Patellarfemoral Pain Syndrome

By: Jennifer Schrage, DPT at ApexNetwork Physical Therapy in Maryville, IL

Patellafemoral Pain is a common knee problem seen in the clinic, especially in adolescent or active young adults. ¹ This is a structural disorder that pain presents with a variety of possible symptoms: pain, instability, crepitus (grinding or popping), stiffness, and swelling. Pain is typically felt in the front of the knee, around the knee cap, or under the knee cap.² Pain typically occurs during or after weight bearing repetitive activity. Therefore pain is associated with running, walking, stair climbing, squatting, etc.

The patellarfemoral joint is composed of the femur (thigh bone), tibia (lower leg bone), and the patella (knee cap). With flexion and extension of the knee, the patella glides of the femur and tibia as well other articulating surfaces in the knee. The muscles, particularly the quadriceps, play a role in balancing the pull of the patella as it moves along the surfaces. Poor biomechanics of this joint may lead the patellarfemoral pain. Many times, the VMO (vastus medialis) of the quadriceps is insuffient or weak and can cause the patella to move laterally (outwards). Other causes can be from muscles tightness or weakness in the hip or knee.³

In order to treat the knee, the biomechanics should be evaluated as well as a full lower extremity strength and flexibility assessment. PT interventions may include knee strengthening, hip strengthening, especially hip external rotator and abductors, core strengthening, stretching, taping, and possible modalities as needed.   Because this is not a degenerative problem, full recovery is possible. ²

1. Chevidikunnan MF, Al Saif A, Gaowgzeh RA, et al. Effectiveness of core muscle strengthening for improving pain and dynamic balance among female patients with patellofemoral pain syndrome. J Phys Ther Sci. 2016 May;28(5):1518-23
2. Alba-Martín P, Gallego-Izquierdo T, Plaza-Manzano G, et al. Effectiveness of therapeutic physical exercise in the treatment of patellofemoral pain syndrome: a systematic review. J Phys Ther Sci. 2015 Jul;27(7):2387-90
3. Roland T, Jesper A, and Jon Karlsson. Patellofemoral pain syndrome: A review of current issues. Sports Med 1999 Oct; 28 (4): 245-262