of the knee and the tissues connected to it.
How is it treated?
Patellofemoral pain syndrome can be relieved by avoiding
activities that make symptoms worse.
Avoid sitting, squatting, or kneeling in the bent-knee
position for long periods of time.
Adjust a bicycle or exercise
bike so that the resistance is not too great and the seat is at an appropriate
height. The rider should be able to spin the pedals of an exercise bike without
shifting weight from side to side. And the rider's legs should not be fully extended at
the lowest part of the pedal stroke.
Avoid bent-knee exercises,
such as squats or deep knee bends.
Other methods to relieve pain include:
Taking nonprescription anti-inflammatory
drugs (NSAIDs), such as ibuprofen or naproxen, to decrease swelling,
stiffness, and pain. Be safe with medicines. Read and follow all instructions on the label.
Ice and rest. You can also try heat to see if it helps.
exercises. Exercises may include stretching to increase flexibility and
decrease tightness around the knee, and straight-leg raises and other exercises
to strengthen the quadriceps muscle.
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Van Linschoten R, et al. (2009). Supervised exercise therapy versus usual care for patellofemoral pain syndrome: An open label randomised controlled trial. BMJ. Published October 20, 2009 (doi:10.1136/bmj.b4074).
William H. Blahd, Jr., MD, FACEP - Emergency Medicine
How this information was developed to help you make better health decisions.