Patellofemoral syndrome is a condition that describes pain in the front of the knee and around the kneecap, known as the patella. Doctors may also call patellofemoral syndrome “jumper’s knee” or “runner’s knee.”
Common causes of the condition are overuse of the knee joint and trauma, such as hitting the kneecap or falling on it. Although the condition occurs more commonly in athletes, anyone can have the symptoms. Some people have a kneecap that abnormally tracks or moves in the groove at the end of the femur. This can cause extra pressure on the cartilage covering the kneecap or on the femur where it rubs, called the trochlear surface.
While patellofemoral syndrome can cause symptoms that range from uncomfortable to very painful, the condition can usually be treated at home. You may be able to reduce your pain with rest and conservative treatment measures.
The hallmark symptom associated with patellofemoral syndrome is a dull, aching pain that usually occurs on the front of the knee. The pain may be in one or both knees. It often worsens with activity.
Additional symptoms include:
- pain when exercising
- pain when bending the knee, such as when climbing the stairs, jumping, or squatting
- pain after sitting for an extended time with the knee bent, such as while watching a movie at a theater
- cracking or popping sounds in the knee when climbing stairs or after sitting for an extended time
Patellofemoral syndrome is not characterized by locking of the knee joint. If a person has this symptom, it usually means they have another injury type, such as a meniscal tear.
How it’s diagnosed
A doctor usually diagnoses the syndrome by conducting a physical exam. They’ll ask about what makes your pain worse or better. They’ll also feel your kneecap for signs of instability and ask you to engage in range-of-motion exercises.
While a doctor can usually diagnose patellofemoral syndrome without imaging studies, they may order an X-ray to rule out other potential injuries.
Because patellofemoral syndrome often results from overuse and overactivity, resting the affected joint can often help treat the underlying problem. Try these treatment options:
- Practice the RICE method (rest, ice, compression, and elevation). Wrap the knee in an elastic bandage or use a pull-on bandage with the kneecap cut out. These can be purchased at a drugstore and can help stabilize and support the joint.
- Take a nonsteroidal anti-inflammatory drug, such as ibuprofen or naproxen.
- Wear special shoe inserts, known as orthotics, to support and stabilize your foot and ankle. The inserts can be purchased at a drugstore or be custom-made with a doctor’s prescription.
- Get a sports massage to reduce the incidence of too-tight muscles causing pain.
Preventing future episodes of patellofemoral pain can mean alternating your activities to avoid overuse. If you do high-impact activities, such as running or playing a sport, try doing a low-impact activity the next day, such as swimming or riding a bicycle. Wearing supportive footwear and stretching before and after exercising also may help.
The exercises below stretch and strengthen the muscles that attach to the muscles that act on the knee. Doing them can help reduce patellofemoral pain. Stretches for the calves and hamstrings can also help reduce tension associated with patellofemoral syndrome.
This exercise strengthens the quadriceps muscles on the front of the upper thigh.
- Sit in a chair with both feet flat on the ground.
- Straighten your right leg to extend it straight, feeling the muscles in the upper thigh working.
- Hold the position for five seconds. Lower the foot and repeat 10 times.
- Repeat on the other leg. Rest for 15 to 30 seconds and repeat on both legs for two more sets.
This stretch is excellent to do after the leg extension exercise because it stretches the muscles that were just worked.
- Stand with your left hand resting gently on something sturdy, such as a piece of furniture.
- Pull your right foot toward your buttocks and grasp the top of your right foot with your right hand. Point your right knee toward the floor to feel a stretch in the front of your leg.
- Hold the stretch for 20 to 30 seconds.
- Release the stretch and repeat on the other leg. Perform three to five repetitions on each side.
If your patellofemoral syndrome doesn’t respond to over-the-counter and at-home treatments, a doctor may recommend surgical intervention. Examples of surgical interventions for patellofemoral syndrome include:
Arthroscopy: This procedure involves a surgeon inserting a camera into the joint to remove damaged cartilage. The doctor can also release tendons that are too tight and pull on the kneecap to allow it to move in the groove correctly.
Tibial tubercle transfer: This process involves realigning the kneecap. A doctor will move the tibial tubercle, which is the bony portion of the shinbone, as well as the patellar tendon to improve the knee’s alignment.
Most often, these treatments aren’t necessary. However, if your pain gets worse with time or never resolves with conservative treatments, see your physician to discuss your options.
Typically, people with patellofemoral syndrome can make changes to their training regimen and at-home care to reduce their symptoms. The condition may be harder to treat in older adults and people who have pain in both kneecaps.
Your recovery may also depend on the severity of your injury and if trauma was the underlying cause. According to the Hospital for Special Surgery in New York, if patellofemoral syndrome results after the dislocation of a kneecap, it can take as long as four to five months to recover.