Patellofemoral Pain
Patellofemoral pain syndrome, or anterior knee pain, is pain that occurs in the front of the knee around the patella (kneecap). The pain is usually diffuse and achy, but it can also be sharp at times. The pain usually comes with walking, running, cycling, playing sports, kneeling, ascending/descending stairs, squatting and/or sitting for prolonged periods. There can be tenderness in the soft tissue around the patella, and the knee may feel stiff at times.
Diagnosis and Treatment
Diagnosis is usually made by a person’s primary care physician after a subjective and physical exam. Radiographic studies are usually normal for this pain, but may show if a person has an inflamed/enlarged plica (which is soft tissue) near the patella that can also be a cause of patellofemoral pain.
Patellofemoral pain can be treated with rest and ice, but often physical therapy is indicated with a big-picture approach that identifies all the possible contributing factors to the pain. Temporary use of tape, a knee brace and/or orthotics can sometimes help decrease this type of knee pain. It is important to follow the advice of your health care provider and gradually return to sport.
What are the causes and risk factors?
Sometimes there is no specific injury or known cause for the pain. Patellofemoral pain is extremely common in youth going through growth spurts, in athletes, and in people starting new physical activity. Some of the common risk factors are excessive pronation in the feet (flat feet in weightbearing), decreased strength or muscle imbalances in the hip and knee musculature, and overtraining in sports with volume and/or intensity. Trauma to the patella and knee surgery can also increase the risk of patellofemoral pain. Female athletes have 1.5 to 3 times higher incidence of patellofemoral pain compared to males.
Prevention
To help prevent anterior knee pain, it is good to exercise regularly with an appropriate form of exercise. Warming up properly, maintaining good flexibility, wearing shoes that fit well and are designed for the activity, and practicing good form and body mechanics with your exercises are all keys to help prevent knee pain. Consulting with a qualified health professional for guidance with an exercise program can help get you on the right track.