Patellofemoral Pain Syndrome

It is not clear how patellofemoral pain develops. Most diagnoses are idiopathic, but generally the pain occurs from overuse and repetitive stress. Some more specific reasons for this pain developing include: 

• • Sports that involve repetitive movements that cause stress on the knee. For example: running, cycling, and track are among the sports where patellofemoral pain most commonly occurs.
  • Weakness of thigh muscles can lead to abnormal movement of the patella over the femur ending in patellofemoral pain.
  • Mal-tracking of the patella. This means that there is a problem with the movement of the patella over the lower part of the thigh bone. In this case, the patella rubs on the thigh bone instead of gliding over it.
  • Recurrent minor knee injuries are thought to contribute to the development of patellofemoral pain. 
  • Flat feet are one of the reasons for knee problems. Flat feet cause your foot to roll inwards while walking. Consequently, the movement of the patella compensates for this inward roll of your feet leading to patellofemoral pain.

• • The main symptom is pain. The pain is usually in the front or around the knee cap. It can also be at the back of the knee. Usually, it is vaguely distributed around the joint without an exact painful point.
  • Both knees can be affected. However, usually one of them is worse.
  • The pain increases with running, walking, or jumping.
  • Sitting for prolonged hours can also increase the pain.
  • You can experience a grinding feeling while bending your knee. This is called crepitus and it is common in patellofemoral pain and osteoarthritis.

The diagnosis of patellofemoral pain syndrome depends on your medical history and the examination carried out by your doctor. Imaging has no role in the diagnosis of patellofemoral pain. However, it can be used to rule out similar conditions. An X-ray can be ordered to exclude fractures and osteoarthritis. MRI can help rule out ligament tears or muscle injury.

• • Avoiding stressful use of the knee joint is the first step toward the treatment of patellofemoral pain. It is recommended to take some time off from training. 
  • Antiinflammatories will help decrease the inflammation in the affected joint.
  • Physical therapy will help correct abnormal movement and gait patterns. Locating the cause of the problems and doing corrective exercises is likely the best form of treatment for this particular condition.
  • Kinesio taping to help stabilize the knee joint and allow less stress and friction on the posterior aspect of the patella with the femur. 
  • Correcting flat feet using customized arch supports may help take pressure off of the medial aspect of the knee and correct the problem.