About Physiatry

Patellofemoral Syndrome

Condition: Patellofemoral pain syndrome (PFPS), sometimes called anterior knee pain syndrome, is pain in the front of the knee and around the kneecap. It is primarily caused by overuse of the knee.

Background: PFPS often occurs in teenagers, manual laborers and athletes, and is the cause of nearly 25% of all knee injuries in runners. It is typically caused by the wearing down, roughening or softening of the cartilage under the kneecap. Women are twice as likely as men to develop it.

Risk Factors: Although PFPS is often caused by overuse, it can also be due to other factors, such as misalignment of the kneecap, abnormal foot mechanics or injuries. Athletes who train improperly—such as running too hard or wearing improper footwear—are at risk.

History and Symptoms: Early on, patients often notice pain when they jump, run or climb stairs. Other symptoms include knee buckling, where the knee suddenly “gives out,” and knee swelling or stiffness. However if it progresses, and the underlying cause is not or cannot be address, it likely will cause pain, even at rest.

Physical Exam: The physician will feel the kneecap for abnormalities as well as check the strength of the thigh muscle. The patient may also be asked to step, squat or run or walk.

Diagnostic Process: Sometimes imaging tests such as X-rays or MRIs are performed so the doctor can view the tissues inside the knee.

Rehab Management: Rest, icing the knee, and taking pain medications such as ibuprofen can help. Strength training involving the hip, knee, and ankle muscles can be beneficial, although patients should avoid bent-knee exercises. Taping to stabilize the knee can help.

Other Resources for Patients and Families: Often improper footwear contributes to PFPS. The American College of Sports Medicine’s Selecting Running Shoes is one resource that can help. 


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