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Patellofemoral Syndrome

The patella contracts the femur with normal knee movement. The joint is called the “patellofemoral joint”. Pain around this joint is patellofemoral pain is one of the most common causes of anterior knee pain. Commonly found in athletes who put heavy stress on their knees, it is also known as runner’s knee.

Causes of Patellofemoral pain

  • Malalignment of the knee cap
  • Patella instability
  • Direct trauma to the knee
  • Tightness, weakness or imbalance of the patella and/or thigh muscle
  • Flat feet

Patella femoral syndrome can also result from other contributing factors such as overuse, inadequate pre-activity stretching, or in ammation of the soft tissue around the knee. Injury to the cartilage of the patella, either from direct injury or malalignment, can also cause patellofemoral pain. This specific cause is called “chondromalacia”. 

Symptoms of Patellofemoral pain

  • Pain under or around the kneecap
  • Pain while walking up and down stairs, or after sitting, squatting or kneeling with a bent knee for a long period of time
  • A grating or grinding sensation when the knee is bent 

Treatment

Think "RICE"
Rest - Avoid activities that cause pain. Some athletes will switch to a non-weight bearing activity until pain subsides.
Ice - Apply cold or ice packs to affected knee for 1-15 minutes several times a day.
Compression - A compression knee sleeve with the knee cut out can be used to help with pain. These can be found at most drugstores.
Elevation - If there is swelling keep the injured knee elevated.

You can also take a nonsteroid anti-inflammatory such as aspirin or ibuprofen to help with the pain. 

Prevention

  1. Stay in shape
  2. Stretch - Before doing any strenuous activity, do a 5 minute warm up and do stretching exercises. Remembering to
  3. stretch your knee will help keep the structures around the knee exible and less likely to be irritated by activity.
  4. Increase training gradually - Dramatic increases in activity over a short period of time can result in overuse injuries
  5. Use proper running gearn - Make sure that your shoes fit properly and provide good support
  6. Use proper running form
  7. Strengthening of thigh, hip and trunk muscles - Helps to “off-load” stress on the patellofemoral joint

Rehabilitation Exercises

  1. Hamstring Stretch
    Lie on your back with your buttocks close to a doorway, and extend your legs straight out in front of you. Raise your injured leg and rest it against the wall next to the door frame. Hold this position for 30–60 seconds, feeling a stretch in the back of your thigh. Repeat 3 times.
  2. Standing Calf Stretch
    Facing a wall, put your hands against the wall at about eye level. Keep the uninjured leg forward and your injured leg back about 12–18 inches behind your uninjured leg. Keep your injured leg straight and your heel on the floor. Next, do a slight lunge by bending the knee of the forward leg. Lean into the wall until you feel a stretch in your calf muscle. Hold this position for 30–60 seconds, and repeat 3 times.
  3. Quadriceps Stretch
    Stand sideways to a wall, about an arm’s length away from the wall, with your injured leg towards the outside. Facing straight ahead, keep the hand nearest the wall against the wall for support. With your other hand, grasp the ankle of your injured leg and pull your heel up toward your buttocks. Do not arch or twist your back. Hold this position for 30 seconds. Repeat 3 times.
  4. Straight Leg Raise
    Sit on the floor with your injured leg straight and your other leg bent, with your foot at on the floor. Move the toes of your injured leg toward you as far as you can, while pressing the back of your knee down and tightening the muscles on the top of your thigh. Raise your leg 6–8 inches off the floor and hold for 5 seconds. Slowly lower it back to the floor. Repeat 20 times.
  5. Prone Hip Extension
    Lie on your stomach. Squeeze your buttocks together and raise your injured leg 5–8 inches off the floor. Keep your back straight. Hold your leg up for seconds, and then lower it. Repeat 10 times. Do 3 sets of 10.