> Patellofemoral Pain Syndrome
The kneecap (patella) is a small,
triangular bone in the front of your knee that moves
and rotates with the knee. It glides up and down along
a track at the end of the thighbone (femur). The kneecap
gives the front thigh muscles (quadriceps) extra leverage
for straightening the leg, and protects the other bones
in the knee against collisions and falls. Patellofemoral
pain syndrome occurs when legs and hips are not aligned
properly or muscles pull unevenly, which forces the
kneecap off its track when you move. Instead of sliding
smoothly along the thighbone, the kneecap is typically
pulled to the outside, putting added pressure on the
bones, which results in pain and possible cartilage
A combination of tight or weak leg
muscles, overuse, and poor kneecap alignment typically
causes patellofemoral pain syndrome. Sports that overload
your knees, like football, basketball, soccer, tennis,
and running, can aggravate an existing abnormal kneecap
alignment. Running on uneven surfaces, like hills or
trails, or playing on multiple surfaces – such
as changing from grass to hardcourt in tennis –
may also increase the likelihood of patellofemoral pain.
Your kneecap pain may be caused by other problems, like
patellar fractures, osteochondral defects, patellar
dislocations, fractures, or arthritis, which should
be diagnosed and treated separately.
Patellofemoral pain syndrome may be
a sign that the protective cartilage under your kneecap
is wearing down, which can eventually cause bone loss
and arthritis. Eighty to 90 percent of people suffering
patellofemoral pain are able to fully recover and return
to activities. Most active people respond to non-operative
treatments. Surgery is prescribed only in rare cases
when patellofemoral pain cannot be eased with braces,
rest, or physical therapy. Depending on the amount of
malalignment your physician finds during the exam, you
will typically be asked to try a well-supervised rehabilitation
program for between six weeks and six months. In most
cases, you will need to continue the exercises you learn
in physical therapy for your entire life. If your patellofemoral
pain continues to bother you, physicians may recommend
that the ligaments and tendons around your kneecap be
There are usually three parts to an
orthopedic evaluation: medical history, physical examination,
and tests your physician may order.
will likely ask you when you noticed your knee pain,
how it has been feeling since the pain began, and if
your knee has been previously injured. Physicians also
typically ask about other conditions, such as diabetes
and allergies, and medications currently being taken.
The doctor may also ask about your physical and athletic
goals – information that will help the doctor
decide what treatment might be best for you in achieving
| PHYSICAL EXAMINATION
A physician usually can make an early
assessment of an injury by feeling around the area.
Because the kneecap is easily visible, physicians can
quickly test for pain and tenderness. By moving your
kneecap around to check how well it tracks as your leg
flexes and extends, physicians can often differentiate
your patellofemoral pain from other knee problems.
Should your physician require a closer look, the following
tests may be conducted:
taken from different angles can clearly show when your
kneecap is off-track.
(magnetic resonance imaging) test may be used to see
if your pain is due to bone, cartilage, or muscle problems.
Results from MRI are usually available in two days.
in which the doctor inserts a tiny camera into your
knee, may be used to determine the diagnosis in more
detail. This is done on an outpatient basis and does
not require a hospital stay.