Patellofemoral Pain Syndrome – also referred to as runner’s knee – causes a persistent dull ache in the front of your knee, usually around or behind the kneecap (patella). The condition is a leading cause of chronic knee pain, which is experienced by up to a third of adults at some point in their lives.
Symptoms of Patellofemoral Pain Syndrome
The pain at the front of the knee tends to get worse when you do everyday things like climbing stairs, kneeling, squatting, or sitting for long periods. The condition can make driving difficult. Patellofemoral Pain Syndrome sometimes produces a grinding or clicking sensation or a popping or crackling sound when you move your knee, or the feeling that your knee might give way. Your knee might be swollen, and tightness can occur in the calves and thighs.
What Causes Patellofemoral Pain Syndrome?
- Overuse – A common reason for developing Patellofemoral Pain Syndrome is placing the knee under repeated stress due to physical activities like running, squatting or climbing stairs. This can occur in people who play sport when you suddenly increase the frequency or intensity of your exercise regime, hence why we always advise building up gradually. Wearing damaged or poorly fitted shoes can also contribute, as can a sudden change of playing surface (for example, switching from grass to a hard surface).
- Structural problems – If you have a structural misalignment of the knee joint, leading to an abnormal movement of the patella in the trochlear groove, you may also be at increased risk of developing the condition. This is because the patella may be pushed out to one side of the groove when you bend your knee. This can lead to increased pressure between the trochlea and the back of the patella and may result in soft tissue irritation. Weakness in the quadriceps muscles and tendon at the front of the thigh can lead to Patellofemoral Pain Syndrome, as these muscles are important for keeping the patella centred in the trochlear groove. You may also be susceptible if you have problems with the way your hips, legs and ankles are aligned, as this can cause the kneecap to shift too far towards the inside or outside of the leg.
- Injuries – If you fall or sustain a heavy blow to the knee this can throw things out of balance and may result in Patellofemoral Pain Syndrome.
- Excess weight – Being overweight increases the strain on your knees and may increase your chances of developing the condition.
Diagnosing Patellofemoral Pain Syndrome
If you have persistent knee pain, a visit to your GP will help to determine whether or not you have Patellofemoral Pain Syndrome. In addition to a physical examination, your GP may send you for an X-ray to rule out a fracture, or an MRI scan may be used to assess the condition of the soft tissues surrounding your knee. Diagnostic imaging can rule out other potential causes of knee pain, including arthritis or torn cartilage.
Treating Patellofemoral Pain Syndrome
Most cases of the Patellofemoral Pain Syndrome can be treated without surgery. The first step is usually to rest and avoid activities that cause pain, giving your knee a chance to recover. Ice packs can help reduce swelling and discomfort – just apply one for about 15-20 minutes every few hours. Over-the-counter painkillers like paracetamol or ibuprofen can also help to ease the ache and a physiotherapist will be able to recommend exercises to improve the symptoms and increase your strength and range of movement. It is particularly important to strengthen the quadriceps and hip muscles as these help to stabilise the patella. Core exercises that strengthen the abdominal and lower back muscles can also be helpful. Shoe inserts may also help to support the foot and ankle, relieving stress on the lower leg.
In rare cases, if the pain doesn’t improve with conservative treatment, your doctor might discuss surgical options. While it is rarely needed, arthroscopic (keyhole surgery) may sometimes be required to remove damaged articular cartilage from the surface of the patella (a procedure known as debridement), or to loosen the lateral retinaculum and correct patella misalignment (known as lateral release).
Preventing Patellofemoral Pain Syndrome
To reduce your risk of developing Patellofemoral Pain Syndrome it is important to strengthen the muscles around your knee, especially your quads, using exercises like leg raises or mini squats. Stretch regularly to keep your hamstrings and calves flexible and, before any exercise, make sure you warm up properly. Rather than suddenly increasing your workout, always build up gradually.
Wearing the right trainers can help you avoid injury and, if you are carrying excess weight, losing a few pounds can take pressure off your knees. Finally, pay attention to how you sit – try not to keep your knees bent for too long, and take breaks to stand and move around.
Contact us for advice about diagnosing, treating and preventing all types of knee pain, including Patellofemoral Pain Syndrome.
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