Patellofemoral pain syndrome, also referred to as PFPS, is one of the most commonly reported knee problems, accounting for one in four knee complaints seen by orthopaedists.
Patellofemoral pain syndrome is caused by a multitude of factors that affect the way the patella moves along the groove of the femur (trochlear groove) when the leg is bent or straightened. The patella normally moves up and down with a slight tilt without touching the other knee bones. In PFPS patients, the patella rubs against the femur causing pain.
A combination of factors can cause this abnormal tracking and include the following:
Anyone can develop patellofemoral pain at any point in their lives; however there are certain risk factors that may predispose you to developing patellofemoral pain. These include the following:
Although it may not always be possible to prevent patellofemoral pain syndrome, there are some measures you can take to decrease your risk.
Evaluating the source of patellofemoral pain is critical in determining your treatment options for relief of the pain. Knee pain should be evaluated by an orthopaedist for proper diagnosis and treatment.
Your physician will perform the following:
Depending on what the history and exam reveal, your doctor may order medical tests to determine the cause of your knee pain and to rule out other conditions.
Used to take pictures of bones
This test creates 3D images from multiple X-rays and shows your physician structures not seen on regular X-ray.
Magnetic and radio waves are used to create computer images of the bones and soft tissue such as nerves and ligaments.
Treatment for patellofemoral pain will depend on the exact cause of the pain and whether the pain is acute or chronic.
Over the counter NSAID’s (non-steroidal anti-inflammatory drugs) such as ibuprofen can help with the pain and any swelling.
Avoid activities that cause the pain as more damage could result from putting pressure on the injury. You can perform non-weight bearing activities such as swimming. Slow, gradual resumption of activities.
Ice: Ice packs applied to the injury will help diminish swelling and pain. Ice should be applied over a towel to the affected area for 20 minutes every hour. Never place ice directly over the skin.
Treatment Options: Chronic
If your knee pain persists despite the above treatments, your doctor may suggest more intensive treatments. These may include the following:
PT can teach you the proper stretching and strengthening exercises appropriate for your condition. Weak or tight quadriceps (thigh muscles) is a common cause of PFPS, so focusing on this muscle group is a primary focus for treatment of PFPS. If the cause of your knee pain is a different muscle group, such as hamstrings, your therapist will individualize your exercises accordingly.
Bracing: Soft braces with cut outs over the patella may be suggested for support and alignment.
Taping: Your therapist may show you how to tape the knee to bring it into proper alignment.
Orthotics: Shoe inserts may be ordered when PFPS is caused by foot abnormalities, such as flat feet.
Approximately 80% of patient with PFPS have satisfactory resolution of their symptoms with conservative treatment. For the 20% of patients with persistent kneecap pain despite conservative treatment, surgical treatment is sometimes necessary.. Common reasons for persistent kneecap pain despite conservative treatment include abnormal tracking of the patella, synovitis with soft tissue impingement, plica band syndrome and recurrent dislocation of the patella. Your surgeon may recommend arthroscopy to evaluate your condition and repair or remove excessive synovial tissue, plica bands, fragmented cartilage or to perform a lateral retinacular release.